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Antimicrobial stewardship program

Wen-Juan Zhou, Zhen-Ni Luo, Chang-Min Tang, Xiao-Xu Zou, Lu Zhao, Peng-Qian Fang
The improvement of antibiotic rational use in China was studied by usage analysis of combination antibiotic therapy for type I incisions in 244 hospitals. Five kinds of hospitals, including general hospital, maternity hospital, children's hospital, stomatological hospital and cancer hospital, from 30 provinces were surveyed. A systematic random sampling strategy was employed to select outpatient prescriptions and inpatient cases in 2011 and 2012. A total of 29 280 outpatient prescriptions and 73 200 inpatient cases from 244 hospitals in each year were analyzed...
October 2016: Journal of Huazhong University of Science and Technology. Medical Sciences
Sara Tedeschi, Filippo Trapani, Maddalena Giannella, Francesco Cristini, Fabio Tumietto, Michele Bartoletti, Annalisa Liverani, Salvatore Pignanelli, Luisa Toni, Roberto Pederzini, Augusto Cavina, Pierluigi Viale
OBJECTIVE To assess the impact of an antimicrobial stewardship program (ASP) on antibiotic consumption, Clostridium difficile infections (CDI), and antimicrobial resistance patterns in a rehabilitation hospital. DESIGN Quasi-experimental study of the periods before (from January 2011 to June 2012) and after (from July 2012 to December 2014) ASP implementation. SETTING 150-bed rehabilitation hospital dedicated to patients with spinal-cord injuries. INTERVENTION Beginning in July 2012, an ASP was implemented based on systematic bedside infectious disease (ID) consultation and structural interventions (ie, revision of protocols for antibiotic prophylaxis and education focused on the appropriateness of antibiotic prescriptions)...
October 17, 2016: Infection Control and Hospital Epidemiology
Bryce T Fukunaga, Wesley K Sumida, Deborah A Taira, James W Davis, Todd B Seto
Methicillin-resistant Staphylococcus aureus (MRSA) results in almost half of all deaths caused by antibiotic resistant organisms. Current evidence suggests that MRSA infections are associated with antibiotic use. This study examined state-level data to determine whether outpatient antibiotic use was associated with hospital-acquired MRSA (HA-MRSA) infections. The 2013 Centers for Disease Control and Prevention (CDC) Healthcare-Associated Infections Progress Report was used to obtain HA-MRSA infection rates...
October 2016: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
Caren McHenry Martin
The Centers for Medicare & Medicaid Services is expected to expand requirements for antimicrobial stewardship in nursing facilities during 2016. Many facilities are looking to pharmacists to help them take the initial steps toward developing these coordinated programs to promote the appropriate use of antimicrobials.
2016: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
Barbara W Trautner, M Todd Greene, Sarah L Krein, Heidi L Wald, Sanjay Saint, Andrew J Rolle, Sara McNamara, Barbara S Edson, Lona Mody
OBJECTIVE To assess knowledge about infection prevention among nursing home personnel and identify gaps potentially addressable through a quality improvement collaborative. DESIGN Baseline knowledge assessment of catheter-associated urinary tract infection, asymptomatic bacteriuria, antimicrobial stewardship, and general infection prevention practices for healthcare-associated infections. SETTING Nursing homes across 14 states participating in the national "Agency for Healthcare Research and Quality Safety Program for Long-Term Care: Healthcare-Associated Infections/Catheter-Associated Urinary Tract Infection...
October 4, 2016: Infection Control and Hospital Epidemiology
Charles Frenette, David Sperlea, Yveta Leharova, Daniel J G Thirion
OBJECTIVE The goal of this long-term quasi-experimental retrospective study was to assess the impact of a 5-year serial infection control and antimicrobial stewardship intervention on surgical site infections (SSIs). METHODS This study was conducted in a tertiary-care public teaching institution over a 5-year period from January 2010 to December 2014. All patients undergoing hepatobiliary surgery and liver, kidney, pancreas, and simultaneous pancreas-kidney transplantation were included. Outcomes were compared between a preintervention group (2010-2011) and a postintervention group (2012-2014)...
October 3, 2016: Infection Control and Hospital Epidemiology
Tristan T Timbrook, Jacob B Morton, Kevin W McConeghy, Aisling R Caffrey, Eleftherios Mylonakis, Kerry L LaPlante
BACKGROUND:  Previous reports on molecular rapid diagnostic testing (mRDT) do not consistently demonstrate improved clinical outcomes in bloodstream infections (BSIs). This meta-analysis seeks to evaluate the impact of mRDT in improving clinical outcomes in BSIs. METHODS:  We searched PubMed, CINAHL, Web of science, and EMBASE through May 2016 for BSI studies comparing clinical outcomes by mRDT and conventional microbiology methods. RESULTS:  Thirty-one studies were included with 5,920 patients...
September 26, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Timothy P Gauthier, Eva Moreira, Chantal Chan, Alexandria Cabrera, Maribel Toro, Mara Z Carrasquillo, Mark Corentin, Elizabeth M Sherman
OBJECTIVES: To describe an innovative hepatitis C virus (HCV) care program and treatment outcomes resulting from pharmacist services. SETTING: Adult ambulatory care HCV clinic within the Miami Veteran Affairs Healthcare System. PRACTICE DESCRIPTION: Pharmacists with limited prescriptive authority are integrated into a medical hepatology care team. PRACTICE INNOVATION: Pharmacists screen patients with HCV infection for treatment eligibility, counsel patients upon treatment initiation, assess ongoing treatment success and toxicity through patient appointments, telephone calls, and the ordering of pertinent laboratory data, and provide oversight of all patients on HCV therapies...
September 22, 2016: Journal of the American Pharmacists Association: JAPhA
Susan Ryan, Elizabeth Gillespie, Rhonda L Stuart
We report an outbreak of parainfluenza 3, which had an attack rate of 30%, in a residential care facility in Melbourne, Australia. One-fifth of affected residents required hospitalization, but there were no deaths. The outbreak demonstrated the value of active surveillance and early microbiologic testing and the urgent need for antimicrobial stewardship programs in the aged care setting.
September 21, 2016: American Journal of Infection Control
Diana Yap Fui Sing, Yang Liang Boo, Roshalina Mukhlis, Pek Woon Chin, Fan Kee Hoo
BACKGROUNDS & OBJECTIVE: Antimicrobial resistance is an alarming public health threat that requires urgent global solution. Implementation of antimicrobial stewardship program (ASP) is an essential practice element for healthcare institutions in gate-keeping judicious antimicrobial use. This study highlighted the development, first year experience, and result of the implementation of ASP utilizing persuasive and restrictive approaches in a Malaysian district hospital. METHODS: An observational study was conducted between January 2015 to December 2015 on implementation of ASP among hospitalized inpatients age 12 years old and above...
July 2016: Pakistan Journal of Medical Sciences Quarterly
C Cotteret, E Vallières, H Roy, P Ovetchkine, J Longtin, J-F Bussières
INTRODUCTION: To reduce risks of antibiotic resistance, governmental and learned societies decreed the optimal use of antibiotics. The relation between antibiotic consumption and bacterial resistance increase has been clearly demonstrated over the last several years. Antibiotic consumption data and bacterial sensitivity data are regularly published, but very few publications have searched for a correlation between these two variables. This study focused on antibiotic use and consumption as well as bacterial sensitivity to these antibiotics...
October 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Cheston B Cunha, Erika M C D'Agata
PURPOSE OF REVIEW: Rates of multidrug-resistant organisms (MDRO), including methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, and multidrug-resistant gram-negative bacteria, continue to rise among the population of chronic hemodialysis. Antimicrobial exposure is the main risk factor for MDRO emergence and dissemination. Up to 30% of antimicrobial doses administered in out-patient dialysis units may not be indicated. Antimicrobial stewardship programs (ASP) improve antimicrobial prescribing patterns...
November 2016: Current Opinion in Nephrology and Hypertension
Christopher J Graber, Makoto M Jones, Peter A Glassman, Charlene Weir, Jorie Butler, Kevin Nechodom, Chad L Kay, Amy E Furman, Thuong T Tran, Christopher Foltz, Lori A Pollack, Matthew H Samore, Matthew Bidwell Goetz
BACKGROUND: Antibiotic time-outs can promote critical thinking and greater attention to reviewing indications for continuation. OBJECTIVE: We pilot tested an antibiotic time-out program at a tertiary care teaching hospital where vancomycin and piperacillin-tazobactam continuation past day 3 had previously required infectious diseases service approval. METHODS: The time-out program consisted of 3 components: (1) an electronic antimicrobial dashboard that aggregated infection-relevant clinical data; (2) a templated note in the electronic medical record that included a structured review of antibiotic indications and that provided automatic approval of continuation of therapy when indicated; and (3) an educational and social marketing campaign...
November 2015: Hospital Pharmacy
Robert T Pammett, Alicia Ridgewell
No abstract text is available yet for this article.
July 2016: Canadian Journal of Hospital Pharmacy
Katie E Barber, Allison M Bell, Samuel Travis King, Jason J Parham, Kayla R Stover
Drug shortages pose a clear detriment to antimicrobial stewardship (AS) efforts. Our objective was to evaluate the effect of a piperacillin-tazobactam shortage on meropenem use, related costs, and associated changes in AS activity. A quasi-experimental quality improvement review compared adult patients receiving meropenem ≥72h three months pre-shortage and three months during the shortage. 320 patients were included (pre-shortage: 103; shortage: 217). Baseline characteristics were similar, but the length of stay was slightly longer in pre-shortage [19 (11-32) days] versus shortage [16 (11-32) days] (p=0...
September 5, 2016: Brazilian Journal of Infectious Diseases
J Pasquau, S Sadyrbaeva, S E De Jesús, C Hidalgo-Tenorio
In order to improve infection prognosis and reduce the existing microbial resistance problem (a challenge similar to that of climate change), a higher implication of the Administration, an increased level of social awareness and the development of specific corporate networks, including the pharmaceutical industry, is needed. However, we must first consolidate Antimicrobial Stewardship Programmes with experts who seek to improve antibiotic therapy effectivity in severe infections and to reduce global antibiotic exposure...
September 2016: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
F J Candel, A B García-García, M Peñuelas, A García-Alvarez, F Chiarella, L López-González, C García-Salguero, C Lejárraga, I Rodríguez-Avial
Antimicrobial resistance increases it health, social and economic impact. in all areas (state, regional and local), initiatives to try to contain the problem of resistance arise. In the update of this year 2016, we study microbiological, epidemiological and clinical aspects of multi-resistant bacteria, as well as resources for therapeutic approach, from ancient to modern drugs from therapeutic combinations to optimization Stewardship programs. In the case of fungal infection, we analyze clinical scenarios with different species in yeast or new clinical settings in filamentous fungi...
September 2016: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
Andrew I T Hebbard, Monica A Slavin, Caroline Reed, Benjamin W Teh, Karin A Thursky, Jason A Trubiano, Leon J Worth
Clostridium difficile infection (CDI) is a significant cause of healthcare-associated diarrhoea, and the emergence of endemic strains resulting in poorer outcomes is recognised worldwide. Patients with cancer are a specific high-risk group for development of infection. Areas covered: In this review, modifiable and non-modifiable risk factors for CDI in adult patients with haematological malignancy or solid tumours are evaluated. In particular, the contribution of antimicrobial exposure, hospitalisation and gastric acid suppression to risk of CDI are discussed...
November 2016: Expert Review of Anti-infective Therapy
Humberto Guanche Garcell, Ariadna Villanueva Arias, Eliezer Alemán Fernandez, Yaquelín Batista Guerrero, Ramon N Alfonso Serrano
OBJECTIVES: We sought to evaluate the trend of antibiotic consumption in patients admitted to a community hospital in Qatar with an antimicrobial stewardship program. METHODS: This observational study was carried out in a 75-bed facility in Western Qatar over a 4-year period (2012-2015). The monitoring of antimicrobial consumption from inpatient wards was performed from the pharmacy records and presented as defined daily dose (DDD) divided by the patient days and expressed as 100 bed-days (DBD)...
September 2016: Oman Medical Journal
Emi Minejima, Annie Wong-Beringer
Antimicrobial stewardship (ASP) is an intervention-based program to improve patient outcomes to infection while limiting spread of resistance and unintended consequences. Many rapid diagnostic tools are now FDA cleared for clinical use, with three evaluated across multiple settings: Matrix Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry, Verigene, and FilmArray. Areas covered: This review will focus on studies published that evaluated ASP intervention with rapid diagnostic implementation on outcomes of infection...
November 2016: Expert Review of Anti-infective Therapy
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