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Antimicrobial stewardship program

Christy P Su, Levita Hidayat, Shafiqur Rahman, Veena Venugopalan
BACKGROUND: Medication reconciliation is a major patient safety concern, and the impact of a structured process to evaluate anti-infective agents at hospital discharge warrants further review. OBJECTIVE: The aim of this study was to (1) describe a structured, multidisciplinary approach to review anti-infectives at discharge and (2) measure the impact of a stewardship-initiated antimicrobial review process in identifying and preventing anti-infective-related medication errors (MEs) at discharge...
January 1, 2018: Journal of Pharmacy Practice
Nicole Le Saux, Bruce Dalton, Kim Abbass, John Conly, Nick Daneman, Linda Dresser, Sergio Fanella, Greg German, Jennifer Grant, Yoav Keynan, Tim T Y Lau, Jamie McDonald, Caroline Nott, David Patrick, Yvonne Shevchuk, Daniel Thirion, Andrew Morris
No abstract text is available yet for this article.
January 2018: Canadian Journal of Hospital Pharmacy
Julie Hui-Chih Wu, Bradley J Langford, Kevin L Schwartz, Rosemary Zvonar, Sumit Raybardhan, Valerie Leung, Gary Garber
Background: Antimicrobial allergy labels, either self-reported or placed in a patient's medical record, are common, but in many cases they are not associated with a true immunoglobulin E-mediated allergic response. Objective: To assess the impact of antimicrobial allergy labels on antimicrobial prescribing, resource utilization, and clinical outcomes. Data Sources: The MEDLINE, Embase, CINAHL, and Scopus electronic databases were searched for the period 1990 to January 2016...
January 2018: Canadian Journal of Hospital Pharmacy
E Esteve-Palau, S Grau, S Herrera, L Sorlí, M Montero, C Segura, X Durán, J P Horcajada
OBJECTIVE: To analyze the clinical and economic impact of an antimicrobial stewardship program (ASP) targeting urinary tract infections (UTI) caused by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli. METHODS: An observational retrospective study that included adults with a diagnosis of UTI caused by ESBL-producing E. coli admitted to a tertiary care hospital in Barcelona, Spain, between January 2014 and December 2015. The impact of the ASP was analyzed in terms of clinical and economic outcomes...
March 9, 2018: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
Şiran Keske, Burak Zabun, Kahraman Aksoy, Füsun Can, Erhan Palaoğlu, Önder Ergönül
Background: We aimed to detect the etiological agents of acute diarrhea by molecular gastrointestinal pathogen test (MGPT) and to assess its impact on antimicrobial stewardship program (ASP). Methods: This is a prospective, observational study and was conducted between 1 January 2015 and 30 June 2017. We included consequent patients, who had acute diarrhea. At the end of 2015, we implemented ASP in acute diarrhea and we compared the outcomes in pre-ASP and post-ASP. An FDA-cleared multiplexed gastrointestinal PCR panel system, BioFire filmArray (Idaho Technology, Salt Lake City, UT) which detects twenty pathogens in stool was used...
March 7, 2018: Journal of Clinical Microbiology
Jennifer Broom, Chin Li Tee, Alex Broom, Mark D Kelly, Tahira Scott, David A Grieve
BACKGROUND: Antimicrobial therapy for intra-abdominal infections is often inappropriately prolonged. An intervention addressing factors influencing the duration of intravenous antibiotic use was undertaken. This study reports the antibiotic prescribing patterns before and after the intervention and a qualitative analysis of the experience of the intervention. METHODS: Quantitative: A retrospective audit of patients with complicated intra-abdominal infection before and after a multifaceted persuasive intervention was performed...
March 6, 2018: ANZ Journal of Surgery
Zhi-Gang Zhang, Fei Chen, Jian-Zhong Chen
BACKGROUND: This study aimed to investigate the effect of antibiotic stewardship programs (ASP) on reducing antimicrobial resistance rate, antibiotics consumption and multi-drug resistance bacterial infections in the pediatric patients. METHODS: This study was carried out in the Pediatric Center of a tertiary hospital of Shandong Province, China. The study duration was separated into two periods according to introduction of ASP (began from April 2011). Before intervention: from April 2009 to March 2011; after intervention: from April 2012 to March 2014...
March 5, 2018: World Journal of Pediatrics: WJP
Sarah Tschudin-Sutter, Ed J Kuijper, Ana Durovic, Maria J G T Vehreschild, Frédéric Barbut, Catherine Eckert, Fidelma Fitzpatrick, Markus Hell, Torbjörn Norén, Jean O'Driscoll, John Coia, Petra Gastmeier, Lutz von Müller, Mark H Wilcox, Andreas F Widmer
SCOPE: Clostridium difficile infection (CDI) is the most important infective cause of healthcare-associated diarrhoea in high income countries and one of the most important healthcare-associated pathogens in both Europe and the United States. It is associated with high morbidity and mortality resulting in both societal and financial burden. A significant proportion of this burden is potentially preventable by a combination of targeted infection prevention and control measures and antimicrobial stewardship...
March 2, 2018: Clinical Microbiology and Infection
Silvia Forni, Giulio Toccafondi, Bruno Viaggi, Maddalena Grazzini, Sara D'Arienzo, Fabrizio Gemmi, Andrea Vannucci, Giorgio Tulli
Antimicrobial resistance is a global threat caused by the rapid spread of multiresistant microorganisms. Antimicrobial stewardship (AS) is a coordinated intervention designed to improve the appropriate use of antimicrobials by promoting the selection of the optimal drug regimen, dose, duration of therapy and route of administration. AS programs have proved effective in reducing antimicrobial resistance, inappropriate antimicrobial use and in improving patient outcomes. Recently developed rapid diagnostic technologies in microbiology (RDTM) allows a faster and etiological diagnosis of infection and a reduction in the use of unnecessary empirical therapies...
February 2018: Recenti Progressi in Medicina
Daniele Donà, Silvia Zingarella, Andrea Gastaldi, Rebecca Lundin, Giorgio Perilongo, Anna Chiara Frigo, Rana F Hamdy, Theoklis Zaoutis, Liviana Da Dalt, Carlo Giaquinto
BACKGROUND: Italian pediatric antimicrobial prescription rates are among the highest in Europe. As a first step in an Antimicrobial Stewardship Program, we implemented a Clinical Pathway (CP) for Community Acquired Pneumonia with the aim of decreasing overall prescription of antibiotics, especially broad-spectrum. MATERIALS AND METHODS: The CP was implemented on 10/01/2015. We collected antibiotic prescribing and outcomes data from children aged 3 months-15 years diagnosed with CAP from 10/15/2014 to 04/15/2015 (pre-intervention period) and from 10/15/2015 to 04/15/2016 (post-intervention period)...
2018: PloS One
Jason M Pogue, Emily L Heil, Paul Lephart, J Kristie Johnson, Ryan P Mynatt, Hossein Salimnia, Kimberly C Claeys
Rapid diagnostic tests (RDTs) have revolutionized the management of Gram-negative bacteremia by allowing antimicrobial stewardship teams the ability to escalate therapy and improve patient outcomes through timely organism identification and detection of certain resistance determinants. However, given the complex nature of Gram-negative resistance, stewardship teams are left without clear direction for how to respond when resistance determinants are absent as the safety of de-escalation in this setting is unknown...
February 26, 2018: Antimicrobial Agents and Chemotherapy
Leandro G Bertollo, Diego S Lutkemeyer, Anna S Levin
BACKGROUND: Antimicrobial stewardship programs (ASPs) have been proposed as a solution for the global burden of antibiotic resistance, despite the lack of evidence on the subject. OBJECTIVE: To analyze the role of ASPs in reducing bacterial resistance to antibiotics in hospital settings. DATA SOURCES: A review in PubMed, Scopus, LILACS, and SciELO databases was performed. The period analyzed was January 1, 2012-January 4, 2017. ELIGIBILITY CRITERIA: Studies that related ASPs to bacterial resistance...
February 19, 2018: American Journal of Infection Control
Lianne Jeffs, Madelyn P Law, Michelle Zahradnik, Marilyn Steinberg, Maria Maione, Linda Jorgoni, Chaim M Bell, Andrew M Morris
Antimicrobial stewardship programs (ASPs) have predominately involved infectious diseases physicians and pharmacists with little attention to the nurses. To achieve optimal success of ASPs, engagement of nurses to actively participate in initiatives, strategies, and solutions to combat antibiotic resistance across the health care spectrum is required. In this context, the experiences of local ASP teams engaging nurses in appropriate antimicrobial use were explored to inform future strategies to enhance their involvement in ASPs...
April 2018: Journal of Nursing Care Quality
Marija Kalaba, Jovan Kosutic, Brian Godman, Vesela Radonjic, Ana Vujic, Slobodan Jankovic, Dragana Srebro, Zlatko Kalaba, Radan Stojanovic, Milica Prostran
AIM: Antimicrobial resistance and inappropriate use of antibiotics in children are important issues. Consequently, there is a need to develop comprehensive stewardship programs even in hospitals with limited resources starting with children's hospitals. METHODS: Retrospective observational analysis of antimicrobial utilization and resistance patterns over 5 years in a tertiary care children's hospital in Serbia. RESULTS: Cumulative antimicrobial resistance decreased but was still high, with high cumulative resistance rates among the most widely used antibiotics in the hospital...
February 21, 2018: Journal of Comparative Effectiveness Research
Juyuan Liu, Na Li, Jinjuan Hao, Yanming Li, Anlei Liu, Yinghong Wu, Meng Cai
BACKGROUND: Surgical site infections (SSIs) are the leading cause of hospital-acquired infections and are associated with substantial healthcare costs, with increased morbidity and mortality. To investigate the effects of the antibiotic stewardship program on prevention and control of SSI during clean surgery, we investigated this situation in our institution. PATIENTS AND METHODS: We performed a quasi-experimental study to compare the effect before and after the antibiotic stewardship program intervention...
February 20, 2018: Surgical Infections
James A McKinnell, Shelby Corman, Dipen Patel, Grace H Leung, Lynne M Gordon, Thomas P Lodise
PURPOSE: Clinicians and stewardship programs are challenged with positioning of novel, higher priced antibiotic agents for the treatment of clinical infections. We developed a decision-analytic model to describe costs, including drug, total treatment costs, and health care outcomes, associated with telavancin (TLV) compared with vancomycin (VAN) for patients with Staphylococcus aureus (SA) hospital-acquired bacterial pneumonia (HABP). METHODS: This decision-analytic model assessed the treatment of SA-HABP with TLV versus VAN...
February 14, 2018: Clinical Therapeutics
Bradley A Lloyd, Clinton K Murray, Faraz Shaikh, M Leigh Carson, Dana M Blyth, Elizabeth R Schnaubelt, Timothy J Whitman, David R Tribble
Introduction: All Department of Defense (DoD) guidance documents recommend cefazolin or clindamycin as post-trauma antibiotic prophylaxis for open soft-tissue injuries. Although not advocated, some patients with open soft-tissue injuries also received expanded Gram-negative coverage (EGN) prophylaxis based on the judgment of front-line trauma providers. During the study period, revised guidelines in 2011/2012 re-emphasized recommendations for using cefazolin or clindamycin, and stewardship efforts in the DoD trauma community aimed to reduce the practice of adding EGN to guideline-recommended antibiotic prophylaxis...
February 13, 2018: Military Medicine
Siddhant Datta, Mary Staicu, Mary Lourdes Brundige, Youssef Soliman, Maryrose Laguio-Vila
No abstract text is available yet for this article.
February 7, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
T Matsuoka, M Kato, Y Shinoda, K Ohashi, S Yoshida, T Mori, T Tachi, T Yoshimura, H Teramachi
We implemented an antimicrobial stewardship (AS) program whereby pharmacists sought appropriate use of antimicrobial agents in January 2012. At that time, we targeted anti-methicillin-resistant Staphylococcus aureus (MRSA) agents and carbapenems; however, in January 2014, we added tazobactam/piperacillin (TAZ/PIPC). We evaluated outcomes using multilateral analyses. The average one-day dosage of carbapenems increased; however, the duration of administration and number of recipient patients decreased significantly (P < 0...
May 1, 2017: Die Pharmazie
Rossana Rosa, Bruno Zavala, Natalie Cain, Shweta Anjan, Laura Aragon, Lilian M Abbo
Antimicrobial stewardship programs can optimize the management of Staphylococcus aureus bacteremia by integrating information technology and microbiology laboratory resources. This study describes our experience implementing an intervention consisting of real-time feedback and the use of an electronic order set for the management of S. aureus bacteremia. Infect Control Hosp Epidemiol 2018;39:346-349.
March 2018: Infection Control and Hospital Epidemiology
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