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Antimicrobial stewardship program

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https://www.readbyqxmd.com/read/29776710/pharmacokinetics-pharmacodynamics-computer-decision-support-technologies-and-antimicrobial-stewardship-the-compass-and-rudder
#1
REVIEW
Robert C Owens, Catharine C Bulik, David R Andes
The first guidelines for conducting antimicrobial stewardship in the hospitalized setting were published in 2007. These guidelines recommend that stewardship programs employ the science of pharmacokinetics-pharmacodynamics (PK-PD) as well as adopting computerized decision support technologies when possible. The United States Food and Drug Administration have adopted PK-PD as a cornerstone in the evaluation of antimicrobial agents during clinical development. The core principles of PK-PD center around describing the relationship between drug exposure indexed to the susceptibility of the infecting bacterial pathogen and patient response...
April 13, 2018: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/29771104/-appropriateness-of-antimicrobial-prescriptions-in-the-emergency-department-of-a-tertiary-hospital
#2
L Yunquera-Romero, I Márquez-Gómez, A Henares-López, M J Morales-Lara, C Gallego Fernández, R Asensi-Díez
OBJECTIVE: Antibiotics are widely prescribed in the Emergency Department (ED), representing 26-62% of outpatient antibiotic prescriptions. Around 40% of antibiotic prescriptions in hospitalized patients are inappropriate or unnecessary. The aim of the study was to assess the appropriateness of antibiotic prescriptions according to local empirical antibiotic treatment guidelines, in the ED of a tertiary hospital. METHODS: Observational, retrospective study including patients attending the ED in November 2016, with an antibiotic prescription, excluding those from residents...
May 16, 2018: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/29750767/potential-for-more-rational-use-of-antibiotics-in-hospitalized-children-in-a-country-with-low-resistance-data-from-eight-point-prevalence-surveys
#3
Christian Magnus Thaulow, Dag Berild, Beate Horsberg Eriksen, Tor Åge Myklebust, Hege Salvesen Blix
BACKGROUND: Antimicrobial resistance (AMR) is low in Norway, but to prevent an increase the Norwegian Government has launched a National Strategy including a 30% reduction of broad-spectrum antibiotics (BSA) in hospitals within 2020. BSA are defined as second- and third-generation cephalosporins, carbapenems, piperacillin/tazobactam and quinolones. There are no recent studies of antibiotic use in Norwegian hospitalized children. AIM OF THE STUDY: To describe the use of antibiotics with emphasis on BSA in Norwegian hospitalized children and neonates in order to detect possibilities for optimization...
May 10, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29750044/successful-control-of-resistance-in-pseudomonas-aeruginosa-using-antibiotic-stewardship-and-infection-control-programs-at-a-chinese-university-hospital-a-6-year-prospective-study
#4
Lei Liu, Bin Liu, Yu Li, Wei Zhang
Objective: Pseudomonas aeruginosa is emerging as a highly multidrug-resistant (MDR) nosocomial pathogen. Data on the efficacy of infection control measures in endemic situations are lacking. We investigated the effect of antimicrobial stewardship (AMS) and infection control programs (ICPs) in controlling the resistance of P. aeruginosa at a tertiary hospital center. Methods: Susceptibility and resistance were investigated using broth microdilution, as per the guidelines of the Clinical and Laboratory Standards Institute...
2018: Infection and Drug Resistance
https://www.readbyqxmd.com/read/29742466/systematic-clinical-management-of-patients-with-candidemia-improves-survival
#5
Rita Murri, Francesca Giovannenze, Marta Camici, Riccardo Torelli, Giulio Ventura, Giancarlo Scoppettuolo, Maurizio Sanguinetti, Roberto Cauda, Massimo Fantoni
OBJECTIVES: . Taking into account the significant morbidity, mortality, and hospital costs related to Candidemia, our objective is to define if improving appropriateness in candidemia management was associated with better clinical outcomes. METHODS: . A prospective observational monocentric cohort study was conducted. Adherence to five main elements was examined: appropriate selection of initial therapy; follow-up blood culture; echocardiography; ophthalmological examination; and removal of a central venous catheter...
May 6, 2018: Journal of Infection
https://www.readbyqxmd.com/read/29732380/antimicrobial-agent-shortages-the-new-norm-for-infectious-diseases-physicians
#6
Adi V Gundlapalli, Susan E Beekmann, Donald R Graham, Philip M Polgreen
Background: In 2012, the US Food and Drug Administration (FDA) required drug manufacturers to give advance notice of impending drug shortages. A survey of infectious diseases (ID) physicians was undertaken to determine the impact of this requirement and to follow-up on prior perceptions of ID physicians on shortages of antimicrobial agents. Methods: We used a web-based survey of ID physician members of the Emerging Infections Network in 2016. Results: Of the 701 of 1597 members (44%) who responded, 70% reported the need to modify their antimicrobial choice because of a shortage in the prior 2 years...
April 2018: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29730141/characteristics-of-antimicrobial-stewardship-programmes-in-rural-east-texas-hospitals
#7
Jonathan C Cho, Rebecca L Dunn, Frank Yu, Grace A Loredo, Bradley Brazill
INTRODUCTION: Antimicrobial stewardship programs (ASPs) serve as the primary method to prevent and manage the development of antimicrobial resistance. Rural settings may lack the recommended personnel and resources needed to provide antimicrobial stewardship services. METHODS: An electronic survey was distributed via e-mail to pharmacy directors or antimicrobial stewardship programme directors of licensed hospitals within the Public Health Region 4/5N of East Texas...
May 3, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29720908/implementation-and-impact-of-an-antimicrobial-stewardship-program-at-a-non-freestanding-children-s-hospital
#8
J Michael Klatte, Kathleen Kopcza, Alexander Knee, Evan R Horton, Erica Housman, Donna J Fisher
OBJECTIVES: Pediatric Antimicrobial Stewardship Programs (ASP) have been associated with improvements in antibiotic utilization and patient outcomes; however, ASP studies originating from non-freestanding children's hospitals are lacking. In this study, we present the implementation and impact of a multidisciplinary ASP that employs a collaborative physician and pharmacist driven thrice-weekly prospective audit-with-feedback approach at a non-freestanding children's hospital. METHODS: Implementation was assessed via descriptive design...
March 2018: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29720043/antimicrobial-stewardship-through-telemedicine-and-its-impact-on-multi-drug-resistance
#9
Rodrigo P Dos Santos, Camila H Dalmora, Stephani A Lukasewicz, Otávio Carvalho, Caroline Deutschendorf, Raquel Lima, Tiago Leitzke, Nilson C Correa, Marcelo V Gambetta
Introduction Telemedicine technologies are increasingly being incorporated into infectious disease practice. We aimed to demonstrate the impact of antimicrobial stewardship through telemedicine on bacterial resistance rates. Methods We conducted a quasi-experimental study in a 220-bed hospital in southern Brazil. An antimicrobial stewardship program incorporating the use of telemedicine was implemented. Resistance and antimicrobial consumption rates were determined and analysed using a segmented regression model...
January 1, 2018: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/29708081/predictors-of-antimicrobial-stewardship-program-recommendation-disagreement
#10
Laura L Bio, Jenna F Kruger, Betty P Lee, Matthew S Wood, Hayden T Schwenk
OBJECTIVETo identify predictors of disagreement with antimicrobial stewardship prospective audit and feedback recommendations (PAFR) at a free-standing children's hospital.DESIGNRetrospective cohort study of audits performed during the antimicrobial stewardship program (ASP) from March 30, 2015, to April 17, 2017.METHODSThe ASP included audits of antimicrobial use and communicated PAFR to the care team, with follow-up on adherence to recommendations. The primary outcome was disagreement with PAFR. Potential predictors for disagreement, including patient-level, antimicrobial, programmatic, and provider-level factors, were assessed using bivariate and multivariate logistic regression models...
April 30, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29706152/health-care-system-leaders-perspectives-on-infection-preventionist-and-registered-nurse-engagement-in-antibiotic-stewardship
#11
Mary Lou Manning, Monika Pogorzelska-Maziarz
BACKGROUND: Infection preventionists (IPs) and registered nurses (RNs) have an important role to play in antibiotic stewardship programs (ASPs). Recent articles highlight their potential roles in practice, research, education, and policy; however, little is known about their actual ASP engagement. Leaders often have early knowledge of emerging trends and evolving health care worker roles. METHODS: A survey was developed using the Centers for Disease Control and Prevention's Core Elements of Hospital Antibiotic Stewardship Programs to assess health care system infection prevention and control leaders' perceptions of IP and RN engagement in hospital ASPs...
May 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29688433/antimicrobial-stewardship-program-in-a-pediatric-intensive-care-unit
#12
Yuta Aizawa, Junichi Suwa, Hiroshi Higuchi, Kahoru Fukuoka, Mihoko Furuichi, Tetsuji Kaneko, Yoshihiko Morikawa, Kaoru Okazaki, Naoki Shimizu, Yuho Horikoshi
We conducted an antimicrobial stewardship program in a pediatric intensive care unit. An interrupted time-series analysis revealed a significant reduction in level and trend of days of therapy per 1000 patient-days for antipseudomonal agents. No increase in adverse patient outcomes was found.
April 23, 2018: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/29679383/shortened-courses-of-antibiotics-for-bacterial-infections-a-systematic-review-of-randomized-controlled-trials
#13
Alexandra M Hanretty, Jason C Gallagher
BACKGROUND: Commonly prescribed durations of therapy for many, if not most, bacterial infections are not evidence-based. Misunderstandings by clinicians and patients alike influence perspectives on antibiotic use, including duration of therapy and its role in antibiotic resistance. OBJECTIVE: To demonstrate that shorter durations of antibiotic therapy are as efficacious as longer durations for many infections. DATA SOURCES: A systematic review of English language articles using PubMed were identified for inclusion...
April 20, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29668905/antimicrobial-stewardship-training-for-infectious-diseases-fellows-program-directors-identify-a-curriculum-need
#14
Vera P Luther, Rachel Shnekendorf, Lilian M Abbo, Sonali Advani, Wendy S Armstrong, Alice E Barsoumian, Cole B Beeler, Rachel Bystritsky, Kartikeya Cherabuddi, Seth Cohen, Keith W Hamilton, Dilek Ince, Julie Ann Justo, Ashleigh Logan, John B Lynch, Priya Nori, Christopher A Ohl, Payal K Patel, Paul S Pottinger, Brian S Schwartz, Conor Stack, Yuan Zhou
A needs assessment survey of Infectious Diseases (ID) training program directors identified gaps concerning comprehensive and structured educational resources for training and evaluating ID fellows in antimicrobial stewardship. An IDSA-sponsored antimicrobial stewardship core curriculum was subsequently developed to address that need.
April 16, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29661630/rapid-diagnostics-for-bloodstream-infections-a-primer-for-infection-preventionists
#15
Charles E Edmiston, Robert Garcia, Marsha Barnden, Barbara DeBaun, Helen Boehm Johnson
Accurate and rapid antimicrobial susceptibility testing with pathogen identification in bloodstream infections is critical to life results for early sepsis intervention. Advancements in rapid diagnostics have shortened the time to results from days to hours and have had positive effects on clinical outcomes and on efforts to combat antimicrobial resistance when paired with robust antimicrobial stewardship programs. This article provides infection preventionists with a working knowledge of available rapid diagnostics for bloodstream infections...
April 13, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29661029/antimicrobial-stewardship-program-in-a-greek-hospital-implementing-a-mandatory-prescription-form-and-prospective-audits
#16
Vassiliki Pitiriga, Petros Kanellopoulos, Elsa Kampos, George Panagiotakopoulos, Athanasios Tsakris, George Saroglou
AIM: Antimicrobial stewardship programs (ASPs) are urgently needed for Greek hospitals in order to improve antibiotic usage. PATIENTS & METHODS: An ASP was implemented to a Greek hospital since February 2014. A mandatory order form was introduced for five antimicrobials; colistin, tigecycline, daptomycin, doripenem and linezolid. Prospective audits allowed for feedback to the prescribers without direct prescribing restriction. RESULTS: Antimicrobials' consumption at the baseline year and the 3 years of ASP implementation was 93...
April 17, 2018: Future Microbiology
https://www.readbyqxmd.com/read/29656062/the-impact-of-antibiotic-prescription-rates-on-the-incidence-of-mrsa-bloodstream-infections-a-county-level-u-s-wide-analysis
#17
Nikolaos Andreatos, Fadi Shehadeh, Elina Eleftheria Pliakos, Eleftherios Mylonakis
OBJECTIVES: To investigate the association of methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection with socioeconomic factors and antibiotic prescriptions at the county level. METHODS: MRSA bloodstream infection rates were extracted from the Medicare Hospital Compare database. Data on socioeconomic factors and antibiotic prescriptions were obtained from the U.S. Census Bureau and the Medicare Part D database, respectively. RESULTS: In multivariate analysis, antibiotic prescriptions demonstrated a powerful positive association with MRSA bloodstream infection rates [Coefficient (Coeff): 0...
April 12, 2018: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29649526/research-electronic-data-capture-redcap%C3%A2-used-as-an-audit-tool-with-a-built-in-database
#18
Signe H Kragelund, Mona Kjærsgaard, Søren Jensen-Fangel, Rita A Leth, Nina Ank
The aim of this study was to develop an audit tool with a built-in database using Research Electronic Data Capture (REDCap®) as part of an antimicrobial stewardship program at a regional hospital in the Central Denmark Region, and to analyse the need, if any, to involve more than one expert in the evaluation of cases of antimicrobial treatment, and the level of agreement among the experts. Patients treated with systemic antimicrobials in the period from 1 September 2015 to 31 August 2016 were included, in total 722 cases...
April 9, 2018: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/29620478/the-rise-of-hospitalists-an-opportunity-for-infectious-diseases-investigators
#19
Matthew W McCarthy, Thomas J Walsh
Despite the essential role played by infectious diseases specialists in patient care, public health, cost-containment, and biomedical research, the field has a substantially higher percentage of vacant positions than other medicine sub-specialties. While much has been written about what this disturbing trend means for patient care, comparatively little attention has been focused on the dire implications for clinical research and the development of novel anti-infective therapy. Areas covered: We examine the ways that hospitalists and infectious disease specialists might collaborate to study emerging diagnostic platforms, novel antimicrobial agents, and strengthen antimicrobial stewardship programs to improve the delivery of high-quality health care...
April 11, 2018: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/29618395/novel-indicators-for-enhancing-the-clinical-outcome-metrics-of-antimicrobial-stewardship-programs
#20
José Molina, Germán Peñalva, José A Lepe, Raquel Valencia, María V Gil-Navarro, José M Cisneros
No abstract text is available yet for this article.
April 5, 2018: Infection Control and Hospital Epidemiology
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