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Antimicrobial stewardship program

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https://www.readbyqxmd.com/read/29342478/design-and-implementation-of-a-visual-analytics-electronic-antibiogram-within-an-electronic-health-record-system-at-a-tertiary-pediatric-hospital
#1
Allan F Simpao, Luis M Ahumada, Beatriz Larru Martinez, Ana M Cardenas, Talene A Metjian, Kaede V Sullivan, Jorge A Gálvez, Bimal R Desai, Mohamed A Rehman, Jeffrey S Gerber
BACKGROUND:  Hospitals use antibiograms to guide optimal empiric antibiotic therapy, reduce inappropriate antibiotic usage, and identify areas requiring intervention by antimicrobial stewardship programs. Creating a hospital antibiogram is a time-consuming manual process that is typically performed annually. OBJECTIVE:  We aimed to apply visual analytics software to electronic health record (EHR) data to build an automated, electronic antibiogram ("e-antibiogram") that adheres to national guidelines and contains filters for patient characteristics, thereby providing access to detailed, clinically relevant, and up-to-date antibiotic susceptibility data...
January 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29340593/the-clinical-utility-of-methicillin-resistant-staphylococcus-aureus-mrsa-nasal-screening-to-rule-out-mrsa-pneumonia-a-diagnostic-meta-analysis-with-antimicrobial-stewardship-implications
#2
Diane M Parente, Cheston B Cunha, Eleftherios Mylonakis, Tristan T Timbrook
Background: Recent literature has highlighted MRSA nasal screening as a possible antimicrobial stewardship program (ASP) tool for avoiding unnecessary empiric MRSA therapy for pneumonia, yet current guidelines recommend MRSA therapy based on risk factors. The objective of this meta-analysis was to evaluate the diagnostic value of MRSA nasal screening in MRSA pneumonia. Methods: Pubmed and EMBASE were searched from inception to November 2016 for English studies evaluating MRSA nasal screening and development of MRSA pneumonia...
January 11, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29339385/effectiveness-of-an-antimicrobial-stewardship-program-in-critical-care-a-before-and-after-study
#3
Francisco Álvarez-Lerma, Santiago Grau Cerrato, Daniel Echeverría Esnal, Montserrat Martínez-Alonso, Maria Pilar Gracia Arnillas, Juan Pablo Horcajada, Juan Ramón Masclans
We evaluated the use of antimicrobials expressed as defined daily doses (DDDs) per 1,000 patient days and days of therapy (DOT) per 100 occupied bed-days in a intensive care unit (UCI) of a general hospital in Barcelona, Spain, before and after implementation of an antimicrobial stewardship (AMS) program (2007-2010 versus 2011-2015). The quarterly costs of antimicrobials used in the ICU and its weight in the overall hospital costs of antimicrobials were calculated. The effect of the applied AMS program on DDDs and DOT time series data was analyzed by means of intervention time series analysis...
January 16, 2018: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29339297/the-experiences-and-perspectives-of-implementing-antimicrobial-stewardship-in-five-french-hospitals-a-qualitative-study
#4
Anne Perozziello, Christelle Routelous, Esmita Charani, Alice Truel, Gabriel Birgand, Yazdan Yazdanpanah, François-Xavier Lescure, Jean-Christophe Lucet
OBJECTIVE: To describe current antimicrobial stewardship program (ASP) in France, both at policy level and at local implementation level, and to assess how ASP leaders (ASPL) worked and prioritised their activities. METHODS: We conducted a qualitative study based on face-to-face semi-structured interviews with healthcare professionals responsible for ASP across five French hospitals. Five infectious disease specialists and one microbiologist were interviewed between April and June 2016...
January 12, 2018: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29334865/-i-never-would-have-caught-that-before-pharmacist-perceptions-of-using-clinical-decision-support-for-antimicrobial-stewardship-in-the-united-states
#5
Christopher A Giuliano, Juliann Binienda, Pramodini B Kale-Pradhan, Mohamad G Fakih
To systematically improve the appropriateness of antibiotic prescribing, antimicrobial stewardship programs have been developed. There is a paucity of literature examining how pharmacists perform antimicrobial stewardship using a clinical decision support system in a hospital setting. The purpose of this qualitative study was to develop a model exploring how pharmacists perform antimicrobial stewardship to identify areas for programmatic improvement. Semistructured interviews were conducted across a health care system until saturation of themes was reached...
January 1, 2018: Qualitative Health Research
https://www.readbyqxmd.com/read/29332209/the-rapid-diagnosis-of-viral-respiratory-tract-infections-and-its-impact-on-antimicrobial-stewardship-programs
#6
Şiran Keske, Önder Ergönül, Faik Tutucu, Doruk Karaaslan, Erhan Palaoğlu, Füsun Can
We aimed to describe the potential benefit of new rapid molecular respiratory tests (MRT) in decreasing inappropriate antibiotic use among the inpatients presenting with influenza-like illness (ILI). We included patients from inpatient and outpatient departments who had ILI and performed MRT between 1 January 2015 and 31 December 2016 in a 265-bed private hospital in Istanbul. At the end of 2015, we implemented antimicrobial stewardship including systematic use of MRT. Then, we compared our observations between the year 2015 and the year 2016...
January 13, 2018: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29325870/the-impact-of-an-infectious-disease-specialist-on-antifungal-use-an-interrupted-time-series-analysis-in-a-tertiary-hospital-in-tokyo
#7
Daiichi Morii, Naoki Ichinose, Takayuki Yokozawa, Toshimi Oda
OBJECTIVES: To assess the efficacy and the limitations of antifungal antimicrobial stewardship programs. METHODS: A bundle to manage infectious diseases was implemented in our hospital in October 2010. Data regarding antimicrobial use density (AUD) from April 2006 to May 2016 were collected. Trends in AUD were assessed using an interrupted time-series model for three separate periods: the pre-bundle, the bundle implementation, and the long-term follow-up periods...
January 8, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29305281/impact-of-real-time-notification-of-clostridium-difficile-test-results-and-early-initiation-of-effective-antimicrobial-therapy
#8
Christian B Polen, William R Judd, Patrick D Ratliff, Gregory S King
BACKGROUND: Clostridium difficile is a prominent nosocomial pathogen and is the most common causative organism of health care-associated diarrhea. To our knowledge, no studies have investigated the impact of real-time notification of culture results with rapid antimicrobial stewardship program (ASP) intervention in the setting of C difficile infection (CDI). The purpose of this study was to assess the impact of real-time notification of detection of toxigenic C difficile by DNA amplification results in patients with confirmed CDI...
January 3, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29299000/roles-of-infectious-diseases-consultant-pharmacists-and-antimicrobial-stewardship-pharmacists-a-survey-of-canadian-tertiary-care-academic-hospitals
#9
Jessica E Beach, Tasha D Ramsey, Sean K Gorman, Tim T Y Lau
Background: Infectious diseases consultant (IDC) pharmacists work within an IDC service to care for inpatients with complex infections. With Accreditation Canada's new Required Organizational Practice promoting the establishment of antimicrobial stewardship (AMS) programs, AMS pharmacists are being employed in acute care hospitals. There is potential for overlap in responsibilities between IDC and AMS pharmacists, but there is no literature outlining the current duties for each group in Canada...
November 2017: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/29290744/antimicrobial-stewardship-program-using-plan-do-study-act-cycles-to-reduce-unjustified-antibiotic-prescribing-in-children-admitted-with-an-asthma-exacerbation
#10
Sasha E Dorzin, Claudia Halaby, Maria Lyn Quintos, Asif Noor, Gladys El-Chaar
OBJECTIVE: Antimicrobial stewardship programs (ASPs) ensure appropriate antibiotic use, reduce health care costs, and minimize antibiotic resistance. National asthma guidelines do not recommend antibiotics during an exacerbation unless the child has an infection or comorbidities. The American Academy of Pediatrics (AAP) established a benchmark for unjustified antibiotic use at 6.6%.9 A retrospective study at our institution showed that 7.8% of antibiotics were prescribed without justification in children admitted for asthma...
November 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29288367/antimicrobial-resistance-and-antibiotic-stewardship-programs-in-the-icu-insistence-and-persistence-in-the-fight-against-resistance-a-position-statement-from-esicm-escmid-waaar-round-table-on-multi-drug-resistance
#11
Jan J De Waele, Murat Akova, Massimo Antonelli, Rafael Canton, Jean Carlet, Daniel De Backer, George Dimopoulos, José Garnacho-Montero, Jozef Kesecioglu, Jeffrey Lipman, Mervyn Mer, José-Artur Paiva, Mario Poljak, Jason A Roberts, Jesus Rodriguez Bano, Jean-François Timsit, Jean-Ralph Zahar, Matteo Bassetti
Antimicrobial resistance (AMR) is a clear and present danger to patients in any intensive care unit (ICU) around the world. Whereas AMR may affect any patient in the hospital, patients in the ICU are particularly at risk of acquiring AMR infections due to the intensity of the treatment, use of invasive devices, increased risk of transmission and exposure to antibiotics. AMR is present in every ICU, although prevalence is geographically different and AMR pathogens encountered are variable. Intensive care and infectious disease specialists from the European Society of Intensive Care Medicine, European Society of Microbiology and Infectious Diseases and World Alliance Against Antimicrobial Resistance, united in the ANTARCTICA (Antimicrobial Resistance in Critical Care) coalition, call for increased awareness and action among health care professionals to reduce AMR development in critically ill patients, to improve treatment of AMR infections and to coordinate scientific research in this high-risk patient population...
December 29, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/29277527/high-excess-costs-of-infections-caused-by-carbapenem-resistant-gram-negative-bacilli-in-an-endemic-region
#12
Carlos Andrés Vargas-Alzate, Luis Felipe Higuita-Gutiérrez, Lucelly López López, Astrid Vanessa Cienfuegos Gallet, Judy Natalia Jiménez Quiceno
BACKGROUND: The financial burden of antibiotic resistance is a serious concern worldwide. The aim of this study is to describe the excess costs associated with pneumonia, bacteremia, surgical site infections and intra-abdominal infections caused by carbapenem-resistant gram-negative bacilli in Medellín, Colombia, an endemic region for carbapenem resistance. METHODS: A cohort study was conducted in a third level hospital from 2014 to 2015. All patients with carbapenem-resistant and carbapenem-susceptible gram-negative bacteria infections were included...
December 22, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29276300/multilayer-model-of-pharmacy-participation-in-the-antimicrobial-stewardship-program-at-a-large-academic-medical-center
#13
Yanina Dubrovskaya, Marco R Scipione, Justin Siegfried, Shin-Pung Jen, Vinh Pham, John Papadopoulos, Arnold Decano, Tyler Lewis, Arash Dabestani
Purpose: Leveraging pharmacy personnel resources for the purpose of antimicrobial stewardship program (ASP) operations presents a challenging task. We describe our experience integrating all pharmacists into an ASP, and evaluate the impact on ASP interventions, antimicrobial utilization, rate of selected hospital-onset infections and readmission. Summary: During a study period (January 1 to December 31, 2015), a total of 14 552 ASP-related pharmacy interventions were performed (ASP clinical pharmacotherapy specialists [CPS] n = 4025; non-ASP CPS n = 4888; hospital pharmacists n = 5639)...
October 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/29276284/navigating-the-new-antimicrobial-stewardship-regulations
#14
Sondra Davis, Collin Verheyden, Mandelin Cooper, Devak Desai
Purpose: Many health care facilities are navigating their way through the new antimicrobial stewardship standards and guidelines. The purpose of this article is to provide information for health care facilities to improve patient care. Summary: New regulations and guidelines surrounding antimicrobial stewardship have prompted facilities to review their process related to antimicrobial stewardship. In setting up a program, there are many factors to consider including involving key personnel, obtaining leadership support, identifying an infectious disease physician to chair or cochair the committee, and meeting agenda, metrics, and educational needs...
September 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/29276281/successful-implementation-of-an-antimicrobial-stewardship-program-at-an-academic-medical-center
#15
Carolyn M Bondarenka, John A Bosso
Background: Focus on antimicrobial use and infection prevention from accrediting or regulatory bodies such as the Joint Commission, as well as regulatory agencies such as the Centers for Medicare and Medicaid Services and the Centers for Disease Control, has highlighted the need for continuing development of antimicrobial stewardship programs at healthcare facilities across the country. Methods: Our institution utilized the 2007 Infectious Diseases Society of America and the Society for Healthcare Epidemiology guidelines to direct the evaluation of its antimicrobial use and develop a successful antimicrobial stewardship program...
July 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/29276239/evaluation-of-antimicrobial-stewardship-related-alerts-using-a-clinical-decision-support-system
#16
Riane J Ghamrawi, Alexander Kantorovich, Seth R Bauer, Andrea M Pallotta, Jennifer K Sekeres, Steven M Gordon, Elizabeth A Neuner
Background: Information technology, including clinical decision support systems (CDSS), have an increasingly important and growing role in identifying opportunities for antimicrobial stewardship-related interventions. Objective: The aim of this study was to describe and compare types and outcomes of CDSS-built antimicrobial stewardship alerts. Methods: Fifteen alerts were evaluated in the initial antimicrobial stewardship program (ASP) review. Preimplementation, alerts were reviewed retrospectively. Postimplementation, alerts were reviewed in real-time...
November 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/29245184/evaluation-of-the-use-of-novel-biomarkers-to-augment-antimicrobial-stewardship-program-activities
#17
Kayla R Stover, Rachel M Kenney, Travis S King, Alan E Gross
As antimicrobial stewardship increasingly receives worldwide attention for improving patient care by optimizing antimicrobial therapy, programs are evaluating new tools that may augment antimicrobial stewardship activities. Biomarkers are objective, accurate, and reproducible measures that provide information about medical conditions. A systematic literature search using PubMed/MEDLINE databases was performed to evaluate the use of novel biomarkers as additions to the antimicrobial stewardship armamentarium...
December 15, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29237496/government-policy-interventions-to-reduce-human-antimicrobial-use-protocol-for-a-systematic-review-and-meta-analysis
#18
Susan Rogers Van Katwyk, Jeremy M Grimshaw, Marc Mendelson, Monica Taljaard, Steven J Hoffman
BACKGROUND: Antimicrobial resistance (AMR) is a recognized threat to global public health. Increasing AMR and a dry pipeline of novel antimicrobial drugs have put AMR in the international spotlight. One strategy to combat AMR is to reduce antimicrobial drug consumption. Governments around the world have been experimenting with different policy interventions, such as regulating where antimicrobials can be sold, restricting the use of last-resort antimicrobials, funding AMR stewardship programs, and launching public awareness campaigns...
December 13, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/29237206/-piperacillin-tazobactam-shortage-central-restriction-and-alternative-recommendations-as-effective-antibiotic-stewardship-intervention-at-a-maximal-care-hospital
#19
Johanna Kessel, Barbara Dolff, Thomas Wichelhaus, Nils Keiner, Michael Hogardt, Claudia Reinheimer, Imke Wieters, Sebastian Harder, Volkhard A J Kempf, Christoph Stephan
Background Drug supply bottleneck is a worldwide challenge, e. g. the antibiotics Piperacillin/Tazobactam shortage in 2016/2017. The efficacy of an appropriate replacement management was evaluated at the University Hospital Frankfurt (UHF). Methods The Antibiotic-Stewardship (ABS)-Team at UHF decreed a restriction of PIP/TAZ and provided alternative antibiotic therapy recommendations during the shortage period. Consequences of this intervention on antibiotic consumption and overall costs were investigated...
December 13, 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29237045/informing-antimicrobial-stewardship-factors-associated-with-inappropriate-antimicrobial-prescribing-in-primary-care
#20
Alexander Singer, Sergio Fanella, Leanne Kosowan, Jamie Falk, Brenden Dufault, Kevin Hamilton, Ashley Walus
Background: Antimicrobial stewardship (AS) programs promote the optimal use of antimicrobials and safe patient care. With most antimicrobials prescribed in the ambulatory setting, establishing benchmark data is imperative to gauge the impact of future AS initiatives. Objectives: To determine the frequency of potentially inappropriate antimicrobial prescribing in primary care practices in Manitoba, Canada and to assess the association between potentially inappropriate antimicrobial prescribing and patient, prescriber and practice-related factors...
December 10, 2017: Family Practice
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