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Antimicrobial stewardship program

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https://www.readbyqxmd.com/read/27917734/effective-antibiotic-conservation-by-emergency-antimicrobial-stewardship-during-a-drug-shortage
#1
Kevin Hsueh, Maria Reyes, Tamara Krekel, Ed Casabar, David J Ritchie, S Reza Jafarzadeh, Amanda J Hays, Michael A Lane, Michael J Durkin
We present the first description of an antimicrobial stewardship program (ASP) used to successfully manage a multi-antimicrobial drug shortage. Without resorting to formulary restriction, meropenem utilization decreased by 69% and piperacillin-tazobactam by 73%. During the shortage period, hospital mortality decreased (P=.03), while hospital length of stay remained unchanged. Infect Control Hosp Epidemiol 2016;1-4.
December 5, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27917707/management-of-pneumonia-in-the-pediatric-critical-care-unit-an-area-for-antimicrobial-stewardship
#2
Aimee M Dassner, David P Nicolau, Jennifer E Girotto
Pediatric pneumonia is one of the most common causes of childhood infection requiring hospitalization and is a substantial driver of antimicrobial use among hospitalized children. About 12-20% of pediatric patients hospitalized with community-acquired pneumonia (CAP) require critical care. Additionally, nosocomial pneumonias (i.e. hospital-acquired and ventilator-associated pneumonias) are responsible for 15-53% of hospital-associated infections and are the most common indication for empiric antibiotics in the pediatric intensive care unit...
December 4, 2016: Current Pediatric Reviews
https://www.readbyqxmd.com/read/27915487/the-epidemiology-of-carbapenemases-in-latin-america-and-the-caribbean
#3
Kevin Escandón-Vargas, Sergio Reyes, Sergio Gutiérrez, María V Villegas
Enterobacteriaceae, Pseudomonas spp., and Acinetobacter spp. infections are major causes of morbidity and mortality, especially due to the emergence and spread of β-lactamases. Carbapenemases, which are β-lactamases with the capacity to hydrolyze or inactivate carbapenems, have become a serious concern as they have the largest hydrolytic spectrum and therefore limit the utility of most β-lactams, including the carbapenems. Areas covered: Here, we present an update of the current status of carbapenemases in Latin America and the Caribbean...
December 3, 2016: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/27908435/antimicrobial-stewardship-programs-that-target-only-high-cost-broad-spectrum-antimicrobials-miss-opportunities-to-reduce-clostridium-difficile-infections
#4
Christine Bui, Elizabeth Zhu, Monica A Donnelley, Machelle D Wilson, Margaret Morita, Stuart H Cohen, Jennifer Brown
Antimicrobial stewardship programs are promoted as a strategy to reduce Clostridium difficile infections. We implemented an antimicrobial stewardship program comprised of formulary restriction plus prospective audit with feedback for high-cost and broad-spectrum antimicrobials. Subsequently, we reviewed all heath care facility-onset, health care facility-associated C difficile infections. We found that most of these infections were associated with the antecedent receipt of nonaudited, and often unnecessary, antimicrobials...
December 1, 2016: American Journal of Infection Control
https://www.readbyqxmd.com/read/27902375/improving-time-to-optimal-staphylococcus-aureus-treatment-using-a-penicillin-binding-protein-2a-assay
#5
Sonia N Rao, Sheila K Wang, Jose Gonzalez Zamora, Amy P Hanson, Radhika S Polisetty, Kamaljit Singh
The penicillin-binding protein 2a (PBP2a) assay is a quick, accurate and inexpensive test for determining methicillin susceptibility in Staphylococcus aureus. A pre-post study design was conducted using a PBP2a assay with and without the impact of an antimicrobial stewardship (AS) intervention to improve time to optimal therapy for methicillin-susceptible (MSSA) and methicillin-resistant Staphylococcus aureus (MRSA) isolates. Our results demonstrate significantly improved time to optimal therapy and support the use of a PBP2a assay as part of an AS program for all healthcare facilities, especially those with limited resources...
October 14, 2016: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/27895446/a-case-of-fatal-sepsis-due-to-multidrug-resistant-corynebacterium-striatum
#6
M Chatzopoulou, T Koufakis, I Voulgaridi, I Gabranis, M Tsiakalou
BACKGROUND: Although non-diphtheria corynebacteria have traditionally been regarded as avirulent members of human bacterial flora, their pathogenic potential is increasingly recognized in our time. Reasons for this include the prolonged survival of severely ill and immunocompromised patients, the development of more invasive diagnostic and therapeutic procedures and the sub-optimal use of antibiotics that disrupts normal microbial balance and favors superinfections. CASE REPORT: We present a rare case of sepsis due to multidrug-resistant Corynebacterium striatum in a 76-year-old host...
January 2016: Hippokratia
https://www.readbyqxmd.com/read/27890038/an-evaluation-of-antibiotic-prescribing-practices-upon-hospital-discharge
#7
Sarah J Scarpato, Daniel R Timko, Valerie C Cluzet, Jillian P Dougherty, Jonathan J Nunez, Neil O Fishman, Keith W Hamilton
We conducted a retrospective study of the appropriateness of antimicrobial agents prescribed on discharge from an acute care hospital. Seventy percent of discharge antibiotics were inappropriate in antibiotic drug choice, dose, or duration. Our findings suggest there is a significant need for antimicrobial stewardship at transitions in care. Infect Control Hosp Epidemiol 2016;1-3.
November 28, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27887595/antimicrobial-stewardship-of-chinese-ministry-of-health-reduces-multidrug-resistant-organism-isolates-in-critically-ill-patients-a-pre-post-study-from-a-single-center
#8
Xudong Ma, Jianfeng Xie, Yi Yang, Fengmei Guo, Zhiwei Gao, Hua Shao, Yingzi Huang, Congshan Yang, Haibo Qiu
BACKGROUND: China's Ministry of Health (MOH) has established a policy about the antimicrobial stewardship. To date, the effects of this policy on multidrug-resistant organism (MDRO) in critically ill patients are unknown. METHODS: A pre-post study was conducted on intensive care unit (ICU) patients from June 2010 to May 2011 and from June 2012 to May 2013. Bacterial cultures were conducted at ICU admission and discharge. In June 2011, our hospital started to administer the antimicrobial stewardship program of Chinese MOH...
November 25, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27874151/a-stepwise-introduction-of-a-successful-antimicrobial-stewardship-program-experience-from-a-tertiary-care-university-hospital-in-western-saudi-arabia
#9
Maha M Alawi, Bayan M Darwesh
OBJECTIVES: To analyze and evaluate the safety and cost-effectiveness of a gradually-implemented antimicrobial stewardship programs (ASP) in a tertiary care center. METHODS: Prospective data were collected from an ASP that was gradually introduced between April 2012 and December 2013 in 6 hospital departments, over successive periods of 3 months each. A multidisciplinary team supervised antibiotic use and regulated pharmacy dispensations of a list of restricted antimicrobials (RAs)...
December 2016: Saudi Medical Journal
https://www.readbyqxmd.com/read/27873126/resistance-to-non-glycopeptide-agents-in-serious-staphylococcus-aureus-infections
#10
REVIEW
Kyle C Molina, Vanthida Huang
The role of vancomycin in the treatment of serious Staphylococcus aureus infections, both methicillin-susceptible and methicillin-resistant, is becoming increasingly ineffective due to increasing MIC and failure. The development of reduced vancomycin susceptibility by S. aureus to glycopeptides highlights the need for clinicians to reexamine the roles of non-glycopeptide therapy. As the use of these alternative non-glycopeptides antimicrobials increases, it will become pertinent to monitor the rates of resistance...
December 2016: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/27856730/multidrug-and-carbapenem-resistant-pseudomonas-aeruginosa-in-children-united-states-1999-2012
#11
Latania K Logan, Sumanth Gandra, Siddhartha Mandal, Eili Y Klein, Jordan Levinson, Robert A Weinstein, Ramanan Laxminarayan
BACKGROUND: Pseudomonas aeruginosa is a common cause of healthcare-associated infection. Multidrug-resistant (MDR) (>3 classes) and carbapenem-resistant (CR) P aeruginosa are significant threats globally. We used a large reference-laboratory database to study the epidemiology of P aeruginosa in children in the United States. METHODS: Antimicrobial susceptibility data from the Surveillance Network were used to phenotypically identify MDR and CR P aeruginosa isolates in children aged 1 to 17 years between January 1999 and July 2012...
November 16, 2016: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/27844028/how-to-pitch-an-antibiotic-stewardship-program-to-the-hospital-c-suite
#12
REVIEW
Brad Spellberg, John G Bartlett, David N Gilbert
Hospitals will soon require antibiotic stewardship programs. Infectious diseases specialists must craft business plans to engage hospital leadership to fund such programs. In this article, we review key cost and revenue elements that should be covered in such plans. Society is placing increasing emphasis on the importance of antimicrobial stewardship programs (ASPs). New regulatory standards require hospitals to implement ASPs. Infectious Diseases (ID) specialists will need to help design and implement such programs at hospitals...
October 2016: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/27832502/a-retrospective-study-of-the-impact-of-rapid-diagnostic-testing-on-time-to-pathogen-identification-and-antibiotic-use-for-children-with-positive-blood-cultures
#13
Angela Fimbres Veesenmeyer, Jared A Olson, Adam L Hersh, Chris Stockmann, Kent Korgenski, Emily A Thorell, Andrew T Pavia, Anne J Blaschke
INTRODUCTION: Rapid identification of bloodstream pathogens provides crucial information that can improve the choice of antimicrobial therapy for children. Previous impact studies have primarily focused on adults. Our objective was to evaluate the impact of rapid testing in a children's hospital on time to organism identification and antibiotic use in the setting of an established antimicrobial stewardship program. METHODS: We conducted a retrospective study over three consecutive time periods (spanning January 2013-August 2015) as our hospital sequentially introduced two rapid testing methods for positive blood cultures...
November 10, 2016: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/27828764/antimicrobial-stewardship-a-call-to-action-for-surgeons
#14
Massimo Sartelli, Therese M Duane, Fausto Catena, Jeffrey M Tessier, Federico Coccolini, Lillian S Kao, Belinda De Simone, Francesco M Labricciosa, Addison K May, Luca Ansaloni, John E Mazuski
Despite current antimicrobial stewardship programs (ASPs) being advocated by infectious disease specialists and discussed by national and international policy makers, ASPs coverage remains limited to only certain hospitals as well as specific service lines within hospitals. The ASPs incorporate a variety of strategies to optimize antimicrobial agent use in the hospital, yet the exact set of interventions essential to ASP success remains unknown. Promotion of ASPs across clinical practice is crucial to their success to ensure standardization of antimicrobial agent use within an institution...
December 2016: Surgical Infections
https://www.readbyqxmd.com/read/27826158/development-and-implementation-of-an-antimicrobial-stewardship-program-in-a-rural-hospital
#15
Kerry-Anne Hogan, Mohamed Gazarin, Julie Lapenskie
No abstract text is available yet for this article.
September 2016: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/27810065/social-media-as-a-tool-for-antimicrobial-stewardship
#16
Jennifer Pisano, Natasha Pettit, Allison Bartlett, Palak Bhagat, Zhe Han, Chuanhong Liao, Emily Landon
BACKGROUND: To increase the reach of our antimicrobial stewardship program (ASP), social media platforms, Facebook and Twitter, were used to increase internal medicine residents' (IMRs') antibiotic (Abx) knowledge and awareness of ASP resources. METHODS: Fifty-five of 110 (50%) IMRs consented to participate; 39 (71%) completed both pre- and postintervention surveys and followed our ASP on social media. Along with 20 basic Abx and infectious diseases (IDs) questions, this survey assessed IMR awareness of ASP initiatives, social media usage, and attitudes and beliefs surrounding Abx resistance...
November 1, 2016: American Journal of Infection Control
https://www.readbyqxmd.com/read/27803503/evaluation-of-pharmacist-impact-on-culture-review-process-for-patients-discharged-from-the-emergency-department
#17
Ruben D Santiago, Jose A Bazan, Nicole V Brown, Eric J Adkins, Mary Beth Shirk
Background: Accurate and timely review of microbiological test results is a core component of antimicrobial stewardship. There is documented success of these programs in the inpatient setting; however, emergency department (ED) patients are typically not included in these initiatives. Objectives: To assess the impact of an emergency medicine pharmacist (EMP)-facilitated review process of positive microbiological test results from patients discharged from the ED as measured by time to positive result review and number of indicated interventions completed...
October 2016: Hospital Pharmacy
https://www.readbyqxmd.com/read/27803499/impact-of-an-antimicrobial-stewardship-program-on-antimicrobial-utilization-bacterial-susceptibilities-and-financial-expenditures-at-an-academic-medical-center
#18
Tristan T Timbrook, John M Hurst, John A Bosso
Background: Antimicrobial stewardship programs (ASPs) have the potential to improve patient outcomes, decrease microbial resistance, increase patient safety, and decrease costs. However, to justify the costs involved with providing an ASP, it is necessary to assess its impact in achieving these outcomes on an ongoing basis. Objective: The purpose of this study was to characterize the overall impact of the ASP at an Academic medical center. Methods: Quasi-experimental, before and after stewardship program implementation, retrospective analyses of quarterly antimicrobial utilization, bacterial susceptibilities, and antibiotic acquisition costs were utilized...
October 2016: Hospital Pharmacy
https://www.readbyqxmd.com/read/27800527/improving-antimicrobial-stewardship-by-antibiotic-allergy-delabeling-evaluation-of-knowledge-attitude-and-practices-throughout-the-emerging-infections-network
#19
Jason A Trubiano, Susan E Beekmann, Leon J Worth, Philip M Polgreen, Karin A Thursky, Monica A Slavin, M Lindsay Grayson, Elizabeth J Phillips
Antibiotic allergy testing (AAT) practices of Emerging Infections Network infectious disease physicians were surveyed. Although AAT was perceived to be necessary for removal of inappropriate or unnecessary allergy labels, there was limited access to any form of testing. In this study, we discuss current antibiotic allergy knowledge gaps and the development of AAT practices within antimicrobial stewardship programs, which will potentially improve antimicrobial prescribing.
September 2016: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/27795921/attitudes-and-perceptions-regarding-antimicrobial-use-and-resistance-among-medical-students-in-central-china
#20
Kun Yang, Dongfang Wu, Fei Tan, Shaojun Shi, Xianxi Guo, Qing Min, Xiaolian Zhang, Hong Cheng
OBJECTIVES: Senior medical students, who are future doctors, should be prepared to use antimicrobials appropriately and will be important partners in antimicrobial stewardship. This survey was designed to investigate the attitudes and perceptions of senior medical students regarding antimicrobial use and resistance. METHODOLOGY: We performed a multi-center survey involving a questionnaire handed out to all fourth year medical students from five representative teaching hospitals in Central China...
2016: SpringerPlus
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