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Antimicrobial stewardship program

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https://www.readbyqxmd.com/read/28532194/cost-effectiveness-of-ceftolozane-tazobactam-plus-metronidazole-compared-with-piperacillin-tazobactam-as-empiric-therapy-for-the-treatment-of-complicated-intra-abdominal-infections-based-on-the-in-vitro-surveillance-of-bacterial-isolates-in-the-uk
#1
Vimalanand Prabhu, Jason Foo, Harblas Ahir, Eric Sarpong, Sanjay Merchant
AIMS: An increase in the prevalence of antimicrobial resistance among gram-negative pathogens has been noted recently.[1] A challenge in empiric treatment of complicated intra-abdominal infection (cIAI) is identifying initial appropriate antibiotic therapy, which is associated with reduced length of stay and mortality compared with inappropriate therapy. The objective of this study was to assess the cost-effectiveness of ceftolozane/tazobactam+metronidazole compared with piperacillin/tazobactam (commonly used in this indication) in the treatment of patients with cIAI in United Kingdom (UK) hospitals...
May 22, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28526402/outpatient-antibiotic-stewardship-interventions-and-opportunities
#2
Erica L Dobson, Michael E Klepser, Jason M Pogue, Matthew J Labreche, Alex J Adams, Timothy P Gauthier, R Brigg Turner, Christy P Su, David M Jacobs, Katie J Suda
Improving the use of antibiotics across the continuum of care is a national priority. Data outlining the misuse of antibiotics in the outpatient setting justify the expansion of antibiotic stewardship programs (ASPs) into this health care setting; however, best practices for outpatient antibiotic stewardship (AS) are not yet defined. In a companion article, we focused on recommendations to overcome challenges related to the implementation of an outpatient ASP (e.g., building the AS team and defining program metrics)...
May 16, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28526311/dramatic-effects-of-a-new-antimicrobial-stewardship-program-in-a-rural-community-hospital
#3
Claudia R Libertin, Stephanie H Watson, William L Tillett, Joy H Peterson
BACKGROUND: New Joint Commission antimicrobial stewardship requirements took effect on January 1, 2017, promoted as a central strategy for coping with the emerging problems of antimicrobial resistance and Clostridium difficile infection. Our objective was to measure the effects of a new antimicrobial stewardship program (ASP) in a rural community hospital with no prior ASP, in the context of having a new infectious disease specialist on staff. METHODS: An ASP team was formed to implement a prospective audit with health care provider feedback and targeting 12 antimicrobial agents in a rural hospital in Georgia...
May 16, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28520865/impact-of-an-integrated-antibiotic-allergy-testing-program-on-antimicrobial-stewardship-a-multicenter-evaluation
#4
Jason A Trubiano, Karin A Thursky, Andrew J Stewardson, Karen Urbancic, Leon J Worth, Cheryl Jackson, Wendy Stevenson, Michael Sutherland, Monica A Slavin, M Lindsay Grayson, Elizabeth J Phillips
Background.: Despite the high prevalence of patient-reported antibiotic allergy (so-called antibiotic allergy labels [AALs]) and their impact on antibiotic prescribing, incorporation of antibiotic allergy testing (AAT) into antimicrobial stewardship (AMS) programs (AAT-AMS) is not widespread. We aimed to evaluate the impact of an AAT-AMS program on AAL prevalence, antibiotic usage, and appropriateness of prescribing. Methods.: AAT-AMS was implemented at two large Australian hospitals during a 14-month period beginning May 2015...
May 18, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28499717/a-call-to-action-for-outpatient-antibiotic-stewardship
#5
Michael E Klepser, Erica L Dobson, Jason M Pogue, Matthew J Labreche, Alex J Adams, Timothy P Gauthier, R Brigg Turner, Christy P Su, David M Jacobs, Katie J Suda
OBJECTIVES: To address the public health threat of antibiotic resistance, there has been an enhanced call for antibiotic stewardship programs throughout the health care continuum. SUMMARY: While antibiotic stewardship programs have been well described in the inpatient setting, data on effectiveness and guidance on implementing outpatient programs is scarce. Establishing stewardship practices in the outpatient setting is necessary because more than 60% of human antibiotic use occurs in this setting...
May 9, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28490386/pharmacists-familiarity-with-and-institutional-utilization-of-rapid-diagnostic-technologies-for-antimicrobial-stewardship
#6
Rachel A Foster, Kristi Kuper, Z Kevin Lu, P Brandon Bookstaver, Christopher M Bland, Monica V Mahoney
Rapid diagnostic technologies (RDTs) significantly reduce organism identification time and can augment antimicrobial stewardship program (ASP) activities. An electronic survey quantified familiarity with and utilization of RDTs by clinical pharmacists participating in ASPs. Familiarity was highest with polymerase chain reaction (PCR). Formal infectious diseases training was the only significant factor influencing RDT familiarity. Infect Control Hosp Epidemiol 2017;1-4.
May 11, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28480770/an-update-on-the-pharmacotherapeutic-management-of-lower-respiratory-tract-infections
#7
Mario Cazzola, Paola Rogliani, Stefano Aliberti, Francesco Blasi, Maria Gabriella Matera
Our knowledge about lower respiratory tract infections (LRTIs) has improved substantially in the last years, but the management of respiratory infections is still a challenge and we are still far from precision medicine in the treatment of LRTIs. Areas covered: The approaches developed in recent years to improve the pharmacotherapeutic management of LRTIs, such as novel diagnostic assays to facilitate medical decision-making, attempts for selecting an optimal empiric antibiotic regimen, and the role of new and possibly unproven adjunctive therapies, are described...
May 6, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28476493/promoting-appropriate-urine-culture-management-to-improve-health-care-outcomes-and-the-accuracy-of-catheter-associated-urinary-tract-infections
#8
REVIEW
Robert Garcia, Eric D Spitzer
Published literature indicates that the unjustified ordering or improper collection of urine for urinalysis or culture from either catheterized patients or those without indwelling devices, or misinterpretation of positive results, often leads to adverse health care events, including increased financial burdens, overreporting of mandated catheter-associated urinary tract infection events, overtreatment of patients with antimicrobial agents, selection of multidrug-resistant organisms, and Clostridium difficile infection...
May 2, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28475791/prevention-and-control-of-multidrug-resistant-gram-negative-bacteria-in-adult-intensive-care-units-a-systematic-review-and-network-meta-analysis
#9
Nattawat Teerawattanapong, Kirati Kengkla, Piyameth Dilokthornsakul, Surasak Saokaew, Anucha Apisarnthanarak, Nathorn Chaiyakunapruk
Background: This study evaluated the relative efficacy of strategies for the prevention of multidrug-resistant gram-negative bacteria (MDR-GNB) in adult intensive care units (ICUs). Methods: A systematic review and network meta-analysis was performed; searches of the Cochrane Library, PubMed, Embase, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) included all randomized controlled trials and observational studies conducted in adult patients hospitalized in ICUs and evaluating standard care (STD), antimicrobial stewardship program (ASP), environmental cleaning (ENV), decolonization methods (DCL), or source control (SCT), simultaneously...
May 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28475788/antimicrobial-stewardship-in-surgery-challenges-and-opportunities
#10
Giorgio Tarchini, Kui Hin Liau, Joseph S Solomkin
Antibiotic stewardship programs have been playing an increasingly important role in patient care and hospital policies. The role of these programs in surgical care presents several unique challenges and opportunities, most notably in the perioperative setting. Controversy remains regarding optimal antibiotic choice, dosage, and length of prophylaxis. Here, we review current best practices and suggest areas for further research specific to antibiotic stewardship in surgical care.
May 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28475777/antimicrobial-stewardship-in-inpatient-settings-in-the-asia-pacific-region-a-systematic-review-and-meta-analysis
#11
Hitoshi Honda, Norio Ohmagari, Yasuharu Tokuda, Caline Mattar, David K Warren
Background: An antimicrobial stewardship program (ASP) is one of the core elements needed to optimize antimicrobial use. Although collaboration at the national level to address the importance of ASPs and antimicrobial resistance has occurred in the Asia Pacific region, hospital-level ASP implementation in this region has not been comprehensively evaluated. Methods: We conducted a systematic review and meta-analysis to assess the efficacy of ASPs in inpatient settings in the Asia Pacific region from January 2005 through March 2016...
May 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28473007/a-novel-metric-to-monitor-the-influence-of-antimicrobial-stewardship-activities
#12
Daniel J Livorsi, Erin O'Leary, Tamra Pierce, Lindsey Reese, Katharina L van Santen, Daniel A Pollock, Jonathan R Edwards, Arjun Srinivasan
The antimicrobial use (AU) option within the National Healthcare Safety Network summarizes antimicrobial prescribing data as a standardized antimicrobial administration ratio (SAAR). A hospital's antimicrobial stewardship program found that greater involvement of an infectious disease physician in prospective audit and feedback procedures was associated with reductions in SAAR values across multiple antimicrobial categories. Infect Control Hosp Epidemiol 2017;1-3.
May 5, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28472293/implementation-of-antimicrobial-stewardship-programs-in-small-community-hospitals-recognizing-the-barriers-and-meeting-the-challenge
#13
Daniel J Sexton, Rebekah W Moehring
No abstract text is available yet for this article.
May 2, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28459929/behavioral-approach-to-appropriate-antimicrobial-prescribing-in-hospitals-the-dutch-unique-method-for-antimicrobial-stewardship-dumas-participatory-intervention-study
#14
Jonne J Sikkens, Michiel A van Agtmael, Edgar J G Peters, Kamilla D Lettinga, Martijn van der Kuip, Christina M J E Vandenbroucke-Grauls, Cordula Wagner, Mark H H Kramer
Importance: Inappropriate antimicrobial prescribing leads to antimicrobial resistance and suboptimal clinical outcomes. Changing antimicrobial prescribing is a complex behavioral process that is not often taken into account in antimicrobial stewardship programs. Objective: To examine whether an antimicrobial stewardship approach grounded in behavioral theory and focusing on preserving prescriber autonomy and participation is effective in improving appropriateness of antimicrobial prescribing in hospitals...
May 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28459897/association-of-inpatient-antimicrobial-utilization-measures-with-antimicrobial-stewardship-activities-and-facility-characteristics-of-veterans-affairs-medical-centers
#15
Christopher J Graber, Makoto M Jones, Ann F Chou, Yue Zhang, Matthew Bidwell Goetz, Karl Madaras-Kelly, Matthew H Samore, Peter A Glassman
BACKGROUND: Antimicrobial stewardship programs (ASPs) have been advocated to improve antimicrobial utilization, but program implementation is variable. Antimicrobial stewardship programs (ASPs) have been advocated to improve antimicrobial utilization, but program implementation is variable. OBJECTIVE: To determine associations between ASPs and facility characteristics, and inpatient antimicrobial utilization measures in the Veterans Affairs (VA) system in 2012. DESIGN: In 2012, VA administered a survey on antimicrobial stewardship practices to designated ASP contacts at VA acute care hospitals...
May 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28458801/how-can-multi-professional-education-support-better-stewardship
#16
REVIEW
Nuno Rocha Pereira, Enrique Castro-Sanchez, Dilip Nathwani
Antimicrobial stewardship is widely accepted as an efficient strategy to combat the growing threat of antimicrobial resistance. Education is one of the cornerstones of successful antimicrobial stewardship programs. There is also general agreement that antimicrobial stewardship is a team effort that must involve the whole continuum of healthcare workers. Providing adequate education for all different professionals although challenging is deemed crucial to achieve good results. This paper reviews the different strategies available to educate the multiple healthcare workers, discusses how education can improve antimicrobial stewardship programs and outlines some of the challenges faced and research gaps that need to be addressed in order to improve education in this field...
March 30, 2017: Infectious Disease Reports
https://www.readbyqxmd.com/read/28458800/challenges-for-a-sustainable-financial-foundation-for-antimicrobial-stewardship
#17
REVIEW
Jan-Willem H Dik, Bhanu Sinha
Antimicrobial resistance is a worldwide threat and a problem with large clinical and economic impact. Antimicrobial Stewardship Programs are a solution to curb resistance development. A problem of resistance is a separation of actions and consequences, financial and clinical. Such a separation makes it difficult to create support among stakeholders leading to a lack of sense of responsibility. To counteract the resistance development it is important to perform diagnostics and know how to interpret the results...
March 30, 2017: Infectious Disease Reports
https://www.readbyqxmd.com/read/28458798/advances-in-rapid-identification-and-susceptibility-testing-of-bacteria-in-the-clinical-microbiology-laboratory-implications-for-patient-care-and-antimicrobial-stewardship-programs
#18
REVIEW
Florian P Maurer, Martin Christner, Moritz Hentschke, Holger Rohde
Early availability of information on bacterial pathogens and their antimicrobial susceptibility is of key importance for the management of infectious diseases patients. Currently, using traditional approaches, it usually takes at least 48 hours for identification and susceptibility testing of bacterial pathogens. Therefore, the slowness of diagnostic procedures drives prolongation of empiric, potentially inappropriate, antibacterial therapies. Over the last couple of years, the improvement of available techniques (e...
March 30, 2017: Infectious Disease Reports
https://www.readbyqxmd.com/read/28458796/technology-to-support-integrated-antimicrobial-stewardship-programs-a-user-centered-and-stakeholder-driven-development-approach
#19
REVIEW
Nienke Beerlage-de Jong, Lisette van Gemert-Pijnen, Jobke Wentzel, Ron Hendrix, Liseth Siemons
The rise of antimicrobial resistance (AMR) is a severe global health problem. Tackling this problem requires the prudent prescribing of antimicrobials. This is promoted through Antimicrobial Stewardship Programs (ASPs). In this position paper we describe i) how a socio-technical multidisciplinary approach (based on the CeHRes Roadmap) can be applied in the development and implementation of Antimicrobial Stewardship technologies and ii) how this approach can be of value to support Antimicrobial Stewardship in practice...
March 30, 2017: Infectious Disease Reports
https://www.readbyqxmd.com/read/28458296/effectiveness-of-a-computer-facilitated-pharmacist-driven-antimicrobial-stewardship-program-for-infection-management
#20
Kengo Ohashi, Tomoko Matsuoka, Yasutaka Shinoda, Shinya Yoshida, Kaori Arai, Misa Kato, Takayuki Mori, Tomoaki Yoshimura
 In recent years, hospitals have routinely implemented antimicrobial stewardship (AS) programs, and it is important that these programs are effective. Consequently, we utilized a customized computer system to support infection management and implemented a pharmacist-driven AS program in our hospital. Using this computer system, a pharmacist monitored the daily usage of carbapenems and agents against anti-methicillin-resistant Staphylococcus aureus and generated a patient database. With the use of this computer system, we found that the patient database entry time significantly decreased from 24 to 12 min (p<0...
2017: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
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