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Pharmacist antimicrobial stewardship

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https://www.readbyqxmd.com/read/28089415/antimicrobial-stewardship-in-the-federal-bureau-of-prisons-approaches-from-the-national-and-local-levels
#1
Michael J Long, Brian N LaPlant, Justin C McCormick
OBJECTIVES: To determine the impact of national and local antimicrobial stewardship measures on overall antibiotic prescribing in the Federal Bureau of Prisons (BOP). SETTING: Care was delivered to more than 160,000 inmates in 122 BOP facilities in the United States and Puerto Rico. PRACTICE DESCRIPTION: Medical centers and health services clinics staffed by in-house medical staff, consultants, and specialists. Staffs include a variety of disciplines, including physicians, pharmacists, dentists, nurses, infection control personnel, therapists, health services administrators, and institution executive staff...
January 12, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28010959/urine-culture-guided-antibiotic-interventions-a-pharmacist-driven-antimicrobial-stewardship-effort-in-the-emergency-department
#2
Xi Zhang, Nicole Rowan, Bethann Mangel Pflugeisen, Sanjin Alajbegovic
BACKGROUND: Antibiotics are overprescribed for abnormal urine tests including asymptomatic bacteriuria (AB), contributing to rising antimicrobial resistance rates. Pharmacists reviewed urine cultures daily from emergency department (ED) encounters to assess antibiotic appropriateness. We studied antibiotic prescribing practices and assessed compliance to national guidelines, correlations with urine analysis (UA) components, and opportunities for antimicrobial stewardship in the ED. METHODS: This quality improvement project (QIP) was a prospective cohort study at a community hospital ED, with data collected from finalized urine cultures resulting October 30, 2014 through January 5, 2015...
December 16, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27999065/electronic-prescribing-system-design-priorities-for-antimicrobial-stewardship-a-cross-sectional-survey-of-142-uk-infection-specialists
#3
Kieran S Hand, Debbie Cumming, Susan Hopkins, Sean Ewings, Andy Fox, Sandya Theminimulle, Robert J Porter, Natalie Parker, Joanne Munns, Adel Sheikh, Taryn Keyser, Richard Puleston
BACKGROUND: The implementation of electronic prescribing and medication administration (EPMA) systems is a priority for hospitals and a potential component of antimicrobial stewardship (AMS). OBJECTIVES: To identify software features within EPMA systems that could potentially facilitate AMS and to survey practising UK infection specialist healthcare professionals in order to assign priority to these software features. METHODS: A questionnaire was developed using nominal group technique and transmitted via email links through professional networks...
December 20, 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27999061/from-guidelines-to-practice-a-pharmacist-driven-prospective-audit-and-feedback-improvement-model-for-peri-operative-antibiotic-prophylaxis-in-34-south-african-hospitals
#4
Adrian J Brink, Angeliki P Messina, Charles Feldman, Guy A Richards, Dena van den Bergh
BACKGROUND: Few data exist on the implementation of process measures to facilitate adherence to peri-operative antibiotic prophylaxis (PAP) guidelines in Africa. OBJECTIVES: To implement an improvement model for PAP utilizing existing resources, in order to achieve a reduction in surgical site infections (SSIs) across a heterogeneous group of 34 urban and rural South African hospitals. METHODS: A pharmacist-driven, prospective audit and feedback strategy involving change management and improvement principles was utilized...
December 20, 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27999034/sustained-impact-of-a-computer-assisted-antimicrobial-stewardship-intervention-on-antimicrobial-use-and-length-of-stay
#5
Vincent Nault, Jacques Pepin, Mathieu Beaudoin, Julie Perron, Jean-Marie Moutquin, Louis Valiquette
OBJECTIVES: Prospective audit and feedback interventions are the core components of an antimicrobial stewardship programme. Herein, we describe the sustained impact of an antimicrobial stewardship programme, based on a novel clinical decision-support system (Antimicrobial Prescription Surveillance System; APSS), on antimicrobial use and costs, hospital length of stay (LOS) in days and the proportion of inappropriate antimicrobial prescriptions. METHODS: A quasi-experimental, retrospective study was conducted using interrupted time series between 2008 and 2013...
December 20, 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27994621/antimicrobial-stewardship-a-cross-sectional-survey-assessing-the-perceptions-and-practices-of-community-pharmacists-in-ethiopia
#6
Daniel Asfaw Erku
Background. Community pharmacists are key healthcare professionals for antimicrobial stewardship programs owing to their role in dispensing of antimicrobials. The aim of the present study was to assess the perception and practices of community pharmacists towards antimicrobial stewardship (AMS) in Ethiopia. Methods. A cross-sectional survey was conducted by selecting pharmacy sites through stratified simple random sampling technique. Descriptive and inferential statistics were used to analyze the data. Results...
2016: Interdisciplinary Perspectives on Infectious Diseases
https://www.readbyqxmd.com/read/27974411/antimicrobial-stewardship-how-the-microbiology-laboratory-can-right-the-ship
#7
REVIEW
Philippe Morency-Potvin, David N Schwartz, Robert A Weinstein
SUMMARYAntimicrobial stewardship is a bundle of integrated interventions employed to optimize the use of antimicrobials in health care settings. While infectious-disease-trained physicians, with clinical pharmacists, are considered the main leaders of antimicrobial stewardship programs, clinical microbiologists can play a key role in these programs. This review is intended to provide a comprehensive discussion of the different components of antimicrobial stewardship in which microbiology laboratories and clinical microbiologists can make significant contributions, including cumulative antimicrobial susceptibility reports, enhanced culture and susceptibility reports, guidance in the preanalytic phase, rapid diagnostic test availability, provider education, and alert and surveillance systems...
January 2017: Clinical Microbiology Reviews
https://www.readbyqxmd.com/read/27928186/implementation-of-a-pharmacist-directed-antimicrobial-stewardship-protocol-utilizing-rapid-diagnostic-testing
#8
Angel Heyerly, Ron Jones, Gordon Bokhart, Mary Shoaff, Douglas Fisher
Background: Rapid identification of gram-positive bacteria and resistance determinants from blood cultures can reduce the time to optimal antibiotic therapy. Objective: This study evaluates the use of technology to rapidly identify gram-positive bacteria in combination with a pharmacist-directed antimicrobial stewardship protocol in a tertiary-care facility. Methods: Rapid diagnostic testing was performed on gram-positive blood cultures. Pharmacists were instructed to notify prescribers of results and recommend appropriate antimicrobial therapy based on targeted treatment chart...
November 2016: Hospital Pharmacy
https://www.readbyqxmd.com/read/27919870/hospital-pharmacists-take-time-out-for-antimicrobial-stewardship
#9
Kate Traynor
No abstract text is available yet for this article.
December 15, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27872355/acceptance-of-pharmacist-driven-antimicrobial-stewardship-recommendations-with-differing-levels-of-physician-involvement-in-a-children-s-hospital
#10
Leah Molloy, Eric McGrath, Ronald Thomas, Keith S Kaye, Michael J Rybak
This prospective interventional study assessed whether a pharmacist-physician team in a setting where physician support is not provided for daily antimicrobial stewardship (AS) activities would improve later acceptance of pharmacist recommendations once multidisciplinary efforts stopped and the pharmacist again worked alone. This was measured by AS recommendation acceptance rate during 3 study phases wherein AS recommendations were provided by a pharmacist alone (Phase 1), a pharmacist and a physician together (Phase 2), and then a pharmacist alone again (Phase 3)...
November 20, 2016: Clinical Pediatrics
https://www.readbyqxmd.com/read/27866945/a-global-call-from-five-countries-to-collaborate-in-antibiotic-stewardship-united-we-succeed-divided-we-might-fail
#11
REVIEW
Debra A Goff, Ravina Kullar, Ellie J C Goldstein, Mark Gilchrist, Dilip Nathwani, Allen C Cheng, Kelly A Cairns, Kevin Escandón-Vargas, Maria Virginia Villegas, Adrian Brink, Dena van den Bergh, Marc Mendelson
In February, 2016, WHO released a report for the development of national action plans to address the threat of antibiotic resistance, the catastrophic consequences of inaction, and the need for antibiotic stewardship. Antibiotic stewardship combined with infection prevention comprises a collaborative, multidisciplinary approach to optimise use of antibiotics. Efforts to mitigate overuse will be unsustainable without learning and coordinating activities globally. In this Personal View, we provide examples of international collaborations to address optimal prescribing, focusing on five countries that have developed different approaches to antibiotic stewardship-the USA, South Africa, Colombia, Australia, and the UK...
November 17, 2016: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/27803503/evaluation-of-pharmacist-impact-on-culture-review-process-for-patients-discharged-from-the-emergency-department
#12
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/27795335/cost-analysis-of-implementing-matrix-assisted-laser-desorption-ionization-time-of-flight-mass-spectrometry-plus-real-time-antimicrobial-stewardship-intervention-for-bloodstream-infections
#13
Twisha S Patel, Rola Kaakeh, Jerod L Nagel, Duane W Newton, James G Stevenson
Studies evaluating rapid diagnostic testing plus stewardship intervention have consistently demonstrated improved clinical outcomes for patients with bloodstream infections. However, the cost of implementing new rapid diagnostic testing can be significant, and such testing usually does not generate additional revenue. There are minimal data evaluating the impact of adding matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) for rapid organism identification and dedicating pharmacy stewardship personnel time on the total hospital costs...
January 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/27789965/pharmacist-managed-dose-adjustment-feedback-using-therapeutic-drug-monitoring-of-vancomycin-was-useful-for-patients-with-methicillin-resistant-staphylococcus-aureus-infections-a-single-institution-experience
#14
Ryuichi Hirano, Yuichi Sakamoto, Junichi Kitazawa, Shoji Yamamoto, Naoki Tachibana
BACKGROUND: Vancomycin (VCM) requires dose adjustment based on therapeutic drug monitoring. At Aomori Prefectural Central Hospital, physicians carried out VCM therapeutic drug monitoring based on their experience, because pharmacists did not participate in the dose adjustment. We evaluated the impact of an Antimicrobial Stewardship Program (ASP) on attaining target VCM trough concentrations and pharmacokinetics (PK)/pharmacodynamics (PD) parameters in patients with methicillin-resistant Staphylococcus aureus (MRSA) infections...
2016: Infection and Drug Resistance
https://www.readbyqxmd.com/read/27767002/experience-with-rapid-microarray-based-diagnostic-technology-and-antimicrobial-stewardship-for-patients-with-gram-positive-bacteremia
#15
Elizabeth A Neuner, Andrea M Pallotta, Simon W Lam, David Stowe, Steven M Gordon, Gary W Procop, Sandra S Richter
OBJECTIVE To describe the impact of rapid diagnostic microarray technology and antimicrobial stewardship for patients with Gram-positive blood cultures. DESIGN Retrospective pre-intervention/post-intervention study. SETTING A 1,200-bed academic medical center. PATIENTS Inpatients with blood cultures positive for Staphylococcus aureus, Enterococcus faecalis, E. faecium, Streptococcus pneumoniae, S. pyogenes, S. agalactiae, S. anginosus, Streptococcus spp., and Listeria monocytogenes during the 6 months before and after implementation of Verigene Gram-positive blood culture microarray (BC-GP) with an antimicrobial stewardship intervention...
November 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27725066/implementing-an-antimicrobial-stewardship-program
#16
Caren McHenry Martin
The Centers for Medicare & Medicaid Services is expected to expand requirements for antimicrobial stewardship in nursing facilities during 2016. Many facilities are looking to pharmacists to help them take the initial steps toward developing these coordinated programs to promote the appropriate use of antimicrobials.
2016: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/27725011/-esprit-de-corps-towards-collaborative-integration-of-pharmacists-and-nurses-into-antimicrobial-stewardship-programmes-in-south-africa
#17
N Schellack, R Pretorius, A P Messina
With the global threat of antimicrobial resistance now more emergent than ever, there should be wider collaboration between members of the multidisciplinary healthcare team. This article proposes possible ways of engagement between the pharmacist, nurse and doctor. The pharmacist and nurse are placed in an ideal position through united efforts (camaraderie) to redirect healthcare towards improved patient outcomes while also reducing antimicrobial resistance.
September 23, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/27686471/targeted-de-escalation-rounds-may-effectively-and-safely-reduce-meropenem-use
#18
U Ni Riain, M Tierney, C Doyle, A Vellinga, C Fleming, M Cormican
OBJECTIVE: Use of meropenem in our hospital has doubled in recent years. An audit in 2013 showed that although initiation of therapy with meropenem was generally appropriate, therapy was rarely subsequently reviewed and de-escalated where appropriate. Therefore, a structured stewardship initiative focussed on meropenem de-escalation was developed. METHODS: A local guideline for review and de-escalation of meropenem was developed and approved by the Antimicrobial Stewardship Team...
September 29, 2016: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/27667501/pharmacist-engagement-within-a-hepatitis-c-ambulatory-care-clinic-in-the-era-of-a-treatment-revolution
#19
Timothy P Gauthier, Eva Moreira, Chantal Chan, Alexandria Cabrera, Maribel Toro, Mara Z Carrasquillo, Mark Corentin, Elizabeth M Sherman
OBJECTIVES: To describe an innovative hepatitis C virus (HCV) care program and treatment outcomes resulting from pharmacist services. SETTING: Adult ambulatory care HCV clinic within the Miami Veteran Affairs Healthcare System. PRACTICE DESCRIPTION: Pharmacists with limited prescriptive authority are integrated into a medical hepatology care team. PRACTICE INNOVATION: Pharmacists screen patients with HCV infection for treatment eligibility, counsel patients upon treatment initiation, assess ongoing treatment success and toxicity through patient appointments, telephone calls, and the ordering of pertinent laboratory data, and provide oversight of all patients on HCV therapies...
September 22, 2016: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/27592160/effect-of-an-antimicrobial-stewardship-intervention-on-outcomes-for-patients-with-clostridium-difficile-infection
#20
Hanna K Welch, Jerod L Nagel, Twisha S Patel, Tejal N Gandhi, Benrong Chen, John De Leon, Carol E Chenoweth, Laraine L Washer, Krishna Rao, Gregory A Eschenauer
BACKGROUND: Although antimicrobial stewardship programs (ASPs) are uniquely positioned to improve treatment of Clostridium difficile infection (CDI) through targeted interventions, studies to date have not rigorously evaluated the influence of ASP involvement on clinical outcomes attributed to CDI. METHODS: We performed a quasiexperimental study of adult patients with CDI before (n = 307) and after (n = 285) a real-time ASP review was initiated. In the intervention group, an ASP pharmacist was notified of positive CDI results and consulted with the care team to initiate optimal therapy, minimize concomitant antibiotic and acid-suppressive therapy, and recommend surgical/infectious diseases consultation in complicated cases...
December 1, 2016: American Journal of Infection Control
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