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Pharmacist antimicrobial stewardship

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https://www.readbyqxmd.com/read/28903514/impact-of-an-antimicrobial-stewardship-program-on-antibiotic-use-at-a-nonfreestanding-children-s-hospital
#1
R Brigg Turner, Elena Valcarlos, Ann M Loeffler, Michael Gilbert, Dominic Chan
Background: Pediatric stewardship programs have been successful at reducing unnecessary antibiotic use. Data from nonfreestanding children's hospitals are currently limited. This study is an analysis of antibiotic use after implementation of an antimicrobial stewardship program at a community nonfreestanding children's hospital. Methods: In April 2013, an antimicrobial stewardship program that consisted of physician-group engagement and pharmacist prospective auditing and feedback was initiated...
September 1, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28853035/expanding-antimicrobial-stewardship-to-urgent-care-centers-through-a-pharmacist-led-culture-follow-up-program
#2
Lisa E Dumkow, Thomas S Beuschel, Kasey L Brandt
INTRODUCTION: Urgent care centers represent a high-volume outpatient setting where antibiotics are prescribed frequently but resources for antimicrobial stewardship may be scarce. In 2015, our pharmacist-led Emergency Department (ED) culture follow-up program was expanded to include two urgent care (UC) sites within the same health system. The UC program is conducted by ED and infectious diseases clinical pharmacists as well as PGY1 pharmacy residents using a collaborative practice agreement (CPA)...
August 29, 2017: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/28842518/formalization-of-an-antimicrobial-stewardship-program-in-a-small-community-hospital
#3
Alexa R Lockwood, Nicole S Bolton, Mark D Winton, Jean T Carter
PURPOSE: Results of a study to formalize an antimicrobial stewardship program (ASP) in a small community hospital are presented. METHODS: The formalization process began with a gap analysis of the hospital's antimicrobial services, followed by the development of a fully integrated, multipharmacist ASP. The impact was studied with an institutional review board-approved study design. Retrospective pre-ASP data were pulled from March 1 to June 30, 2012 and 2013 patient records; prospective post-ASP data were collected for March 1 to June 30, 2015...
September 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28768593/staff-nurses-as-antimicrobial-stewards-an-integrative-literature-review
#4
REVIEW
Elizabeth Monsees, Jennifer Goldman, Lori Popejoy
BACKGROUND: Guidelines on antimicrobial stewardship emphasize the importance of an interdisciplinary team, but current practice focuses primarily on defining the role of infectious disease physicians and pharmacists; the role of inpatient staff nurses as antimicrobial stewards is largely unexplored. METHODS: An updated integrative review method guided a systematic appraisal of 13 articles spanning January 2007-June 2016. Quantitative and qualitative peer-reviewed publications including staff nurses and antimicrobial knowledge or stewardship were incorporated into the analysis...
August 1, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28709439/enhanced-antimicrobial-de-escalation-for-pneumonia-in-mechanically-ventilated-patients-a-cross-over-study
#5
Tracy Trupka, Kristen Fisher, Scott T Micek, Paul Juang, Marin H Kollef
BACKGROUND: Antibiotics are commonly administered to hospitalized patients with infiltrates for possible bacterial pneumonia, often leading to unnecessary treatment and increasing the risk for resistance emergence. Therefore, we performed a study to determine if an enhanced antibiotic de-escalation practice could improve antibiotic utilization in mechanically ventilated patients with suspected pneumonia cared for in an academic closed intensive care unit (ICU). METHODS: This was a prospective cross-over trial comparing routine antibiotic management (RAM) and enhanced antimicrobial de-escalation (EAD) performed within two medical ICUs (total 34 beds) at Barnes-Jewish Hospital, an academic referral center...
July 15, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28694537/survey-of-antimicrobial-stewardship-practices-in-public-hospitals-in-new-zealand-district-health-boards
#6
Sharon J Gardiner, Jane A Pryer, Eamon J Duffy
AIMS: To determine what antimicrobial stewardship (AMS) practices exist in New Zealand public hospitals. METHODS: A quantitative survey based on recommended components of hospital AMS programmes was sent to the 20 DHBs in June 2016. RESULTS: Ten of the 20 DHBs had an AMS committee, nine had dedicated AMS pharmacist full-time equivalents (FTEs) and eight had lead clinician FTEs. Only one DHB met FTE recommendations for AMS pharmacists and two for clinicians (0...
July 7, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28694232/reinforcement-of-an-antimicrobial-stewardship-task-force-aims-at-a-better-use-of-antibiotics-of-last-resort-the-colitifos-study
#7
Benjamin Davido, Frédérique Bouchand, Aurélien Dinh, Christian Perronne, Maryvonne Villart, Olivia Senard, Jérome Salomon
BACKGROUND: Physicians are facing a worldwide increase in multidrug-resistant (MDR) organisms. Eradication of such bacteria, including so called superbugs (XDR), may cause physicians to prescribe last-resort antibiotics. However, experience with these drugs is limited and few data are available. METHODS: A before and after retrospective study was conducted from January 2008 to June 2016. Prescriptions of parenteral antimicrobials considered as last-resort antibiotics (colistin, fosfomycin, tigecycline and temocillin) were reviewed by 4 infectious disease specialists (according to microbiology results, susceptibility testing, clinical situation and alternative agents), while doses were analysed by a pharmacist...
August 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28674308/improved-clinical-outcomes-in-patients-with-positive-blood-culture-by-proactive-intervention-of-antimicrobial-use-impact-of-antimicrobial-stewardship-program-implementation-on-clinical-practice
#8
Takehiro Yamada, Keisuke Kagami, Shungo Imai, Koji Akizawa, Sumio Iwasaki, Tatsuya Fukumoto, Nobuhisa Ishiguro, Ken Iseki
 Bacteremia is one of the most serious infectious illness resulting from nosocomial infection. Therefore, appropriate antimicrobial chemotherapy should be provided as soon as possible to patients exhibiting symptoms of infectious disease and having positive blood culture results. Antimicrobial stewardship (AS) guidelines were recently released by the Infectious Diseases Society of America. The guidelines recommend "proactive intervention and feedback" as one of the core strategies for implementing optimal antimicrobial drug use to improve patient outcomes in clinical settings...
2017: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
https://www.readbyqxmd.com/read/28655372/antibiotic-stewardship-new-frontier-familiar-journey
#9
Caren McHenry Martin
Recent changes in regulations by the Centers for Medicare & Medicaid Services require long-term care facilities to meet specific requirements on antibiotic stewardship, promoting the appropriate use of antibiotics and antimicrobials. The goal is to improve patient outcomes and decrease the spread of infections caused by multi-drug-resistant organisms. Consultant pharmacists can help facility personnel implement policies and procedures for effective antibiotic stewardship, assist prescribers and facility staff in understanding how to use the facility's antibiogram, find appropriate resources, and provide facility personnel with feedback on their antimicrobial stewardship efforts...
May 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28655371/implementing-an-antimicrobial-stewardship-program
#10
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.
May 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28605452/optimizing-preoperative-prophylaxis-in-patients-with-reported-%C3%AE-lactam-allergy-a-novel-extension-of-antimicrobial-stewardship
#11
Alon Vaisman, Janine McCready, Sandy Hicks, Jeff Powis
Background: Use of alternative second-line antibiotics is associated with adverse events in patients reporting β-lactam allergy. In the perioperative setting, we hypothesized that structured allergy histories, without the use of skin testing, can reduce alternative prophylactic antibiotic use. Objectives: Assess the impact of structured allergy histories on patients with self-reported β-lactam allergy (SRBA) undergoing elective surgical procedures. Methods: Structured allergy histories were performed by a pharmacist and reviewed with an infectious diseases physician...
September 1, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28596021/pharmacist-driven-antimicrobial-stewardship-in-intensive-care-units-in-east-china-a-multicenter-prospective-cohort-study
#12
Zhongwang Li, Baoli Cheng, Kai Zhang, Guohao Xie, Yan Wang, Jinchao Hou, Lihua Chu, Jialian Zhao, Zhijun Xu, Zhongqiu Lu, Huaqin Sun, Jian Zhang, Zhiyi Wang, Haiya Wu, Xiangming Fang
BACKGROUND: Antimicrobial stewardship programs, particularly pharmacist-driven programs, help reduce the unnecessary use of antimicrobial agents. The objective of this study was to assess the influence of pharmacist-driven antimicrobial stewardship on antimicrobial use, multidrug resistance, and patient outcomes in adult intensive care units in China. METHOD: We conducted a multicenter prospective cohort study with a sample of 577 patients. A total of 353 patients were included under a pharmacist-driven antimicrobial stewardship program, whereas the remaining 224 patients served as controls...
June 5, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28540641/evaluation-of-penicillin-allergy-in-the-hospitalized-patient-opportunities-for-antimicrobial-stewardship
#13
REVIEW
Justin R Chen, David A Khan
PURPOSE OF REVIEW: Penicillin allergy is often misdiagnosed and is associated with adverse consequences, but testing is infrequently done in the hospital setting. This article reviews historical and contemporary innovations in inpatient penicillin allergy testing and its impact on antimicrobial stewardship. RECENT FINDINGS: Adoption of the electronic medical record allows rapid identification of admitted patients carrying a penicillin allergy diagnosis. Collaboration with clinical pharmacists and the development of computerized clinical guidelines facilitates increased testing and appropriate use of penicillin and related β-lactams...
June 2017: Current Allergy and Asthma Reports
https://www.readbyqxmd.com/read/28490386/pharmacists-familiarity-with-and-institutional-utilization-of-rapid-diagnostic-technologies-for-antimicrobial-stewardship
#14
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;38:863-866.
July 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28480231/an-interprofessional-curriculum-on-antimicrobial-stewardship-improves-knowledge-and-attitudes-toward-appropriate-antimicrobial-use-and-collaboration
#15
Conan MacDougall, Brian S Schwartz, Lisa Kim, Mari Nanamori, Sharmin Shekarchian, Peter V Chin-Hong
BACKGROUND: Inappropriate antimicrobial use can threaten patient safety and is the focus of collaborative physician and pharmacist antimicrobial stewardship teams. However, antimicrobial stewardship is not comprehensively taught in medical or pharmacy school curricula. Addressing this deficiency can teach an important concept as well as model interprofessional healthcare. METHODS: We created an antimicrobial stewardship curriculum consisting of an online learning module and workshop session that combined medical and pharmacy students, with faculty from both professions...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28470637/-antimicrobial-stewardship-in-daily-life-ask-your-doctor-and-your-pharmacist
#16
Anette Friedrichs, Bibiane Steinborn, Swantje Eisend
Antimicrobial Stewardship (AMS) cannot be practised as a one-man show. A well-established AMS-team with formal authority and dedicated time given by the hospital management can manage its tasks also in exceptional situations as for example an outbreak due to a multi-drug-resistant pathogen. Know-how of clinical infectious diseases is mandatory for all members of the AMS-team. The AMS-team plays various roles in an outbreak situation with the rational use of last-resort antibiotics and optimization of the dosage by therapeutic drug monitoring being most important...
April 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28459897/association-of-inpatient-antimicrobial-utilization-measures-with-antimicrobial-stewardship-activities-and-facility-characteristics-of-veterans-affairs-medical-centers
#17
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/28458296/effectiveness-of-a-computer-facilitated-pharmacist-driven-antimicrobial-stewardship-program-for-infection-management
#18
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
https://www.readbyqxmd.com/read/28395369/antibiotics-prescriptions-in-the-neonatal-intensive-care-unit-how-to-overcome-everyday-challenges
#19
D Donà, E Mozzo, V Mardegan, U Trafojer, P Lago, S Salvadori, E Baraldi, C Giaquinto
Antimicrobial prescriptions in neonatal intensive care units (NICUs) represent a point of concern for the emergence of MDROs and for morbidity associated with prolonged antibiotic exposure (e.g., invasive candidiasis, necrotizing enterocolitis, and late-onset sepsis). Antimicrobial stewardship programs (ASPs) have shown to be a valuable tool for the prevention of resistance with the goals of optimizing clinical outcomes while decreasing unnecessary prescribing. The most frequent ASP strategies include the correct collection and interpretation of microbiological specimens, prescription of the narrowest-spectrum antibiotic appropriate for a particular case, and de-escalation or discontinuation of therapy in defined situations...
April 10, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28379408/sharing-antimicrobial-reports-for-pediatric-stewardship-sharps-a-quality-improvement-collaborative
#20
Jason G Newland, Jeffrey S Gerber, Matthew P Kronman, Georgann Meredith, Brian R Lee, Cary Thurm, Adam L Hersh
Background.: Although many children's hospitals have established antimicrobial stewardship programs (ASPs), data-driven benchmarks for optimizing antimicrobial use across centers are lacking. We developed a multicenter quality improvement collaborative focused on sharing data reports and benchmarking antimicrobial use to improve antimicrobial prescribing among hospitalized children. Methods.: A national antimicrobial stewardship collaborative among children's hospitals, Sharing Antimicrobial Reports for Pediatric Stewardship (SHARPS), was established in 2013...
April 4, 2017: Journal of the Pediatric Infectious Diseases Society
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