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Antimicrobial stewardship regional

Wen-Juan Zhou, Zhen-Ni Luo, Chang-Min Tang, Xiao-Xu Zou, Lu Zhao, Peng-Qian Fang
The improvement of antibiotic rational use in China was studied by usage analysis of combination antibiotic therapy for type I incisions in 244 hospitals. Five kinds of hospitals, including general hospital, maternity hospital, children's hospital, stomatological hospital and cancer hospital, from 30 provinces were surveyed. A systematic random sampling strategy was employed to select outpatient prescriptions and inpatient cases in 2011 and 2012. A total of 29 280 outpatient prescriptions and 73 200 inpatient cases from 244 hospitals in each year were analyzed...
October 2016: Journal of Huazhong University of Science and Technology. Medical Sciences
F J Candel, A B García-García, M Peñuelas, A García-Alvarez, F Chiarella, L López-González, C García-Salguero, C Lejárraga, I Rodríguez-Avial
Antimicrobial resistance increases it health, social and economic impact. in all areas (state, regional and local), initiatives to try to contain the problem of resistance arise. In the update of this year 2016, we study microbiological, epidemiological and clinical aspects of multi-resistant bacteria, as well as resources for therapeutic approach, from ancient to modern drugs from therapeutic combinations to optimization Stewardship programs. In the case of fungal infection, we analyze clinical scenarios with different species in yeast or new clinical settings in filamentous fungi...
September 2016: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
Javier Fernández, Frédéric Bert, Marie-Hélène Nicolas-Chanoine
Antimicrobial resistance has become a major global public health security problem that needs coordinated approaches at regional, national and international levels. Antibiotic overuse and the failure of control measures to prevent the spread of resistant bacteria in the healthcare environment have led to an alarming increase in the number of infections caused by resistant bacteria, organisms that resist many (multi-drug and extensively drug-resistant strains), if not all (pan-drug-resistant bacteria) currently available antibiotics...
November 2016: Journal of Hepatology
Michael Y Lin, William E Trick
Informatics tools are becoming integral to routine infection control activities. Informatics has the potential to improve infection control outcomes in surveillance, prevention, and connections with public health. Surveillance activities include fully or semiautomated surveillance of infections, surveillance of device use, and hospital/ward outbreak investigation. Prevention activities include awareness of multidrug-resistant organism carriage on admission, enhanced interfacility communication, identifying inappropriate infection precautions, reducing device use, and antimicrobial stewardship...
September 2016: Infectious Disease Clinics of North America
Nobuo Murakami
In order to provide safe and secure medical care for patients, health care-associated infections (HAI) must not occur. HAI should be considered as incidents, and countermeasures should be viewed as a patient safety management itself. Healthcare-associated infection control (HAIC) is practiced by the infection control team (ICT), which is based on multidisciplinary cooperation. Team members have to recognize that it is the most important to make use of the expertise of each discipline. In addition, all members must try to respond quickly, to help the clinic staff...
March 2016: Rinsho Byori. the Japanese Journal of Clinical Pathology
Yu A Belkova, S A Rachina, R S Kozlov, V M Mishchenko, R A Pavlukov, A I Abubakirova, B V Berezhanskiy, E V Eliseeva, N A Zubareva, I A Karpov, I A Kopylova, Sh Kh Palyutin, U S Portnyagina, O V Pribytkova, E K Samuylo
The results of the systemic antimicrobials (AM) consumption and expenditures assessment in the departments of surgery of multi-profile hospitals in different regions of the Russian Federation and the Republic of Belarus in 2009-2010 based on retrospective collection and analysis of the data from the hospital expenditure notes using ATC/DDD methodology are presented. The average AM consumption and expenditure rates in the above mentioned departments varied from 24.9 DDD/100 bed-days to 61.7 DDD/100 bed-days depending on the department profile, with beta-lactams (cephalosporins and penicillins) share in the consumption being as high as 70-90%, followed by fluoroquinolones and aminoglycosides...
2016: Antibiotiki i Khimioterapii︠a︡, Antibiotics and Chemoterapy [sic]
J Ugalde-Espiñeira, J Bilbao-Aguirregomezcorta, A Z Sanjuan-López, C Floristán-Imízcoz, L Elorduy-Otazua, M Viciola-García
OBJECTIVE: Programs for optimizing the use of antibiotics (PROA) or antimicrobial stewardship programs are multidisciplinary programs developed in response to the increase of antibiotic resistant bacteria, the objective of which are to improve clinical results, to minimize adverse events and to reduce costs associated with the use of antimicrobials. The implementation of a PROA program in a 128-bed general hospital and the results obtained at 6 months are here reported. METHODS: An intervention quasi-experimental study with historical control group was designed with the objective of assessing the impact of a PROA program with a non-restrictive intervention model to help prescription, with a direct and bidirectional intervention...
August 2016: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
P Benedetti, A M Sefton, M Menegozzo, C Guerriero, G Bordignon, G Da Rin, C Romualdi, G Pellizzer, D M Livermore
International - predominantly American - studies undertaken in the ICUs of teaching centres show that inadequate antibiotic therapy increases mortality and length of stay. We sought to ascertain whether this also pertains to smaller ICUs in the Veneto region of north-east Italy. To the best of our knowledge, this is the first such survey in the Veneto area or in Italy as a whole. A retrospective, observational study was performed across five general-hospital ICUs to examine appropriateness of microbiological sampling, empirical antibiotic adequacy, and outcomes...
October 2016: European Journal of Clinical Microbiology & Infectious Diseases
Stuart E Bond, Craig S Boutlis, Stuart G Jansen, Spiros Miyakis
BACKGROUND: Gentamicin has historically been used prior to insertion and removal of indwelling urinary catheters (IDCs) around elective joint replacement surgery to prevent infection; however, this indication is not recognized in the Australian Therapeutic Guidelines: Antibiotic and the paradigm for safe use of gentamicin has shifted. METHODS: The antimicrobial stewardship team of a 500 bed tertiary regional hospital performed a retrospective clinical study of gentamicin IDC prophylaxis around total hip and knee arthroplasties...
June 3, 2016: ANZ Journal of Surgery
Dean Ironmonger, Obaghe Edeghere, Savita Gossain, Peter M Hawkey
BACKGROUND: There is a marked variation in both antibiotic prescribing practice and urine sampling rates for diagnostic microbiology across general practices in England. To help understand factors driving this variation, we undertook a survey in 2012/13 to determine sampling protocols and antibiotic formularies used by general practitioners (GPs) for managing urinary tract infections (UTIs) in the West Midlands region of England. METHOD: Cross-sectional survey of all eligible general practices in the West Midlands region of England undertaken in November 2012...
2016: BMC Infectious Diseases
Nuntra Suwantarat, Karen C Carroll
BACKGROUND: Multidrug-resistant Gram-negative bacteria (MDRGN), including extended-spectrum β-lactamases (ESBLs) and multidrug-resistant glucose-nonfermenting Gram-negative bacilli (nonfermenters), have emerged and spread throughout Southeast Asia. METHODS: We reviewed and summarized current critical knowledge on the epidemiology and molecular characterization of MDRGN in Southeast Asia by PubMed searches for publications prior to 10 March 2016 with the term related to "MDRGN definition" combined with specific Southeast Asian country names (Thailand, Singapore, Malaysia, Vietnam, Indonesia, Philippines, Laos, Cambodia, Myanmar, Brunei)...
2016: Antimicrobial Resistance and Infection Control
Kevin A Brown, Makoto Jones, Nick Daneman, Frederick R Adler, Vanessa Stevens, Kevin E Nechodom, Matthew B Goetz, Matthew H Samore, Jeanmarie Mayer
BACKGROUND: Although clinical factors affecting a person's susceptibility to Clostridium difficile infection are well-understood, little is known about what drives differences in incidence across long-term care settings. OBJECTIVE: To obtain a comprehensive picture of individual and regional factors that affect C difficile incidence. DESIGN: Multilevel longitudinal nested case-control study. SETTING: Veterans Health Administration health care regions, from 2006 through 2012...
June 21, 2016: Annals of Internal Medicine
Jan-Willem H Dik, Ron Hendrix, Randy Poelman, Hubert G Niesters, Maarten J Postma, Bhanu Sinha, Alexander W Friedrich
Antimicrobial Stewardship Programs (ASPs) are being implemented worldwide to optimize antimicrobial therapy, and thereby improve patient safety and quality of care. Additionally, this should counteract resistance development. It is, however, vital that correct and timely diagnostics are performed in parallel, and that an institution runs a well-organized infection prevention program. Currently, there is no clear consensus on which interventions an ASP should comprise. Indeed this depends on the institution, the region, and the patient population that is served...
June 2016: Expert Review of Anti-infective Therapy
Mario Morgenstern, Christoph Erichsen, Simon Hackl, Julia Mily, Matthias Militz, Jan Friederichs, Sven Hungerer, Volker Bühren, T Fintan Moriarty, Virginia Post, R Geoff Richards, Stephen L Kates
Nasal colonization with antibiotic resistant bacteria represents both a risk factor for the colonized individual and their immediate contacts. Despite the fact that healthcare workers such as orthopedic surgeons are at a critical interface between the healthcare environment and an at-risk patient population, the prevalence of antibiotic resistant bacteria within the surgical profession remains unclear. This study offers a snapshot of the rate of nasal colonization of orthopedic surgeons with multi-resistant staphylococci including methicillin-resistant S...
2016: PloS One
Charlie Tan, Michael Ritchie, Jason Alldred, Nick Daneman
OBJECTIVES: Antibiotic purchasing data are a widely used, but unsubstantiated, measure of antibiotic consumption. To validate this source, we compared purchasing data from hospitals and external medical databases with patient-level dispensing data. METHODS: Antibiotic purchasing and dispensing data from internal hospital records and purchasing data from IMS Health were obtained for two hospitals between May 2013 and April 2015. Internal purchasing data were validated against dispensing data, and IMS data were compared with both internal metrics...
February 2016: Journal of Antimicrobial Chemotherapy
David Morquin, Yatrika Koumar, Roxana Ologeanu-Taddei, Jean Bousquet, Rodolphe Bourret, Jacques Reynes
Improvements in the optimal use of antibiotics is the cornerstone of the French national point-of-care alert for antibiotics (2011-2016). Integrated electronic medical records for antibiotic prescriptions have been deployed in the Montpellier University Hospital (2,800 beds) since 2012. The present paper proposes an overview of integrated electronic medical records for antibiotic prescriptions and how telecounselling at the Montpellier Hospital fits with the global anti-infection ICT strategy. This management change is fully traceable...
2014: World Hospitals and Health Services: the Official Journal of the International Hospital Federation
Timothy Lawes, José-María Lopez-Lozano, Cesar A Nebot, Gillian Macartney, Rashmi Subbarao-Sharma, Ceri Rj Dare, Karen D Wares, Ian M Gould
BACKGROUND: Restriction of antibiotic consumption to below predefined total use thresholds might remove the selection pressure that maintains antimicrobial resistance within populations. We assessed the effect of national antibiotic stewardship and infection prevention and control programmes on prevalence density of meticillin-resistant Staphylococcus aureus (MRSA) infections across a region of Scotland. METHODS: This non-linear time-series analysis and quasi-experimental study explored ecological determinants of MRSA epidemiology among 1,289,929 hospital admissions and 455,508 adults registered in primary care in northeast Scotland...
December 2015: Lancet Infectious Diseases
P-M Roger, J Courjon, S Léotard, C Déchamp, N Négrin, M Vassallo
Recent data indicate that both the overall numbers of antibiotic prescription and the frequency of multidrug-resistant bacteria are increasing significantly. These threatening features are observed, despite national antimicrobial stewardship (AMS) policies aimed at decreasing antibiotic use. AMS should also focus on the initial steps leading to antibiotic prescription. Physicians and their patients should benefit from the structured clinical pathways, the latter being adapted to regional epidemiological data and resources...
November 2015: European Journal of Clinical Microbiology & Infectious Diseases
Bin Cao, Jiu-Xin Qu, Yu-Dong Yin, Johan Van Eldere
BACKGROUND AND AIMS: Community-acquired pneumonia (CAP) is a common infectious disease affecting children and adults of any age. Mycoplasma pneumoniae has emerged as leading causative agent of CAP in some region, and the abrupt increasing resistance to macrolide that widely used for management of M. pneumoniae has reached to the level that it often leads to treatment failures. OBJECTIVE: We aim to discuss the drivers for development of macrolide-resistant M. pneumoniae, antimicrobial stewardship and also the potential treatment options for patients infected with macrolide-resistant M...
September 14, 2015: Clinical Respiratory Journal
Jan-Willem H Dik, Randy Poelman, Alexander W Friedrich, Prashant Nannan Panday, Jerome R Lo-Ten-Foe, Sander van Assen, Julia E W C van Gemert-Pijnen, Hubert G M Niesters, Ron Hendrix, Bhanu Sinha
Considering the threat of antimicrobial resistance and the difficulties it entails in treating infections, it is necessary to cross borders and approach infection management in an integrated, multidisciplinary manner. We propose the antimicrobial, infection prevention and diagnostic stewardship model comprising three intertwined programs: antimicrobial, infection prevention and diagnostic stewardship, involving all stakeholders. The focus is a so-called 'theragnostics' approach. This leads to a personalized infection management plan, improving patient care and minimizing resistance development...
2016: Future Microbiology
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