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Antibiotic Stewardship (PROA)

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77 papers 0 to 25 followers Antibiotic Stewardship
https://www.readbyqxmd.com/read/28882723/antibiotic-stewardship-update-and-perspectives
#1
EDITORIAL
Céline Pulcini
No abstract text is available yet for this article.
September 4, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28882725/what-is-antimicrobial-stewardship
#2
REVIEW
Oliver J Dyar, Benedikt Huttner, Jeroen Schouten, Céline Pulcini
BACKGROUND: The use of the term "antimicrobial stewardship" (AMS) has grown exponentially in recent years, typically referring to programmes and interventions that aim to optimise antimicrobial use. Although AMS originated within human healthcare, it is increasingly applied in broader contexts including animal health and One Health. As the use of the term AMS becomes more common, it is important to consider what AMS is, as well as what it is not. AIMS: To review the emergence and evolution of the term "antimicrobial stewardship"...
September 4, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/27139473/a-multinational-preregistered-cohort-study-of-%C3%AE-lactam-%C3%AE-lactamase-inhibitor-combinations-for-treatment-of-bloodstream-infections-due-to-extended-spectrum-%C3%AE-lactamase-producing-enterobacteriaceae
#3
Belén Gutiérrez-Gutiérrez, Salvador Pérez-Galera, Elena Salamanca, Marina de Cueto, Esther Calbo, Benito Almirante, Pierluigi Viale, Antonio Oliver, Vicente Pintado, Oriol Gasch, Luis Martínez-Martínez, Johann Pitout, Murat Akova, Carmen Peña, José Molina, Alicia Hernández, Mario Venditti, Nuria Prim, Julia Origüen, German Bou, Evelina Tacconelli, Mario Tumbarello, Axel Hamprecht, Helen Giamarellou, Manel Almela, Federico Pérez, Mitchell J Schwaber, Joaquín Bermejo, Warren Lowman, Po-Ren Hsueh, Marta Mora-Rillo, Clara Natera, Maria Souli, Robert A Bonomo, Yehuda Carmeli, David L Paterson, Alvaro Pascual, Jesús Rodríguez-Baño
The spread of extended-spectrum-β-lactamase (ESBL)-producing Enterobacteriaceae (ESBL-E) is leading to increased carbapenem consumption. Alternatives to carbapenems need to be investigated. We investigated whether β-lactam/β-lactamase inhibitor (BLBLI) combinations are as effective as carbapenems in the treatment of bloodstream infections (BSI) due to ESBL-E. A multinational, retrospective cohort study was performed. Patients with monomicrobial BSI due to ESBL-E were studied; specific criteria were applied for inclusion of patients in the empirical-therapy (ET) cohort (ETC; 365 patients), targeted-therapy (TT) cohort (TTC; 601 patients), and global cohort (GC; 627 patients)...
July 2016: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/27104951/empiric-piperacillin-tazobactam-versus-carbapenems-in-the-treatment-of-bacteraemia-due-to-extended-spectrum-beta-lactamase-producing-enterobacteriaceae
#4
Tat Ming Ng, Wendy X Khong, Patrick N A Harris, Partha P De, Angela Chow, Paul A Tambyah, David C Lye
Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae are a common cause of bacteraemia in endemic countries and may be associated with high mortality; carbapenems are considered the drug of choice. Limited data suggest piperacillin-tazobactam could be equally effective. We aimed to compare 30-day mortality of patients treated empirically with piperacillin-tazobactam versus a carbapenem in a multi-centre retrospective cohort study in Singapore. Only patients with active empiric monotherapy with piperacillin-tazobactam or a carbapenem were included...
2016: PloS One
https://www.readbyqxmd.com/read/28850804/emerging-microtechnologies-and-automated-systems-for-rapid-bacterial-identification-and-antibiotic-susceptibility-testing
#5
Yiyan Li, Xing Yang, Weian Zhao
Rapid bacterial identification (ID) and antibiotic susceptibility testing (AST) are in great demand due to the rise of drug-resistant bacteria. Conventional culture-based AST methods suffer from a long turnaround time. By necessity, physicians often have to treat patients empirically with antibiotics, which has led to an inappropriate use of antibiotics, an elevated mortality rate and healthcare costs, and antibiotic resistance. Recent advances in miniaturization and automation provide promising solutions for rapid bacterial ID/AST profiling, which will potentially make a significant impact in the clinical management of infectious diseases and antibiotic stewardship in the coming years...
August 1, 2017: SLAS Technology
https://www.readbyqxmd.com/read/28842518/formalization-of-an-antimicrobial-stewardship-program-in-a-small-community-hospital
#6
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/28711319/procalcitonin-guided-antibiotic-stewardship-from-newborns-to-centennials
#7
Philipp Schuetz, Beat Mueller
No abstract text is available yet for this article.
August 26, 2017: Lancet
https://www.readbyqxmd.com/read/28717037/impact-of-a-carbapenem-antimicrobial-stewardship-program-on-patient-outcomes
#8
Valerie Xue Fen Seah, Rina Yue Ling Ong, Ashley Shi Yuan Lim, Chia Yin Chong, Natalie Woon Hui Tan, Koh Cheng Thoon
Antimicrobial stewardship programs (ASPs) aim to improve appropriate antimicrobial use. However, concerns of the negative consequences from accepting ASP interventions exist, particularly when deescalation or discontinuation of broad-spectrum antibiotics is recommended. Hence, we sought to evaluate the impact on clinical outcomes when ASP interventions for inappropriate carbapenem use were accepted or rejected by primary providers. We retrospectively reviewed all carbapenem prescriptions deemed inappropriate according to institutional guidelines with ASP interventions between July 2011 and December 2014...
September 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28629876/effect-of-antibiotic-stewardship-on-the-incidence-of-infection-and-colonisation-with-antibiotic-resistant-bacteria-and-clostridium-difficile-infection-a-systematic-review-and-meta-analysis
#9
REVIEW
David Baur, Beryl Primrose Gladstone, Francesco Burkert, Elena Carrara, Federico Foschi, Stefanie Döbele, Evelina Tacconelli
BACKGROUND: Antibiotic stewardship programmes have been shown to reduce antibiotic use and hospital costs. We aimed to evaluate evidence of the effect of antibiotic stewardship on the incidence of infections and colonisation with antibiotic-resistant bacteria. METHODS: For this systematic review and meta-analysis, we searched PubMed, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and Web of Science for studies published from Jan 1, 1960, to May 31, 2016, that analysed the effect of antibiotic stewardship programmes on the incidence of infection and colonisation with antibiotic-resistant bacteria and Clostridium difficile infections in hospital inpatients...
September 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28637307/sparing-carbapenem-usage
#10
A Peter R Wilson
Background: Carbapenem resistance in Gram-negative bacteria is increasing in many countries and use of carbapenems and antibiotics to which resistance is linked should be reduced to slow its emergence. There are no directly equivalent antibiotics and the alternatives are less well supported by clinical trials. The few new agents are expensive. Objectives: To provide guidance on strategies to reduce carbapenem usage. Methods: A literature review was performed as described in the BSAC/HIS/BIA/IPS Joint Working Party on Multiresistant Gram-negative Infection Report...
September 1, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28362938/the-use-of-noncarbapenem-%C3%AE-lactams-for-the-treatment-of-extended-spectrum-%C3%AE-lactamase-infections
#11
Pranita D Tamma, Jesus Rodriguez-Bano
The continued rise in infections caused by extended-spectrum β-lactamase (ESBL)-producing pathogens is recognized globally as one of the most pressing concerns facing the healthcare community. Carbapenems are widely regarded as the antibiotics of choice for the treatment of ESBL-producing infections, even when in vitro activity to other β-lactams has been demonstrated. However, indiscriminant carbapenem use is not without consequence, and carbapenem overuse has contributed to the emergence of carbapenem-resistant Enterobacteriaceae...
April 1, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28483315/addressing-inpatient-beta-lactam-allergies-a-multihospital-implementation
#12
REVIEW
Kimberly G Blumenthal, Erica S Shenoy, Anna R Wolfson, David N Berkowitz, Victoria A Carballo, Diana S Balekian, Kathleen A Marquis, Ramy Elshaboury, Ronak G Gandhi, Praveen Meka, David W Kubiak, Jennifer Catella, Barbara B Lambl, Joyce T Hsu, Monique M Freeley, Alana Gruszecki, Paige G Wickner
Addressing inaccurate penicillin allergies is encouraged as part of antibiotic stewardship in the inpatient setting. However, implementing interventions targeted at the 10% to 15% of inpatients reporting a previous penicillin allergy can pose substantial logistic challenges. We implemented a computerized guideline for patients with reported beta-lactam allergy at 5 hospitals within a single health care system in the Boston area. In this article, we describe our implementation roadmap, including both successes achieved and challenges faced...
May 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28443360/overview-of-procalcitonin-assays-and-procalcitonin-guided-protocols-for-the-management-of-patients-with-infections-and-sepsis
#13
Philipp Schuetz, Celine Bretscher, Luca Bernasconi, Beat Mueller
Procalcitonin is a surrogate infection blood marker whose levels help estimate the likelihood of bacterial infections and correlate with their resolution. Recent trials have revealed the benefits of inclusion of procalcitonin in antibiotic stewardship protocols for initiation and discontinuation of antimicrobial therapy. Areas covered: Procalcitonin-guided antibiotic stewardship protocols have shown appreciable reductions in antibiotic use and duration of therapy in respiratory infections, sepsis, and other infections, with positive effects on clinical outcomes...
June 2017: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/28459912/moving-antibiotic-stewardship-from-theory-to-practice
#14
EDITORIAL
Payal K Patel, Arjun Srinivasan
No abstract text is available yet for this article.
May 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28472291/antibiotic-stewardship-in-small-hospitals-barriers-and-potential-solutions
#15
Edward Stenehjem, David Y Hyun, Ed Septimus, Kalvin C Yu, Marc Meyer, Deepa Raj, Arjun Srinivasan
Antibiotic stewardship programs (ASPs) improve antibiotic prescribing. 73% of United States (US) hospitals have < 200 beds. Small hospitals (< 200 beds) have similar rates of antibiotic prescribing compared to large hospitals but the majority of small hospitals lack ASPs that satisfy the Centers for Disease Control and Prevention's (CDC) core elements. All hospitals, regardless of size, are now required to have ASPs by The Joint Commission and the Centers for Medicare and Medicaid Services has proposed a similar requirement...
May 2, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28350902/the-role-of-stewardship-in-addressing-antibacterial-resistance-stewardship-and-infection-control-committee-of-the-antibacterial-resistance-leadership-group
#16
Deverick J Anderson, Timothy C Jenkins, Scott R Evans, Anthony D Harris, Robert A Weinstein, Pranita D Tamma, Jennifer H Han, Ritu Banerjee, Robin Patel, Theoklis Zaoutis, Ebbing Lautenbach
Antibacterial resistance is increasing globally and has been recognized as a major public health threat. Antibacterial stewardship is the coordinated effort to improve the appropriate use of antibiotics with the aim to decrease selective pressure for multidrug-resistant organisms in order to preserve the utility of antibacterial agents. This article describes the activities of the Antibacterial Resistance Leadership Group (ARLG) in the area of antibacterial stewardship. To date, the ARLG has focused intensely on development of rapid diagnostic tests, which (when coupled with educational and institutional initiatives) will enable the robust stewardship that is needed to address the current crisis of antibacterial resistance...
March 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28353185/pk-pd-compass-bringing-infectious-diseases-pharmacometrics-to-the-patient-s-bedside
#17
Catharine C Bulik, Justin C Bader, Li Zhang, Scott A Van Wart, Christopher M Rubino, Sujata M Bhavnani, Kim L Sweeney, Paul G Ambrose
Antimicrobial stewardship programs face many challenges, one of which is a lack of guidance regarding antimicrobial dose, interval, and duration. There is no tool that considers patient demographic, pathogen susceptibility, and pharmacokinetic-pharmacodynamic (PK-PD) targets for efficacy in order to evaluate appropriate antimicrobial dosing regimens. The PK-PD Compass, an educational mobile application, was developed to address this unmet need. The application consists of a Monte Carlo simulation algorithm which integrates pharmacokinetic (PK) and PK-PD data, patient-specific characteristics, and pathogen susceptibility data...
April 2017: Journal of Pharmacokinetics and Pharmacodynamics
https://www.readbyqxmd.com/read/28365884/de-escalating-antibiotic-use-in-the-inpatient-setting-strategies-controversies-and-challenges
#18
REVIEW
J Daniel Markley, Shaina Bernard, Gonzalo Bearman, Michael P Stevens
PURPOSE OF REVIEW: Antibiotic de-escalation (ADE) is widely accepted as an integral strategy to curtail the global antibiotic resistance crisis. However, there is significant uncertainty regarding the ideal ADE strategy and its true impact on antibiotic resistance. Rapid diagnostic testing has the potential to enhance ADE strategies. Herein, we aim to discuss the current strategies, controversies, and challenges of ADE in the inpatient setting. RECENT FINDINGS: A consensus definition of ADE remains elusive at this time...
April 2017: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/28370003/clinical-outcomes-following-inpatient-penicillin-allergy-testing-a-systematic-review-and-meta-analysis
#19
REVIEW
K A Sacco, A Bates, T J Brigham, J S Imam, M C Burton
BACKGROUND: A documented penicillin allergy is associated with increased morbidity including length of hospital stay and an increased incidence of resistant infections attributed to use of broader-spectrum antibiotics. The aim of the systematic review was to identify whether inpatient penicillin allergy testing affected clinical outcomes during hospitalization. METHODS: We performed an electronic search of Ovid MEDLINE/PubMed, Embase, Web of Science, Scopus, and the Cochrane Library over the past 20 years...
September 2017: Allergy
https://www.readbyqxmd.com/read/28285740/fight-antibiotic-resistance-it-s-in-your-hands-to-improve-antibiotic-stewardship
#20
EDITORIAL
A Bashir, J Gray
No abstract text is available yet for this article.
April 2017: Journal of Hospital Infection
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