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Antibiotic Stewardship (PROA)

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42 papers 0 to 25 followers Antibiotic Stewardship
https://www.readbyqxmd.com/read/27844028/how-to-pitch-an-antibiotic-stewardship-program-to-the-hospital-c-suite
#1
REVIEW
Brad Spellberg, John G Bartlett, David N Gilbert
Hospitals will soon require antibiotic stewardship programs. Infectious diseases specialists must craft business plans to engage hospital leadership to fund such programs. In this article, we review key cost and revenue elements that should be covered in such plans. Society is placing increasing emphasis on the importance of antimicrobial stewardship programs (ASPs). New regulatory standards require hospitals to implement ASPs. Infectious Diseases (ID) specialists will need to help design and implement such programs at hospitals...
October 2016: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/27859453/past-present-and-future-of-antibacterial-economics-increasing-bacterial-resistance-limited-antibiotic-pipeline-and-societal-implications
#2
Katherine H Luepke, Katie J Suda, Helen Boucher, Rene L Russo, Michael W Bonney, Timothy D Hunt, John F Mohr
Growing antimicrobial resistance and a dwindling antibiotic pipeline has resulted in an emerging postantibiotic era, as patients are now dying from bacterial infections that were once treatable. The fast-paced "Golden Age" of antibiotic development that started in the 1940s has lost momentum, as from the 1980s to the early 2000s, there was a 90% decline in approval of new antibiotics as well as discovery of few new novel classes. Many companies have shifted away from development due to scientific, regulatory, and economic hurdles that proved antibiotic development to be less attractive compared with more lucrative therapeutic areas...
November 12, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27880718/contribution-of-jac-to-antimicrobial-stewardship
#3
REVIEW
Alan P Johnson
Antimicrobial stewardship programmes are increasingly being used to improve the quality of antimicrobial prescribing, with the dual aim of optimizing clinical outcomes and minimizing the emergence and spread of antimicrobial resistance. The Journal of Antimicrobial Chemotherapy (JAC) is celebrating its 40th anniversary and, as part of activities to commemorate this event, this article highlights the contribution of JAC to antimicrobial stewardship. Papers published in JAC have contributed to the evidence base for stewardship, have highlighted educational and behavioural change initiatives aimed at improving antibiotic prescribing practice, and have actively sought to foster the practice of antimicrobial stewardship amongst its readers...
November 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27608314/-the-role-of-antimicrobial-stewardship-programs-in-the-control-of-bacterial-resistance
#4
REVIEW
J Pasquau, S Sadyrbaeva, S E De Jesús, C Hidalgo-Tenorio
In order to improve infection prognosis and reduce the existing microbial resistance problem (a challenge similar to that of climate change), a higher implication of the Administration, an increased level of social awareness and the development of specific corporate networks, including the pharmaceutical industry, is needed. However, we must first consolidate Antimicrobial Stewardship Programmes with experts who seek to improve antibiotic therapy effectivity in severe infections and to reduce global antibiotic exposure...
September 2016: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/27621341/optimizing-antibiotic-use-in-nursing-homes-through-antibiotic-stewardship
#5
Philip D Sloane, Kirk Huslage, Christine E Kistler, Sheryl Zimmerman
Antibiotic stewardship is becoming a requirement for nursing homes. Programs should be interdisciplinary and multifaceted; should have support from nursing home administrators; and should aim to promote antibiotics only when needed, not just in case. Recommended components include use of evidence-based guidelines; ongoing monitoring of antibiotic prescriptions, cultures, and study results; monitoring of health outcomes; use of nursing home-specific antibiograms; regular reporting and feedback to medical providers and nurses; and education of residents and families...
September 2016: North Carolina Medical Journal
https://www.readbyqxmd.com/read/27584587/the-management-of-multidrug-resistant-enterobacteriaceae
#6
Matteo Bassetti, Maddalena Peghin, Davide Pecori
PURPOSE OF REVIEW: Multidrug-resistant (MDR) Enterobacteriaceae are often related to the production of extended-spectrum b-lactamases (ESBLs) and carbapenemase-producing Enterobacteriaceae (CRE), and represent an increasing global threat. Recommendations for the therapeutic management of MDR-related infections, however, are mainly derived from retrospective and nonrandomized prospective studies. The aim of this review is to discuss the challenges in the treatment of patients with infections because of MDR Enterobacteriaceae and provide an expert opinion while awaiting for more definitive data...
December 2016: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/27515147/antimicrobial-stewardship-for-the-infection-control-practitioner
#7
REVIEW
Jerod L Nagel, Keith S Kaye, Kerry L LaPlante, Jason M Pogue
Antibiotic misuse is a serious patient safety concern and a national public health priority. Years of indiscriminant antibiotic use has promoted selection for antibiotic resistant bacteria and Clostridium difficile This crisis has led to clinicians being faced with managing untreatable infections, often in the most vulnerable patient populations. This review summarizes the goals of antimicrobial stewardship programs, the essential members needed to initiate a program, various antimicrobial stewardship strategies, the role of the infection control practitioner in stewardship, barriers to its implementation and maintenance, approaches to measure the impact of a program, and the steps needed to initiate a program...
September 2016: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/27494918/antimicrobial-stewardship-in-wound-care-a-position-paper-from-the-british-society-for-antimicrobial-chemotherapy-and-european-wound-management-association
#8
REVIEW
Benjamin A Lipsky, Matthew Dryden, Finn Gottrup, Dilip Nathwani, Ronald Andrew Seaton, Jan Stryja
BACKGROUND: With the growing global problem of antibiotic resistance it is crucial that clinicians use antibiotics wisely, which largely means following the principles of antimicrobial stewardship (AMS). Treatment of various types of wounds is one of the more common reasons for prescribing antibiotics. OBJECTIVES: This guidance document is aimed at providing clinicians an understanding of: the basic principles of why AMS is important in caring for patients with infected wounds; who should be involved in AMS; and how to conduct AMS for patients with infected wounds...
November 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27498601/sustained-impact-of-an-antibiotic-stewardship-intervention-for-community-acquired-pneumonia
#9
David X Li, Marcela A Ferrada, Edina Avdic, Pranita D Tamma, Sara E Cosgrove
Antibiotic stewardship interventions targeting community-acquired pneumonia have been successful in reducing antibiotic overuse in the short term, but the sustainability of their effects has not been investigated. We report that improvements in antibiotic use due to a syndrome-focused intervention for community-acquired pneumonia were sustained 3 years later without additional intervention. Infect Control Hosp Epidemiol 2016;1-4.
October 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27502752/ten-key-points-for-the-appropriate-use-of-antibiotics-in-hospitalised-patients-a-consensus-from-the-antimicrobial-stewardship-and-resistance-working-groups-of-the-international-society-of-chemotherapy
#10
REVIEW
Gabriel Levy Hara, Souha S Kanj, Leonardo Pagani, Lilian Abbo, Andrea Endimiani, Heiman F L Wertheim, Carlos Amábile-Cuevas, Pierre Tattevin, Shaheen Mehtar, Fernando Lopes Cardoso, Serhat Unal, Ian Gould
The Antibiotic Stewardship and Resistance Working Groups of the International Society for Chemotherapy propose ten key points for the appropriate use of antibiotics in hospital settings. (i) Get appropriate microbiological samples before antibiotic administration and carefully interpret the results: in the absence of clinical signs of infection, colonisation rarely requires antimicrobial treatment. (ii) Avoid the use of antibiotics to 'treat' fever: use them to treat infections, and investigate the root cause of fever prior to starting treatment...
September 2016: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/27184564/advances-in-antibiotic-therapy-in-the-critically-ill
#11
REVIEW
Jean-Louis Vincent, Matteo Bassetti, Bruno François, George Karam, Jean Chastre, Antoni Torres, Jason A Roberts, Fabio S Taccone, Jordi Rello, Thierry Calandra, Daniel De Backer, Tobias Welte, Massimo Antonelli
Infections occur frequently in critically ill patients and their management can be challenging for various reasons, including delayed diagnosis, difficulties identifying causative microorganisms, and the high prevalence of antibiotic-resistant strains. In this review, we briefly discuss the importance of early infection diagnosis, before considering in more detail some of the key issues related to antibiotic management in these patients, including controversies surrounding use of combination or monotherapy, duration of therapy, and de-escalation...
May 17, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27329228/antibiotic-strategies-in-the-era-of-multidrug-resistance
#12
REVIEW
George Karam, Jean Chastre, Mark H Wilcox, Jean-Louis Vincent
The rapid emergence and dissemination of antibiotic-resistant microorganisms in ICUs worldwide threaten adequate antibiotic coverage of infected patients in this environment. The causes of this problem are multifactorial, but the core issues are clear: the emergence of antibiotic resistance is highly correlated with selective pressure resulting from inappropriate use of these drugs. Because a significant increase in mortality is observed when antibiotic therapy is delayed in infected ICU patients, initial therapy should be broad enough to cover all likely pathogens...
June 22, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27385708/antimicrobial-stewardship-in-the-microbiology-laboratory-impact-of-selective-susceptibility-reporting-on-ciprofloxacin-utilization-and-susceptibility-of-gram-negative-isolates-to-ciprofloxacin-in-a-hospital-setting
#13
B J Langford, J Seah, A Chan, M Downing, J Johnstone, L M Matukas
The objective of this study was to determine the impact of selective susceptibility reporting on ciprofloxacin utilization and Gram-negative susceptibility to ciprofloxacin in a hospital setting. Historically at our institution, the microbiology laboratory practice was to report ciprofloxacin susceptibility for all Enterobacteriaceae regardless of susceptibility to other agents. A selective reporting policy was implemented which involved the suppression of ciprofloxacin susceptibility to Enterobacteriaceae when there was lack of resistance to the antibiotics on the Gram-negative panel...
September 2016: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/27394025/infections-in-nursing-homes-epidemiology-and-prevention-programs
#14
REVIEW
Ana Montoya, Marco Cassone, Lona Mody
This review summarizes current literature pertaining to infection prevention in nursing home population including post-acute care patients and long-term care residents. Approximately 2 million infections occur each year and more than one-third of older adults harbor multidrug-resistant organisms in this setting. Surveillance, hand hygiene, isolation precautions, resident and employee health programs, education, and antibiotic stewardship are essential elements of infection prevention and control programs in nursing homes...
August 2016: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/27118828/executive-summary-implementing-an-antibiotic-stewardship-program-guidelines-by-the-infectious-diseases-society-of-america-and-the-society-for-healthcare-epidemiology-of-america
#15
Tamar F Barlam, Sara E Cosgrove, Lilian M Abbo, Conan MacDougall, Audrey N Schuetz, Edward J Septimus, Arjun Srinivasan, Timothy H Dellit, Yngve T Falck-Ytter, Neil O Fishman, Cindy W Hamilton, Timothy C Jenkins, Pamela A Lipsett, Preeti N Malani, Larissa S May, Gregory J Moran, Melinda M Neuhauser, Jason G Newland, Christopher A Ohl, Matthew H Samore, Susan K Seo, Kavita K Trivedi
Evidence-based guidelines for implementation and measurement of antibiotic stewardship interventions in inpatient populations including long-term care were prepared by a multidisciplinary expert panel of the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. The panel included clinicians and investigators representing internal medicine, emergency medicine, microbiology, critical care, surgery, epidemiology, pharmacy, and adult and pediatric infectious diseases specialties...
May 15, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/27098167/approaches-to-modifying-the-behavior-of-clinicians-who-are-noncompliant-with-antimicrobial-stewardship-program-guidelines
#16
Ellie J C Goldstein, Debra A Goff, William Reeve, Snezana Naumovski, Erin Epson, Jonathan Zenilman, Keith S Kaye, Thomas M File
Antimicrobial stewardship programs (ASPs) are a key national initiative to promote appropriate use of antibiotics and to reduce the burden of resistance. The dilemma of managing the outlier physician is especially complex. We outline strategies to establish a successful ASP that reviews appropriate efforts to achieve the goal of modifying outlier physicians' behavior. One must try to differentiate deviation from ASP norms from all other issues of outliers. Essential elements include identifying and understanding the local problems, planning, and achieving hospital administration and medical staff support...
August 15, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/27080992/implementing-an-antibiotic-stewardship-program-guidelines-by-the-infectious-diseases-society-of-america-and-the-society-for-healthcare-epidemiology-of-america
#17
Tamar F Barlam, Sara E Cosgrove, Lilian M Abbo, Conan MacDougall, Audrey N Schuetz, Edward J Septimus, Arjun Srinivasan, Timothy H Dellit, Yngve T Falck-Ytter, Neil O Fishman, Cindy W Hamilton, Timothy C Jenkins, Pamela A Lipsett, Preeti N Malani, Larissa S May, Gregory J Moran, Melinda M Neuhauser, Jason G Newland, Christopher A Ohl, Matthew H Samore, Susan K Seo, Kavita K Trivedi
Evidence-based guidelines for implementation and measurement of antibiotic stewardship interventions in inpatient populations including long-term care were prepared by a multidisciplinary expert panel of the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. The panel included clinicians and investigators representing internal medicine, emergency medicine, microbiology, critical care, surgery, epidemiology, pharmacy, and adult and pediatric infectious diseases specialties...
May 15, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/26914942/new-societal-approaches-to-empowering-antibiotic-stewardship
#18
Brad Spellberg, Arjun Srinivasan, Henry F Chambers
No abstract text is available yet for this article.
March 22, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/26809591/decreased-antimicrobial-resistance-and-defined-daily-doses-after-implementation-of-a-clinical-culture-guided-antimicrobial-stewardship-program-in-a-local-hospital
#19
Chang-Teng Wu, Chyi-Liang Chen, Hao-Yuan Lee, Chee-Jen Chang, Pi-Yu Liu, Chin-Ying Li, Ming-Ying Liu, Chien-Hsisung Liu
BACKGROUND: We aimed to report the implementation of an antimicrobial stewardship program (ASP) guided by clinically significant cultures in a hospital to assess its pharmaceutical, microbiological, financial, and outcome effects. METHODS: A 3-year cohort study of an antimicrobial restriction policy implementation was performed. The ASP with culture-guided de-escalation of antibiotics was instituted in a local hospital since January 1, 2012. The cost of antimicrobials, defined daily dose (DDD), susceptibility to antimicrobials, and outcome of all admitted patients were calculated and evaluated before and after the ASP implementation...
November 19, 2015: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/26698014/proper-use-of-carbapenems-role-of-the-infectious-disease-specialist
#20
N Issa, S Pedeboscq, F Le Quellec, E Bessède, M Vandenhende, F Bonnet, P Morlat, F Camou
OBJECTIVE: One of the objectives of the French national plan on antibiotics is to preserve antibiotic effectiveness. A group of infectious disease specialists of the University hospital of Bordeaux aimed to monitor the prescriptions of broad-spectrum antibiotics. Particular attention was paid to carbapenem (CBP) prescriptions given the increase in betalactamase- and carbapenemase-producing bacteria. PATIENTS AND METHODS: We carried out a three-step Professional Practice Evaluation (PPE): evaluation of CBP prescriptions made at the hospital between January and June 2013; CBP prescription training for prescribers; and another evaluation of CBP prescriptions between January and June 2014...
February 2016: Médecine et Maladies Infectieuses
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