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Antibiotic Stewardship (PROA)

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47 papers 0 to 25 followers Antibiotic Stewardship
https://www.readbyqxmd.com/read/27999049/improving-feedback-of-surveillance-data-on-antimicrobial-consumption-resistance-and-stewardship-in-england-putting-the-data-at-your-fingertips
#1
Alan P Johnson, Berit Muller-Pebody, Emma Budd, Diane Ashiru-Oredope, David Ladenheim, Doris Hain, Russell Hope, Alex Bhattacharya, Suzanne Elgohari, Rebecca Guy, Katherine Henderson, Richard Puleston, Graeme Rooney, Simon Thelwall, Edgar Wellington, Theresa Lamagni, Susan Hopkins
The provision of better access to and use of surveillance data is a key component of the UK 5 Year Antimicrobial Resistance (AMR) Strategy Since April 2016, PHE has made data on practice (infection prevention and control; antimicrobial stewardship) and outcome (prevalence of AMR, antibiotic use and healthcare-associated infections) available through Fingertips, a publicly accessible web tool (https://fingertips.phe.org.uk/profile/amr-local-indicators). Fingertips provides access to a wide range of public health data presented as thematic profiles, with the above data being available through the 'AMR local indicators' profile...
December 20, 2016: Journal of Antimicrobial Chemotherapy
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/27974411/antimicrobial-stewardship-how-the-microbiology-laboratory-can-right-the-ship
#3
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/27874151/a-stepwise-introduction-of-a-successful-antimicrobial-stewardship-program-experience-from-a-tertiary-care-university-hospital-in-western-saudi-arabia
#4
Maha M Alawi, Bayan M Darwesh
OBJECTIVES: To analyze and evaluate the safety and cost-effectiveness of a gradually-implemented antimicrobial stewardship programs (ASP) in a tertiary care center. METHODS: Prospective data were collected from an ASP that was gradually introduced between April 2012 and December 2013 in 6 hospital departments, over successive periods of 3 months each. A multidisciplinary team supervised antibiotic use and regulated pharmacy dispensations of a list of restricted antimicrobials (RAs)...
December 2016: Saudi Medical Journal
https://www.readbyqxmd.com/read/27927861/what-is-the-more-effective-antibiotic-stewardship-intervention-pre-prescription-authorization-or-post-prescription-review-with-feedback
#5
Pranita D Tamma, Edina Avdic, John F Keenan, Yuan Zhao, Gobind Anand, James Cooper, Rebecca Dezube, Steven Hsu, Sara E Cosgrove
BACKGROUND: The optimal approach to conducting antibiotic stewardship interventions has not been defined. We compared days of antibiotic therapy (DOT) using pre-prescription authorization (PPA) versus post-prescription review with feedback (PPRF) strategies. METHODS: A quasi-experimental, crossover trial comparing PPA and PPRF for adult inpatients prescribed any antibiotic was conducted. For the first four months, two medicine teams were assigned to the PPA arm and the other two teams to the PPRF arm...
December 7, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/27844028/how-to-pitch-an-antibiotic-stewardship-program-to-the-hospital-c-suite
#6
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
#7
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 have 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; from the 1980s to the early 2000s, there was a 90% decline in the approval of new antibiotics as well as the 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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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