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Antimicrobial Stewardship

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36 papers 0 to 25 followers
Darunee Chotiprasitsakul, Jennifer H Han, Sara E Cosgrove, Anthony D Harris, Ebbing Lautenbach, Anna T Conley, Pam Tolomeo, Jacqueleen Wise, Pranita D Tamma
Background: The recommended duration of antibiotic treatment for Enterobacteriaceae bloodstream infections is 7-14 days. We compared the outcomes of patients receiving short-course (6-10 days) vs prolonged-course (11-16 days) antibiotic therapy for Enterobacteriaceae bacteremia. Methods: A retrospective cohort study was conducted at 3 medical centers and included patients with monomicrobial Enterobacteriaceae bacteremia treated with in vitro active therapy in the range of 6-16 days between 2008 and 2014...
January 6, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Tracelyn Freeman, Greg Eschenauer, Twisha Patel, Tejal Gandhi, Lindsay Petty, Carol Chenoweth, Maressa Santarossa, Jerod Nagel
No abstract text is available yet for this article.
October 2017: Infection Control and Hospital Epidemiology
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)...
September 2017: Infectious Diseases and Therapy
Michael J Lipsky, Christopher Sayegh, Marissa C Theofanides, Mitchell C Benson, Kimberly L Cooper
OBJECTIVE: To compare postoperative infectious outcomes of bladder biopsies performed in the office without antibiotic prophylaxis vs those done with preoperative antibiotic prophylaxis in the operating room (OR). MATERIALS AND METHODS: Our institutional review board-approved database was retrospectively reviewed for patients who underwent bladder biopsy in the office or in the OR between July 2014 and August 2015. All patients with bladder biopsies performed in the OR and none in the office received preoperative antibiotic prophylaxis...
August 31, 2017: Urology
C Pulcini
No abstract text is available yet for this article.
November 2017: Clinical Microbiology and Infection
Arjun Srinivasan
Improving our antibiotic use is critical to the safety of our patients and the future of medicine. This can improve patient outcomes, save money, reduce resistance, and help prevent negative consequences such as Clostridium difficile infection. The US Centers for Disease Control and Prevention (CDC) is undertaking a nationwide effort to appropriately improve antibiotic use in inpatient and outpatient settings.
September 2017: Cleveland Clinic Journal of Medicine
José Molina, Germán Peñalva, María V Gil-Navarro, Julia Praena, José A Lepe, María A Pérez-Moreno, Carmen Ferrándiz, Teresa Aldabó, Manuela Aguilar, Peter Olbrich, Manuel E Jiménez-Mejías, María L Gascón, Rosario Amaya-Villar, Olaf Neth, María J Rodríguez-Hernández, Antonio Gutiérrez-Pizarraya, José Garnacho-Montero, Cristina Montero, Josefina Cano, Julián Palomino, Raquel Valencia, Rocío Álvarez, Elisa Cordero, Marta Herrero, José M Cisneros
Background: The global crisis of bacterial resistance urges the scientific community to implement intervention programs in healthcare facilities to promote an appropriate use of antibiotics. However, the clinical benefits or the impact on resistance of these interventions has not been definitively proved. Methods: We designed a quasi-experimental intervention study with an interrupted time-series analysis. A multidisciplinary team conducted a multifaceted educational intervention in our tertiary-care hospital over a 5-year period...
November 29, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Erin N O'Leary, Katharina L van Santen, Amy K Webb, Daniel A Pollock, Jonathan R Edwards, Arjun Srinivasan
To assess uptake of the Centers for Disease Control and Prevention's Core Elements of Hospital Antibiotic Stewardship Programs, we analyzed stewardship practices as reported in the 2015 National Healthcare Safety Network's Annual Hospital Survey. Hospital uptake of all 7 core elements increased from 40.9% in 2014 to 48.1% in 2015.
October 30, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Tanya Babich, Oren Zusman, Michal Elbaz, Haim Ben-Zvi, Mical Paul, Leonard Leibovici, Tomer Avni
Background: Catheter associated urinary tract infection (CAUTI) is the most common healthcare-associated acquired infection. We aimed to describe the short- and long-term survival of patients with CAUTI and the impact of the empirical antibiotic treatment on survival rates. Methods: In this prospective observational study we included consecutive adult patients with a chronic indwelling catheter-associated UTI and sepsis hospitalized in medical departments. The primary outcomes were 30-days all-cause mortality and long-term survival at end of the follow-up...
November 13, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Philipp Schuetz, Yannick Wirz, Ramon Sager, Mirjam Christ-Crain, Daiana Stolz, Michael Tamm, Lila Bouadma, Charles E Luyt, Michel Wolff, Jean Chastre, Florence Tubach, Kristina B Kristoffersen, Olaf Burkhardt, Tobias Welte, Stefan Schroeder, Vandack Nobre, Long Wei, Heiner C Bucher, Neera Bhatnagar, Djillali Annane, Konrad Reinhart, Angela Branche, Pierre Damas, Maarten Nijsten, Dylan W de Lange, Rodrigo O Deliberato, Stella Ss Lima, Vera Maravić-Stojković, Alessia Verduri, Bin Cao, Yahya Shehabi, Albertus Beishuizen, Jens-Ulrik S Jensen, Caspar Corti, Jos A Van Oers, Ann R Falsey, Evelien de Jong, Carolina F Oliveira, Bianca Beghe, Matthias Briel, Beat Mueller
BACKGROUND: Acute respiratory infections (ARIs) comprise of a large and heterogeneous group of infections including bacterial, viral, and other aetiologies. In recent years, procalcitonin (PCT), a blood marker for bacterial infections, has emerged as a promising tool to improve decisions about antibiotic therapy (PCT-guided antibiotic therapy). Several randomised controlled trials (RCTs) have demonstrated the feasibility of using procalcitonin for starting and stopping antibiotics in different patient populations with ARIs and different settings ranging from primary care settings to emergency departments, hospital wards, and intensive care units...
October 12, 2017: Cochrane Database of Systematic Reviews
M T Krishna, A P Huissoon, M Li, A Richter, D G Pillay, D Sambanthan, S C Raman, S Nasser, S A Misbah
Approximately 90-99% of patients with a label of penicillin allergy (PenA) are not allergic when comprehensively investigated. An inaccurate label of PenA has major public health implications-longer hospital stay, more frequent hospital admissions, greater use of fluoroquinolones, glycopeptides, cephalosporins and other expensive antibiotics resulting in significantly higher costs to the health service and predisposing to Clostridium difficile, methicillin-resistant Staphylococcus aureus infections and vancomycin-resistant enterococcus...
November 2017: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
Jerod L Nagel, Angela M Huang, Anjly Kunapuli, Tejal N Gandhi, Laraine L Washer, Jessica Lassiter, Twisha Patel, Duane W Newton
Rapid diagnostic testing with matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) decreases the time to organism identification by 24 to 36 h compared to the amount of time required by conventional methods. However, there are limited data evaluating the impact of MALDI-TOF with real-time antimicrobial stewardship team (AST) review and intervention on antimicrobial prescribing and outcomes for patients with bacteremia and blood cultures contaminated with coagulase-negative Staphylococcus (CoNS)...
August 2014: Journal of Clinical Microbiology
Angela W S Fung, Daniel Beriault, Eleftherios P Diamandis, Carey-Ann D Burnham, Todd Dorman, Mark Downing, Joshua Hayden, Bradley J Langford
No abstract text is available yet for this article.
September 2017: Clinical Chemistry
O J Dyar, B Huttner, J Schouten, C Pulcini
BACKGROUND: The use of the term 'antimicrobial stewardship' has grown exponentially in recent years, typically referring to programmes and interventions that aim to optimize antimicrobial use. Although antimicrobial stewardship originated within human healthcare, it is increasingly applied in broader contexts including animal health and One Health. As the use of the term 'antimicrobial stewardship' becomes more common, it is important to consider what antimicrobial stewardship is, as well as what it is not...
November 2017: Clinical Microbiology and Infection
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
Ritu Banerjee, Romney Humphries
Carbapenem resistance among the Enterobacteriaceae has become a significant clinical and public health dilemma. Rapid administration of effective antimicrobials and implementation of supplemental infection control practices is required to both improve patient outcomes and limit the spread of these highly resistant organisms. However, carbapenem-resistant Enterobacteriaceae (CRE)-infected patients are predominantly identified by routine culture methods, which take days to perform. Rapid genomic and phenotypic methods are currently available to accelerate the identification of carbapenemase-producing CRE...
May 19, 2017: Virulence
Rachael K Ross, Jonathan M Beus, Talene A Metjian, A Russell Localio, Eric D Shelov, Bimal R Desai, Sean P O'Neill, Theoklis E Zaoutis, Jeffrey S Gerber
Following implementation of automatic end dates for antimicrobial orders to facilitate antimicrobial stewardship at a large, academic children's hospital, no differences were observed in patient mortality, length of stay, or readmission rates, even among patients with documented bacteremia. Infect Control Hosp Epidemiol 2016;37:974-978.
August 2016: Infection Control and Hospital Epidemiology
John B Lynch
An institution that uses a value-based approach to manage and prevent problems related to the suboptimal use of antibiotics will improve its bottom line through: Efficiencies brought about by aggressive management of institutional resources. Reductions in hospital admission/readmission. Fewer complications. Better transitions in care. Increased revenues through preferential referrals.
March 2016: Healthcare Financial Management: Journal of the Healthcare Financial Management Association
Darren Wong, Brad Spellberg
Carbapenem-resistant Enterobacteriaceae (CRE) are among the most critical threats facing our healthcare system and account for significant patient mortality. There is considerable interest in the development of new treatment strategies. However, less attention has been paid to reducing CRE infection rates. Antibiotic stewardship programs can be uniquely empowered to reduce widespread pathogen resistance and by extension, optimize patient care and lower healthcare costs.
May 19, 2017: Virulence
Todd C Lee, Charles Frenette, Dev Jayaraman, Laurence Green, Louise Pilote
BACKGROUND: Antibiotic use is an important quality improvement target. Nearly 50% of antibiotic use is unnecessary or inappropriate. To combat overuse, the Centers for Disease Control and Prevention (CDC) proposed "time-outs" to reevaluate antibiotics. OBJECTIVE: To optimize antibiotic use through trainee-led time-outs. DESIGN: Before-after study. SETTING: Internal medicine (2 units, 46 beds) at a university hospital...
November 18, 2014: Annals of Internal Medicine
2016-05-18 21:28:53
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