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Antimicrobial Stewardship

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21 papers 0 to 25 followers
https://www.readbyqxmd.com/read/27168451/clinical-and-laboratory-considerations-for-the-rapid-detection-of-carbapenem-resistant-enterobacteriaceae
#1
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 11, 2016: Virulence
https://www.readbyqxmd.com/read/27174362/safety-of-automatic-end-dates-for-antimicrobial-orders-to-facilitate-stewardship
#2
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
https://www.readbyqxmd.com/read/27183757/promoting-value-through-antimicrobial-stewardship
#3
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
https://www.readbyqxmd.com/read/27187821/leveraging-antimicrobial-stewardship-into-improving-rates-of-carbapenem-resistant-enterobacteriaceae
#4
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 17, 2016: Virulence
https://www.readbyqxmd.com/read/25402404/antibiotic-self-stewardship-trainee-led-structured-antibiotic-time-outs-to-improve-antimicrobial-use
#5
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
https://www.readbyqxmd.com/read/22495073/impact-of-an-antimicrobial-stewardship-intervention-on-shortening-the-duration-of-therapy-for-community-acquired-pneumonia
#6
Edina Avdic, Lisa A Cushinotto, Andrew H Hughes, Amanda R Hansen, Leigh E Efird, John G Bartlett, Sara E Cosgrove
BACKGROUND: Initial management of community-acquired pneumonia (CAP) has been a Centers for Medicare and Medicaid Services performance measure for a decade. We hypothesized that an intervention directed at management of CAP that assesses areas not covered by the performance measures-treatment duration and antimicrobial selection after additional microbiology data are available--would further improve CAP management. METHODS: We performed a single-center, prospective study to compare management of adult inpatients with presumed CAP before (from 1 January 2008 through 31 March 2008) and after (from 1 February 2010 through 10 May 2010) an intervention consisting of education and prospective feedback to teams regarding antibiotic choice and duration...
June 2012: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/24633207/effect-of-antibiotic-stewardship-programmes-on-clostridium-difficile-incidence-a-systematic-review-and-meta-analysis
#7
REVIEW
Leah M Feazel, Ashish Malhotra, Eli N Perencevich, Peter Kaboli, Daniel J Diekema, Marin L Schweizer
OBJECTIVES: Despite vigorous infection control measures, Clostridium difficile continues to cause significant disease burden. Antibiotic stewardship programmes (ASPs) may prevent C. difficile infections by limiting exposure to certain antibiotics. Our objective was to perform a meta-analysis of published studies to assess the effect of ASPs on the risk of C. difficile infection in hospitalized adult patients. METHODS: Searches of PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature and two Cochrane databases were conducted to find all published studies on interventions related to antibiotic stewardship and C...
July 2014: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/15825035/risk-factors-for-increasing-multidrug-resistance-among-extended-spectrum-beta-lactamase-producing-escherichia-coli-and-klebsiella-species
#8
Emily P Hyle, Adam D Lipworth, Theoklis E Zaoutis, Irving Nachamkin, Neil O Fishman, Warren B Bilker, Xiangquin Mao, Ebbing Lautenbach
BACKGROUND: The importance of infections due to extended-spectrum beta -lactamase-producing Escherichia coli and Klebsiella species (ESBL-EK) has been increasingly recognized in recent years. ESBL-EK infections are of clinical concern, because few antimicrobials are available as therapeutic options. Increased reliance on carbapenems has led to increasing carbapenem resistance. Efforts to maintain current therapeutic options for ESBL-EK infections are essential. METHODS: We conducted a case-control study to identify risk factors for multidrug resistance (MDR) among ESBL-EK...
May 1, 2005: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/16801511/reemergence-of-gram-negative-health-care-associated-bloodstream-infections
#9
COMPARATIVE STUDY
Svenja J Albrecht, Neil O Fishman, Jennifer Kitchen, Irving Nachamkin, Warren B Bilker, Cindy Hoegg, Carol Samel, Stephanie Barbagallo, Judy Arentzen, Ebbing Lautenbach
BACKGROUND: Primary health care-associated bloodstream infections (PHA-BSIs) affect as many as 350 000 patients in the United States annually. Whereas gram-negative organisms were the leading cause before the 1970s, gram-positive organisms have been the predominant microbial isolates since then. METHODS: We identified all PHA-BSIs among adult inpatients in a 625-bed quaternary care hospital from January 1, 1996, through December 31, 2003, and evaluated trends in the microbial etiology, geographic distribution within the institution, and antimicrobial susceptibilities...
June 26, 2006: Archives of Internal Medicine
https://www.readbyqxmd.com/read/24857395/antimicrobial-stewardship-interventions-thinking-inside-and-outside-the-box
#10
REVIEW
Keith W Hamilton, Neil O Fishman
At present, less than half of all acute health care facilities have antimicrobial stewardship programs. By targeting areas that are vulnerable to inappropriate antimicrobial use and by using novel strategies to increase the reach of stewardship interventions, providers can make antimicrobial stewardship a universal practice in all health care settings. This review discusses how stewardship can make large impacts in areas where it has traditionally been absent in facilities both with and without formal antimicrobial stewardship programs...
June 2014: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/25111916/comparison-of-prior-authorization-and-prospective-audit-with-feedback-for-antimicrobial-stewardship
#11
COMPARATIVE STUDY
Jimish M Mehta, Kevin Haynes, E Paul Wileyto, Jeffrey S Gerber, Daniel R Timko, Steven C Morgan, Shawn Binkley, Neil O Fishman, Ebbing Lautenbach, Theoklis Zaoutis
OBJECTIVE: Although prior authorization and prospective audit with feedback are both effective antimicrobial stewardship program (ASP) strategies, the relative impact of these approaches remains unclear. We compared these core ASP strategies at an academic medical center. DESIGN: Quasi-experimental study. METHODS: We compared antimicrobial use during the 24 months before and after implementation of an ASP strategy change. The ASP used prior authorization alone during the preintervention period, June 2007 through May 2009...
September 2014: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27139059/prevalence-of-inappropriate-antibiotic-prescriptions-among-us-ambulatory-care-visits-2010-2011
#12
Katherine E Fleming-Dutra, Adam L Hersh, Daniel J Shapiro, Monina Bartoces, Eva A Enns, Thomas M File, Jonathan A Finkelstein, Jeffrey S Gerber, David Y Hyun, Jeffrey A Linder, Ruth Lynfield, David J Margolis, Larissa S May, Daniel Merenstein, Joshua P Metlay, Jason G Newland, Jay F Piccirillo, Rebecca M Roberts, Guillermo V Sanchez, Katie J Suda, Ann Thomas, Teri Moser Woo, Rachel M Zetts, Lauri A Hicks
IMPORTANCE: The National Action Plan for Combating Antibiotic-Resistant Bacteria set a goal of reducing inappropriate outpatient antibiotic use by 50% by 2020, but the extent of inappropriate outpatient antibiotic use is unknown. OBJECTIVE: To estimate the rates of outpatient oral antibiotic prescribing by age and diagnosis, and the estimated portions of antibiotic use that may be inappropriate in adults and children in the United States. DESIGN, SETTING, AND PARTICIPANTS: Using the 2010-2011 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, annual numbers and population-adjusted rates with 95% confidence intervals of ambulatory visits with oral antibiotic prescriptions by age, region, and diagnosis in the United States were estimated...
May 3, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/20705661/long-term-impacts-of-antibiotic-exposure-on-the-human-intestinal-microbiota
#13
REVIEW
Cecilia Jernberg, Sonja Löfmark, Charlotta Edlund, Janet K Jansson
Although it is known that antibiotics have short-term impacts on the human microbiome, recent evidence demonstrates that the impacts of some antibiotics remain for extended periods of time. In addition, antibiotic-resistant strains can persist in the human host environment in the absence of selective pressure. Both molecular- and cultivation-based approaches have revealed ecological disturbances in the microbiota after antibiotic administration, in particular for specific members of the bacterial community that are susceptible or alternatively resistant to the antibiotic in question...
November 2010: Microbiology
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
#14
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/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/27080992/implementing-an-antibiotic-stewardship-program-guidelines-by-the-infectious-diseases-society-of-america-and-the-society-for-healthcare-epidemiology-of-america
#16
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/27074955/research-methods-in-healthcare-epidemiology-and-antimicrobial-stewardship
#17
Daniel J Morgan, Nasia Safdar, Aaron M Milstone, Deverick J Anderson
Research in Healthcare Epidemiology and Antimicrobial Stewardship (HE&AS) is rapidly expanding with the involvement of researchers from varied countries and backgrounds. Researchers must use scientific methods that will provide the strongest evidence to advance healthcare epidemiology, but there are limited resources for information on specific aspects of HE&AS research or easy ways to access examples of studies using specific methods with HE&AS. In response to this need, the SHEA Research Committee has developed a series of white papers on research methods in HE&AS...
June 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27019058/choosing-wisely-in-healthcare-epidemiology-and-antimicrobial-stewardship
#18
Daniel J Morgan, Lindsay D Croft, Valerie Deloney, Kyle J Popovich, Chris Crnich, Arjun Srinivasan, Neil O Fishman, Kristina Bryant, Sara E Cosgrove, Surbhi Leekha
OBJECTIVE To identify Choosing Wisely items for the American Board of Internal Medicine Foundation. METHODS The Society for Healthcare Epidemiology of America (SHEA) elicited potential items from a hospital epidemiology listserv, SHEA committee members, and a SHEA-Infectious Diseases Society of America compendium with SHEA Research Network members ranking items by Delphi method voting. The SHEA Guidelines Committee reviewed the top 10 items for appropriateness for Choosing Wisely. Five final recommendations were approved via individual member vote by committees and the SHEA Board...
July 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/25419765/guidance-for-the-knowledge-and-skills-required-for-antimicrobial-stewardship-leaders
#19
Sara E Cosgrove, Elizabeth D Hermsen, Michael J Rybak, Thomas M File, Sarah K Parker, Tamar F Barlam
Antimicrobial stewardship programs are increasingly recognized as critical in optimizing the use of antimicrobials. Consequently, more physicians, pharmacists, and other healthcare providers are developing and implementing such programs in a variety of healthcare settings. The purpose of this guidance document is to outline the knowledge and skills that are needed to lead an antimicrobial stewardship program. It was developed by antimicrobial stewardship experts from organizations that are engaged in advancing the field of antimicrobial stewardship...
December 2014: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/22418625/policy-statement-on-antimicrobial-stewardship-by-the-society-for-healthcare-epidemiology-of-america-shea-the-infectious-diseases-society-of-america-idsa-and-the-pediatric-infectious-diseases-society-pids
#20
(no author information available yet)
Antimicrobial resistance has emerged as a significant healthcare quality and patient safety issue in the twenty-first century that, combined with a rapidly dwindling antimicrobial armamentarium, has resulted in a critical threat to the public health of the United States. Antimicrobial stewardship programs optimize antimicrobial use to achieve the best clinical outcomes while minimizing adverse events and limiting selective pressures that drive the emergence of resistance and may also reduce excessive costs attributable to suboptimal antimicrobial use...
April 2012: Infection Control and Hospital Epidemiology
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