keyword
Keywords 'Antimicrobial Stewardship' AN...

'Antimicrobial Stewardship' AND (critical OR intensive) AND outcome*

https://read.qxmd.com/read/38525881/antimicrobial-stewardship-and-molecular-diagnostics-a-symbiotic-approach-to-combating-resistance-in-the-ed-and-icu
#1
JOURNAL ARTICLE
Jan J De Waele, Jerina Boelens
PURPOSE OF THE REVIEW: This review aims to evaluate the incorporation of rapid molecular diagnostics (RMD) in antimicrobial stewardship programs (ASPs) in the management of patients in the emergency department (ED) and intensive care unit (ICU), highlighting a shift from conventional microbiological diagnostic tests to RMD strategies to optimize antimicrobial use and improve patient outcomes. RECENT FINDINGS: Recent advances in RMD have demonstrated the superior accuracy of RMD in identifying pathogens, combined with shorter turnaround times...
March 22, 2024: Current Opinion in Critical Care
https://read.qxmd.com/read/38507842/eleven-years-impact-of-a-stepwise-educational-program-on-healthcare-associated-infections-and-antibiotics-consumption-in-an-intensive-care-unit-of-a-tertiary-hospital-in-brazil
#2
JOURNAL ARTICLE
Jakeline Neves Giovanetti, Pedro Henrique Della Libera, Matheus Liguori Feliciano da Silva, Ícaro Boszczowski, Luis Carlos Maia Cardozo Junior, Yuri de Albuquerque Pessoa Dos Santos, Daniel Neves Forte, Raquel de Nardi, Rogerio Zigaib, Marcelo Park
BACKGROUND: Hospital acquired infections (HAI) and liberal use of broad-spectrum antibiotics are common in intensive care unit(ICU)s of low-middle income countries. We investigated the long-term association of a stepwise multifaceted educational program with the incidence of HAIs and antibiotics use in a Brazilian ICU. We also evaluated the program's cost impact. METHODS: We retrieved data from a prospective daily collected database of a twelve bedrooms ICU, all admitted patients within a period of eleven years were enrolled...
March 19, 2024: Journal of Critical Care
https://read.qxmd.com/read/38494451/antimicrobial-resistance-in-ocular-infection-a-review
#3
REVIEW
Maria Cabrera-Aguas, Ngozi Chidi-Egboka, Himal Kandel, Stephanie L Watson
Antimicrobial resistance (AMR) is a global public health threat with significant impact on treatment outcomes. The World Health Organization's Global Action Plan on AMR recommended strengthening the evidence base through surveillance programs and research. Comprehensive, timely data on AMR for organisms isolated from ocular infections are needed to guide treatment decisions and inform researchers and microbiologists of emerging trends. This article aims to provide an update on the development of AMR in ocular organisms, AMR in bacterial ocular infections and on AMR stewardship programs globally...
March 17, 2024: Clinical & Experimental Ophthalmology
https://read.qxmd.com/read/38476940/hospital-antimicrobial-stewardship-profiling-the-oral-microbiome-after-exposure-to-covid-19-and-antibiotics
#4
JOURNAL ARTICLE
Patricia Buendia, Krystal Fernandez, Castle Raley, Ali Rahnavard, Keith A Crandall, Jose Guillermo Castro
INTRODUCTION: During the COVID-19 Delta variant surge, the CLAIRE cross-sectional study sampled saliva from 120 hospitalized patients, 116 of whom had a positive COVID-19 PCR test. Patients received antibiotics upon admission due to possible secondary bacterial infections, with patients at risk of sepsis receiving broad-spectrum antibiotics (BSA). METHODS: The saliva samples were analyzed with shotgun DNA metagenomics and respiratory RNA virome sequencing. Medical records for the period of hospitalization were obtained for all patients...
2024: Frontiers in Microbiology
https://read.qxmd.com/read/38448955/resident-prescriber-and-facility-level-factors-associated-with-antibiotic-use-in-long-term-care-facilities-a-systematic-review-of-quantitative-studies
#5
REVIEW
Aurélie Bocquier, Berkehan Erkilic, Martin Babinet, Céline Pulcini, Nelly Agrinier
BACKGROUND: Antimicrobial stewardship programmes are needed in long-term care facilities (LTCFs) to tackle antimicrobial resistance. We aimed to identify factors associated with antibiotic use in LTCFs. Such information would be useful to guide antimicrobial stewardship programmes. METHOD: We conducted a systematic review of studies retrieved from PubMed, Cochrane Library, Embase, APA PsycArticles, APA PsycINFO, APA PsycTherapy, ScienceDirect and Web of Science...
March 6, 2024: Antimicrobial Resistance and Infection Control
https://read.qxmd.com/read/38403973/study-of-empiric-antibiotic-prescription-patterns-and-microbiological-isolates-in-hemodynamically-stable-and-unstable-icu-patients-with-community-acquired-sepsis
#6
JOURNAL ARTICLE
Mahuya Bhattacharyya, Ananya Saha, Subhash Todi
Background: The efficacy of combination empiric antibiotic therapy for all intensive care unit (ICU) patients with community-acquired sepsis is a subject of ongoing debate in the era of increasing antibiotic resistance. This study was conducted to evaluate the patterns of antibiotic usage and microbial resistance in sepsis patients admitted to the ICU with both hemodynamically stable (HS) and unstable states and to analyze their clinical outcomes. Methods: In this observational study, patients aged 18 years and above who received antibiotics upon admission and had a culture report were included...
February 25, 2024: Journal of Intensive Care Medicine
https://read.qxmd.com/read/38391547/practical-lessons-on-antimicrobial-therapy-for-critically-ill-patients
#7
REVIEW
Rachael Cusack, Elizabeth Little, Ignacio Martin-Loeches
Sepsis stands as a formidable global health challenge, with persistently elevated mortality rates in recent decades. Each year, sepsis not only contributes to heightened morbidity but also imposes substantial healthcare costs on survivors. This narrative review aims to highlight the targeted measures that can be instituted to alleviate the incidence and impact of sepsis in intensive care. Here we discuss measures to reduce nosocomial infections and the prevention of equipment and patient colonisation by resilient pathogens...
February 6, 2024: Antibiotics
https://read.qxmd.com/read/38378100/impact-of-altered-mental-status-on-antibiotic-prescribing-and-outcomes-in-hospitalized-patients-presenting-with-pyuria
#8
JOURNAL ARTICLE
Haley N Boerckel, Lacy J Worden, Lisa A Salvati, Andrew P Jameson, Lisa E Dumkow
BACKGROUND: Pyuria is non-specific and may result in over-treatment of asymptomatic bacteriuria (ASB). The Infectious Diseases Society of America recommends against antibiotic treatment of ASB for most patients including those presenting with altered mental status (AMS). Close observation is recommended over treatment to avoid missing alternative causes of AMS and overuse of antibiotics resulting in adverse events and resistance. OBJECTIVES: The purpose of this study was to evaluate patient outcomes associated with antibiotic treatment of pyuria in patients presenting with AMS at hospital admission without specific UTI symptoms...
February 18, 2024: Journal of the American Pharmacists Association: JAPhA
https://read.qxmd.com/read/38355044/clinical-evaluation-of-the-biofire-respiratory-pathogen-panel-for-the-guidance-of-empirical-antimicrobial-therapy-in-critically-ill-patients-with-hospital-acquired-pneumonia-a-multicenter-quality-improvement-project
#9
JOURNAL ARTICLE
Cécile Poulain, Yoann Launey, Marwan Bouras, Karim Lakhal, Laura Dargelos, Lise Crémet, Sophie-Anne Gibaud, Stephane Corvec, Philippe Seguin, Bertrand Rozec, Karim Asehnoune, Fanny Feuillet, Antoine Roquilly
BACKGROUND: We aimed to determine whether implementing antimicrobial stewardship based on multiplex bacterial PCR examination of respiratory fluid can enhance outcomes of critically ill patients with hospital-acquired pneumonia (HAP). METHODS: We conducted a quality improvement study in two hospitals in France. Adult patients requiring invasive mechanical ventilation with a diagnosis of HAP were included. In the pre-intervention period (August 2019 to April 2020), antimicrobial therapy followed European guidelines...
February 12, 2024: Anaesthesia, Critical Care & Pain Medicine
https://read.qxmd.com/read/38347703/evaluation-of-short-versus-long-courses-of-antibiotics-in-critically-ill-patients-with-gram-negative-bloodstream-infections
#10
JOURNAL ARTICLE
Daniel T Anderson, Divisha Sharma, Aaron M Chase, Zoheb Irshad Sulaiman, August H Anderson, Ashley L Huggett, Joshua Eudy
BACKGROUND: Short courses of antibiotics (7-10 days) are effective for uncomplicated gram-negative bloodstream infections (GN-BSI). However, prior studies have been limited to small cohorts of critically ill patients. OBJECTIVE: The objective of this study was to evaluate the safety and efficacy of short courses of therapy compared with longer courses in patients admitted to the intensive care unit (ICU) with GN-BSI. METHODS: Propensity-matched, retrospective cohort study of critically ill patients with GN-BSI...
February 12, 2024: Annals of Pharmacotherapy
https://read.qxmd.com/read/38332718/-practice-vs-potential-the-impact-of-the-biofire-filmarray-pneumonia-panel-on-antibiotic-use-in-children
#11
JOURNAL ARTICLE
Alexander S Plattner, Christine R Lockowitz, Rebekah Dumm, Ritu Banerjee, Jason G Newland, Rebecca G Same
BACKGROUND: The BioFire FilmArray Pneumonia Panel (BFPP), a multiplex PCR panel for diagnosis of lower respiratory tract infections, has been proposed as a tool for antimicrobial stewardship. Few studies evaluate real-world implementation of the BFPP and no studies focus exclusively on children. Our institution implemented BFPP testing without restrictions. METHODS: We conducted a retrospective cohort study in children hospitalized at St. Louis Children's Hospital to 1) characterize use of the BFPP in pediatric patients and 2) assess how results impacted antibiotic use...
February 9, 2024: Journal of the Pediatric Infectious Diseases Society
https://read.qxmd.com/read/38332590/efficacy-and-safety-of-short-vs-standard-course-antibiotics-for-culture-negative-neonatal-sepsis-a-systematic-review-and-meta-analysis
#12
JOURNAL ARTICLE
Risha Devi, Mayank Priyadarshi, Poonam Singh, Suman Chaurasia, Sriparna Basu
OBJECTIVES: To conduct a systematic review and meta-analysis of evidence from randomized controlled trials (RCTs) comparing a short course of antibiotics (2-4 days), to a standard course (5-7 days), for the treatment of culture-negative neonatal sepsis. METHODS: Relevant databases were searched for RCTs comparing short- vs. standard-course of antibiotics for culture-negative sepsis. The primary outcomes were mortality and treatment failure, defined as the reappearance of clinical signs suggestive of sepsis within 7 days of stoppage of antibiotics...
February 7, 2024: Journal of Tropical Pediatrics
https://read.qxmd.com/read/38322295/antimicrobial-stewardship-and-improved-antibiotic-utilization-in-the-pediatric-cardiac-intensive-care-unit
#13
JOURNAL ARTICLE
Margot M Hillyer, Preeti Jaggi, Nikhil K Chanani, Alfred J Fernandez, Hania Zaki, Michael P Fundora
BACKGROUND: We developed a multidisciplinary antimicrobial stewardship team to optimize antimicrobial use within the Pediatric Cardiac Intensive Care Unit. A quality improvement initiative was conducted to decrease unnecessary broad-spectrum antibiotic use by 20%, with sustained change over 12 months. METHODS: We conducted this quality improvement initiative within a quaternary care center. PDSA cycles focused on antibiotic overuse, provider education, and practice standardization...
2024: Pediatric Quality & Safety
https://read.qxmd.com/read/38315022/culture-independent-identification-of-bloodstream-infections-from-whole-blood-prospective-evaluation-in-specimens-of-known-infection-status
#14
JOURNAL ARTICLE
Vidya Iyer, Daniel Castro, Bipin Malla, Britta Panda, Arthur R Rabson, Gary Horowitz, Nicholas Heger, Kamlesh Gupta, Alon Singer, Errol R Norwitz
Sepsis caused by bloodstream infection (BSI) is a major healthcare burden and a leading cause of morbidity and mortality worldwide. Timely diagnosis is critical to optimize clinical outcome, as mortality rates rise every hour treatment is delayed. Blood culture remains the "gold standard" for diagnosis but is limited by its long turnaround time (1-7 days depending on the organism) and its potential to provide false-negative results due to interference by antimicrobial therapy or the presence of mixed (i.e., polymicrobial) infections...
February 5, 2024: Journal of Clinical Microbiology
https://read.qxmd.com/read/38301713/risk-of-multidrug-resistant-pathogens-in-severe-community-acquired-pneumonia
#15
JOURNAL ARTICLE
E Campaña-Duel, M Camprubí-Rimblas, A Areny-Balagueró, Sara Quero, A Artigas, A Ceccato
Severe community-acquired pneumonia (SCAP) is difficult to treat when caused by difficult-to-treat (DTR) pathogens because of limited treatment options and poorer clinical outcomes. Over time, several predictive scoring systems based on risk factors for infection with multidrug resistant pathogens have been developed. We reviewed the available tools for identifying DTR pathogens as the cause of SCAP, both predictive scoring systems and rapid diagnostic methods, to develop management strategies aimed at early identification of DTR pathogens, reducing broad-spectrum antibiotic use and improving clinical outcomes...
February 1, 2024: Seminars in Respiratory and Critical Care Medicine
https://read.qxmd.com/read/38267206/the-leaders-in-epidemiology-antimicrobial-stewardship-and-public-health-leap-fellowship-a-novel-training-program-in-public-health-for-infectious-diseases-physicians
#16
JOURNAL ARTICLE
Kevin Hsueh, Arianne Teherani, Judith A Guzman-Cottrill
The severe acute respiratory syndrome coronavirus 2 pandemic demonstrated a critical need for partnerships between practicing infectious diseases (ID) physicians and public health departments. The soon-to-launch combined ID and Epidemic Intelligence Service fellowship can only address a fraction of this need, and otherwise US ID training lacks development pathways for physicians aiming to make careers working with public health departments. The Leaders in Epidemiology, Antimicrobial Stewardship, and Public Health (LEAP) fellowship is a model compatible with the current training paradigm with a proven track record of developing careers of long-term collaboration...
January 24, 2024: Clinical Infectious Diseases
https://read.qxmd.com/read/38261606/-burkholderia-cepacia-complex-in-cystic-fibrosis-critical-gaps-in-diagnosis-and-therapy
#17
REVIEW
Juan Carlos Gutiérrez Santana, Victor Rafael Coria Jiménez
Burkholderia cepacia complex ( Bcc ) is a bacterial group with 'natural' multi-antimicrobial resistance. This complex has generated epidemic outbreaks across the world. In people with cystic fibrosis (CF), Bcc can cause severe lung infections that lead to accelerated lung damage, which can be complicated by necrotizing pneumonia accompanied by high fevers, leucocytosis, and bacteraemia, which commonly causes fatal outcomes. Specifically, infection by Burkholderia cenocepacia is considered an exclusion criterion for lung transplantation...
December 2024: Annals of Medicine
https://read.qxmd.com/read/38233960/efficacy-of-an-antimicrobial-stewardship-intervention-for-early-adaptation-of-antibiotic-therapy-in-high-risk-neutropenic-patients
#18
JOURNAL ARTICLE
Claire Durand, Karine Risso, Michael Loschi, Nicolas Retur, Audrey Emery, Johan Courjon, Thomas Cluzeau, Michel Carles
BACKGROUND: The 4th European Conference on Infections in Leukemia recommends early adaptation of empirical antibiotic therapy (EAT) for febrile neutropenia in stable patients. OBJECTIVES: To assess the efficacy of an antimicrobial stewardship (AMS) intervention promoting early de-escalation and discontinuation of EAT in high-risk neutropenic patients. METHODS: This before-after study was conducted in the hematology department of the University Hospital of Nice, France...
January 17, 2024: Antimicrobial Resistance and Infection Control
https://read.qxmd.com/read/38223862/evaluation-of-an-automated-pharmacist-driven-antimicrobial-patient-acuity-scoring-system-for-hospitalized-bacteremic-patients
#19
JOURNAL ARTICLE
Riley Karpen, Claire Murphy, Erica Reed, Anthony T Gerlach, Kari Cape, John Mellett, Sara A Atyia
Purpose: The implementation of an automated, pharmacist-driven, scoring system within the EMR has been shown to improve patient care in patients with Staphylococcus aureus bacteremia by increasing the adherence to disease specific quality-of-care measures. However, there are a lack of studies evaluating the incorporation of blood culture review into standard, non-antimicrobial stewardship pharmacist workflow. Our institution implemented an automated, pharmacist-driven, antimicrobial scoring system in the electronic medical record (EMR) on August 6, 2019...
February 2024: Hospital Pharmacy
https://read.qxmd.com/read/38216206/sepsis-epidemiology-in-austral-i-an-and-new-zealand-children-sentinel-protocol-for-a-multicountry-prospective-observational-study
#20
JOURNAL ARTICLE
Elliot Long, Meredith L Borland, Shane George, Shefali Jani, Eunicia Tan, Jocelyn Neutze, Natalie Phillips, Amit Kochar, Simon Craig, Anna Lithgow, Arjun Rao, Stuart Dalziel, Ed Oakley, Stephen Hearps, Sonia Singh, Ben Gelbart, Sarah McNab, Fran Balamuth, Scott Weiss, Nathan Kuppermann, Amanda Williams, Franz E Babl
INTRODUCTION: Sepsis affects 25.2 million children per year globally and causes 3.4 million deaths, with an annual cost of hospitalisation in the USA of US$7.3 billion. Despite being common, severe and expensive, therapies and outcomes from sepsis have not substantially changed in decades. Variable case definitions, lack of a reference standard for diagnosis and broad spectrum of disease hamper efforts to evaluate therapies that may improve sepsis outcomes. This landscape analysis of community-acquired childhood sepsis in Australia and New Zealand will characterise the burden of disease, including incidence, severity, outcomes and cost...
January 12, 2024: BMJ Open
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