Evaluation of the Implementation of Hospital Antibiotic Policy in Oncosurgery Ward: A Six-Year Experience

Author(s):  
Aneta Nitsch-Osuch ◽  
Damian Okruciński ◽  
Magdalena Dawgiałło ◽  
Izabela Gołębiak ◽  
Ernest Kuchar
Keyword(s):  
2011 ◽  
Vol 56 (2) ◽  
pp. 989-994 ◽  
Author(s):  
C. Plüss-Suard ◽  
A. Pannatier ◽  
C. Ruffieux ◽  
A. Kronenberg ◽  
K. Mühlemann ◽  
...  

ABSTRACTThe original cefepime product was withdrawn from the Swiss market in January 2007 and replaced by a generic 10 months later. The goals of the study were to assess the impact of this cefepime shortage on the use and costs of alternative broad-spectrum antibiotics, on antibiotic policy, and on resistance ofPseudomonas aeruginosatoward carbapenems, ceftazidime, and piperacillin-tazobactam. A generalized regression-based interrupted time series model assessed how much the shortage changed the monthly use and costs of cefepime and of selected alternative broad-spectrum antibiotics (ceftazidime, imipenem-cilastatin, meropenem, piperacillin-tazobactam) in 15 Swiss acute care hospitals from January 2005 to December 2008. Resistance ofP. aeruginosawas compared before and after the cefepime shortage. There was a statistically significant increase in the consumption of piperacillin-tazobactam in hospitals with definitive interruption of cefepime supply and of meropenem in hospitals with transient interruption of cefepime supply. Consumption of each alternative antibiotic tended to increase during the cefepime shortage and to decrease when the cefepime generic was released. These shifts were associated with significantly higher overall costs. There was no significant change in hospitals with uninterrupted cefepime supply. The alternative antibiotics for which an increase in consumption showed the strongest association with a progression of resistance were the carbapenems. The use of alternative antibiotics after cefepime withdrawal was associated with a significant increase in piperacillin-tazobactam and meropenem use and in overall costs and with a decrease in susceptibility ofP. aeruginosain hospitals. This warrants caution with regard to shortages and withdrawals of antibiotics.


Author(s):  
Kala P. ◽  
Jamuna Rani R. ◽  
Sangeetha Raja

Objective: This study was designed to analyze the prescription pattern of prophylactic antimicrobial agents used in preoperative patients.Methods: A descriptive observational study was done at a tertiary care teaching hospital in Potheri from July to December 2013 after obtaining of Institutional Ethics Committee clearance.Results: Total 284 patients were included in this study, out of which 141(49.6%) were females and 143(50%) were males. In the department of general surgery, the very commonly used antimicrobial agents were cefotaxime (81%) followed by cefoperazone sodium (42%). In the orthopaedics department, the frequently used antimicrobial agents were cefoperazone and sulbactam (39%) followed by cefazolin (29%). Most commonly used antimicrobial agent was cefotaxime (100%) in gynaecology department.Conclusion: Antimicrobial prophylaxis is helpful in declining the frequency of post-operative infections. This study explained about the various antimicrobial agents used prior to surgeries. Practitioners must prescribe an antibiotic based on their hospital antibiotic policy.


BMJ ◽  
1975 ◽  
Vol 3 (5976) ◽  
pp. 161-161
Author(s):  
O J Gilmore ◽  
P J Sanderson
Keyword(s):  

2011 ◽  
Vol 63 (6) ◽  
pp. e20-e21
Author(s):  
Beth White ◽  
Donald Inverarity ◽  
Steve McCormick ◽  
Stephanie Dundas
Keyword(s):  

2002 ◽  
Vol 23 (8) ◽  
pp. 441-446 ◽  
Author(s):  
Geir Bukholm ◽  
Tone Tannæs ◽  
Anne Britt Bye Kjelsberg ◽  
Nils Smith-Erichsen

Objective:To investigate an outbreak of multidrug-resistantPseudomonas aeruginosain an intensive care unit (ICU).Design:Epidemiologic investigation, environmental assessment, and ambidirectional cohort study.Setting:A secondary-care university hospital with a 10-bed ICU.Patients:All patients admitted to the ICU receiving ventilator treatment from December 1,1999, to September 1, 2000.Results:An outbreak in an ICU with multidrug-resistant isolates ofP. aeruginosabelonging to one amplified fragment-length polymorphism (AFLP)–defined genetic cluster was identified, characterized, and cleared. Molecular typing of bacterial isolates with AFLP made it possible to identify the outbreak and make rational decisions during the outbreak period. The outbreak included 19 patients during the study period. Infection with bacterial isolates belonging to the AFLP cluster was associated with reduced survival (odds ratio, 5.26; 95% confidence interval, 1.14 to 24.26). Enhanced barrier and hygiene precautions, cohorting of patients, and altered antibiotic policy were not sufficient to eliminate the outbreak. At the end of the study period (in July), there was a change in the outbreak pattern from long (December to June) to short Quly) incubation times before colonization and from primarily tracheal colonization (December to June) to primarily gastric or enteral Quly) colonization. In this period, the bacterium was also isolated from water taps.Conclusion:Complete elimination of the outbreak was achieved after weekly pasteurization of the water taps of the ICU and use of sterile water as a solvent in the gastric tubes.


2013 ◽  
Vol 04 (04) ◽  
pp. 583-595 ◽  
Author(s):  
K. Oliver ◽  
B. Egan ◽  
L. Li ◽  
K. Richardson ◽  
I. Sandaradura ◽  
...  

SummaryBackground: There is now little doubt that improving antimicrobial use is necessary for the containment of resistance.Objective: To determine whether providing individualised feedback to doctors about their recent compliance with the hospital’s antibiotic policy improves compliance with the policy.Methods: This study was conducted at a teaching hospital in Sydney, Australia. Computerised alerts integrated into the electronic prescribing system (ePS) inform prescribers of the local antibiotic policy. We utilised prescribing data extracted from the ePS for ‘audit and feedback’. Thirty-six prescribers were sent feedback letters via email. We also interviewed doctors who had received letters to explore their views of the feedback and the policy in general.Results: There was no significant change in compliance with the policy following implementation of the feedback intervention (0% compliant vs 11.9%; p = 0.07). Several problems with the policy and the approval process were identified by researchers during auditing and by prescribers during interviews. Some problems identified made it difficult to accurately assess compliance and for doctors to comply with the policy.Conclusions: Our intervention did not result in improved compliance with the antibiotic policy but revealed practical problems with the policy and approval process that had not been identified prior to the trial. Greater support for the policy by senior doctors and the assignment of more clearly defined roles and responsibilities associated with antibiotic use and approval may result in improved compliance. Harnessing the full potential of technology would streamline the antimicrobial approval process and allow more efficient and reliable monitoring of antibiotic use and compliance. Many of the problems we identified are generic issues of importance to all organisations seeking to integrate antimicrobial stewardship into ePS.Citation: Baysari MT, Oliver K, Egan B, Li L, Richardson K, Sandaradura I, Westbrook J I, Day RO. Audit and feedback of antibiotic use: Utilising electronic prescription data. Appl Clin Inf 2013; 4: 583–595http://dx.doi.org/10.4338/ACI-2013-08-RA-0063


The Lancet ◽  
1987 ◽  
Vol 330 (8549) ◽  
pp. 45
Author(s):  
C.R.V. Tomson ◽  
D. Veale ◽  
K. Gould

2013 ◽  
Vol 5 (2) ◽  
pp. 59-63 ◽  
Author(s):  
Jyoti Bagla ◽  
Vidya Ghosh ◽  
S. Ramji ◽  
Dipti Gothi

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