scholarly journals Meropenem antimicrobial stewardship program: clinical, economic, and antibiotic resistance impact

2018 ◽  
Vol 38 (1) ◽  
pp. 161-170 ◽  
Author(s):  
J. F. García-Rodríguez ◽  
B. Bardán-García ◽  
M. F. Peña-Rodríguez ◽  
H. Álvarez-Díaz ◽  
A. Mariño-Callejo
Author(s):  
Shivani Kalmegh ◽  
Saima Siddique ◽  
Priyanka Paul Madhu ◽  
Kumar Gaurav Chhabra ◽  
Amit Reche ◽  
...  

Background: Antibiotic resistance makes to the top ten threats to global health in 2019. It is important for dental faculty to make efforts to improve the quality of services provided; As a result the study of awareness of the dental faculty regarding antibiotic resistance and antibiotic stewardship program was undertaken. Objectives: Assessment of the knowledge, attitude and practices of the dental faculty towards Antibiotic stewardship program through a questionnaire study in Maharashtra. Methodology: The dental faculty in dental institutes located in Maharashtra will be the study participants. The questionnaire will be sent to all the faculty members as an online questionnaire survey. Expected Results: Evaluating the need of Implementation of antimicrobial stewardship program in institutions which will reduce the profuse use of unnecessary antibiotic prescription and improve the appropriateness of the antibiotic use by the dental health faculty working in a dental college without compromising the clinical patient outcome. Conclusion: The present study will assess the knowledge, attitude and practices of the dental faculty towards Antibiotic stewardship program.


Author(s):  
O.I. Chub ◽  
O.V. Bilchenko ◽  
O.M. Godlevska ◽  
S.V. Teslenko

 Resistance to common groups of antibiotics has been increasing in the treatment of urinary tract infections worldwide. In the United States, CDC has estimated that more thаn 2 million infections and 23,000 deaths are due to antibiotic resistance each year. In Europe, an еstimated 25,000 deaths are attributable to antibiotic-rеsistant infections. By 2050, it is estimated that antibiotic resistance will cause 10 million deaths every year.At the EU/EEA level, more than half (58.2%) of the E. coli isolates reported to EARS-Net for 2017 were resistant to at least one of the antimicrobial groups under regular surveillance, i.e. aminopenicillins, fluoroquinolones, third-generation cephalosporins, aminoglycosides and carbapenems. A majority (87.4%) of the third-generation cephalosporin-resistant E. coli isolates from 2017 were extended-spectrum beta-lactamase (ESBL)-positive. Use of broad-spectrum antimicrobials is a known risk factor for colonization and spread of resistant Enterobacteriaceae, including E. coli. The high levels of ESBLs and increasing resistance to key antimicrobial groups might also lead to an increased consumption of carbapenems, which in turn can increase the selection pressure and facilitated the spread of carbapenem-resistant Enterobacteriaceae. According to annual reports of CDC, WHO, EARS-Net and others,estimate that 30 percent of all antibiotics prescribed in outpatient clinics and 40 percent of all antibiotics prescribed in inpatient clinics were unnecessary. Improving the way we use antibiotics, often referred to as «antibiotic stewardship», is part of the National Action Plan. Appropriate antibiotic use means using the right antibiotic, at theright dose, for the right duration, and at the right time. The article reflects the recommendations of the European Association of Urology 2019 on the management and treatment of urinary tract infections in accordance with the principles of Antimicrobial Stewardship Program.


2020 ◽  
Vol 18 ◽  
Author(s):  
Humberto Guanche Garcell ◽  
Juan José Pisonero Socias ◽  
Gilberto Pardo Gómez

Background: During the last 30 years an antimicrobial stewardship program (ASP) was implemented in a facility with periods of weakness. We aim to describe the history of the sustainability failure in the local ASP. Methods: A historical review was conducted using original data from the facility library and papers published. An analysis of factors related to the failure was conducted based on the Doyle approach. Results: The first ASP was implemented from 1989 to 1996 based on the international experiences and contributes to the improvement in the quality of prescription, reduction of 52% in cost and in the incidence of nosocomial infection. The second program restarts in 2008 and decline in 2015, while the third program was guided by the Pan-American Health Organization from 2019. This program, in progress, is more comprehensive than previous ones and introduced as a novel measure the monitoring of antibiotic prophylaxis in surgery. The factors related to the sustainability were considered including the availability of antimicrobials, the leader´s support, safety culture, and infrastructure. Conclusions: The history behind thirty years of experiences in antimicrobial stewardship programs has allowed us to identify the gaps that require proactive strategies and actions to achieve sustainability and continuous quality improvement.


Author(s):  
Konstantina Chrysou ◽  
Olympia Zarkotou ◽  
Sofia Kalofolia ◽  
Panagiota Papagiannakopoulou ◽  
Vasiliki Mamali ◽  
...  

Antibiotics ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 470
Author(s):  
Dipu T. Sathyapalan ◽  
Jini James ◽  
Sangita Sudhir ◽  
Vrinda Nampoothiri ◽  
Praveena N. Bhaskaran ◽  
...  

Polymyxins being last resort drugs to treat infections triggered by multidrug-resistant pathogens necessitates the implementation of antimicrobial stewardship program (ASP) initiatives to support its rational prescription across healthcare settings. Our study aims to describe the change in the epidemiology of polymyxins and patient outcomes following the implementation of ASP at our institution. The antimicrobial stewardship program initiated in February 2016 at our 1300 bed tertiary care center involved post-prescriptive audits tracking polymyxin consumption and evaluating prescription appropriateness in terms of the right indication, right frequency, right drug, right duration of therapy and administration of the right loading dose (LD) and maintenance dose (MD). Among the 2442 polymyxin prescriptions tracked over the entire study period ranging from February 2016 to January 2020, the number of prescriptions dropped from 772 prescriptions in the pre-implementation period to an average of 417 per year during the post-implementation period, recording a 45% reduction. The quarterly patient survival rates had a significant positive correlation with the quarterly prescription appropriateness rates (r = 0.4774, p = 0.02), right loading dose (r = 0.5228, p = 0.015) and right duration (r = 0.4361, p = 0.04). Our study on the epidemiology of polymyxin use demonstrated favorable effects on the appropriateness of prescriptions and mortality benefits after successful implementation of antimicrobial stewardship in a real-world setting.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S82-S82
Author(s):  
Travis B Nielsen ◽  
Maressa Santarossa ◽  
Beatrice D Probst ◽  
Laurie Labuszewski ◽  
Jenna Lopez ◽  
...  

Abstract Background Antimicrobial-resistant infections lead to increased morbidity, mortality, and healthcare costs. Among the most facile modifiable risk factors for developing resistance is inappropriate prescribing. The CDC estimates that 47 million (or ≥30% of) outpatient antibiotic prescriptions in the United States are unnecessary. This has provided impetus for expanding our antimicrobial stewardship program (ASP) into the outpatient setting. Initial goals included the following: continuous evaluation and reporting of antibiotic prescribing compliance; minimize underuse of antibiotics from delayed diagnoses and misdiagnoses; ensure proper drug, dose, and duration; improve the percentage of appropriate prescriptions. Methods To achieve these goals, we first sent a baseline survey to outpatient prescribers, assessing their understanding of stewardship and antimicrobial resistance. Questions were modeled from the Illinois Department of Public Health (IDPH) Precious Drugs & Scary Bugs Campaign. The survey was sent to prescribers at 19 primary care and three immediate/urgent care clinics. Compliance rates for prescribing habits were subsequently tracked via electronic health records and reported to prescribers in accordance with IRB approval. Results Prescribers were highly knowledgeable about what constitutes appropriate prescribing, with verified compliance rates highly concordant with self-reported rates. However, 74% of respondents reported intense pressure from patients to inappropriately prescribe antimicrobials. Compliance rates have been tracked since December 2018 and comparing pre- with post-intervention rates shows improvement in primary care since reporting rates to prescribers in August 2019. Conclusion Reporting compliance rates has been helpful in avoiding inappropriate antimicrobial therapy. However, the survey data reinforce the importance of behavioral interventions to bolster ASP efficacy in the outpatient setting. Going forward, posters modeled off of the IDPH template will be conspicuously exhibited in exam rooms, indicating institutional commitment to the enumerated ASP guidelines. Future studies will allow for comparison of pre- and post-intervention knowledge and prescriber compliance. Disclosures All Authors: No reported disclosures


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