scholarly journals Measuring Appropriate Antimicrobial Use: Attempts at Opening the Black Box

2016 ◽  
Vol 63 (12) ◽  
pp. 1-6 ◽  
Author(s):  
Emily S. Spivak ◽  
Sara E. Cosgrove ◽  
Arjun Srinivasan
Keyword(s):  
Public Health ◽  
Black Box ◽  
Antimicrobial Use ◽  
Reference Standard ◽  
Consensus Definition ◽  
Antimicrobial Prescribing ◽  
Life Saving ◽  
Public Health Officials ◽  
Appropriate Antimicrobial Use

Abstract Indiscriminate antimicrobial use has plagued medicine since antibiotics were first introduced into clinical practice >70 years ago. Infectious diseases physicians and public health officials have advocated for preservation of these life-saving drugs for many years. With rising burden of antimicrobial-resistant organisms and Clostridium difficile infections, halting unnecessary antimicrobial use has become one of the largest public health concerns of our time. Inappropriate antimicrobial use has been quantified in various settings using numerous definitions; however, no established reference standard exists. With mounting national efforts to improve antimicrobial use, a consensus definition and standard method of measuring appropriate antimicrobial use is imperative. We review existing literature on systematic approaches to define and measure appropriate antimicrobial use, and describe a collaborative effort at developing standardized audit tools for assessing the quality of antimicrobial prescribing.

scholarly journals Contact Tracing: A Memory Task With Consequences for Public Health

2020 ◽  
pp. 174569162097820
Author(s):  
Maryanne Garry ◽  
Lorraine Hope ◽  
Rachel Zajac ◽  
Ayesha J. Verrall ◽  
Jamie M. Robertson
Keyword(s):  
Public Health ◽  
Memory Task ◽  
Human Memory ◽  
Contact Tracing ◽  
Investigative Interviewing ◽  
Infected People ◽  
Variable Level ◽  
Public Health Officials ◽  
Crucial Part

In the battle for control of coronavirus disease-19 (COVID-19), we have few weapons. Yet contact tracing is among the most powerful. Contact tracing is the process by which public-health officials identify people, or contacts, who have been exposed to a person infected with a pathogen or another hazard. For all its power, though, contact tracing yields a variable level of success. One reason is that contact tracing’s ability to break the chain of transmission is only as effective as the proportion of contacts who are actually traced. In part, this proportion turns on the quality of the information that infected people provide, which makes human memory a crucial part of the efficacy of contact tracing. Yet the fallibilities of memory, and the challenges associated with gathering reliable information from memory, have been grossly underestimated by those charged with gathering it. We review the research on witnesses and investigative interviewing, identifying interrelated challenges that parallel those in contact tracing, as well as approaches for addressing those challenges.

scholarly journals Critical evaluation of antimicrobial use - A Turkish university hospital example

2013 ◽  
Vol 7 (11) ◽  
pp. 873-879 ◽  
Author(s):  
Salih Hosoglu ◽  
Zafer Parlak ◽  
Mehmet Faruk Geyik ◽  
Yilmaz Palanci
Keyword(s):  
Infectious Diseases ◽  
Critical Evaluation ◽  
Positive Culture ◽  
Antimicrobial Treatment ◽  
Influential Factors ◽  
University Hospital ◽  
Antimicrobial Use ◽  
Tract Infections ◽  
Appropriate Antimicrobial Use

Introduction: Antimicrobials are being used unnecessarily for different reasons. The aims of this study were: assessment of the quality of antimicrobial use and determination of the factors related to correct use. Method: Antimicrobial practice at Dicle University Hospital (DUH) was evaluated with a point prevalence approach. Using a standardized data collection form, the patients’ data (clinic, epidemiology, laboratory and antimicrobial use) was collected. Possible influential factors on antimicrobial use were examined. Results: In the surveillance study 1,350 inpatients were evaluated; 461 (34.1%) of them were using antimicrobials for treatment and 187 (13.9%) for prophylaxis. Antimicrobial indication was found in 355 of 461 patients (77.0%), and the number of antimicrobials was 1.8 per patient in the treatment group. The most common reason for antimicrobial use was community-acquired infection (57.9%). Pneumonia (20.4%), skin and soft tissue infections (9.11%) and urinary tract infections (7.9%) were the most common infectious diseases. Positive culture results were available for 39 patients (8.5.0%) when antimicrobial treatment started. All steps of antimicrobial use were found appropriate  in 243 patients (52.7%). In multivariate analyses, clinical manifestation of infection at the beginning (p<0.001), presence of leukocyte counting (p<0.001) and prescription by an infectious disease specialist were found significantly positive factors for wholly appropriate antimicrobial use. Hospitalization with a diagnosis other than infection was found a significantly negative factor for appropriate antimicrobial use (p=0.001). Conclusion: The quality of antimicrobial use could be improved with better clinical and laboratory diagnosis and consultation with infectious diseases specialists

scholarly journals Trends and correlates of antimicrobial use in broiler and turkey farms: a poultry company registry-based study in Italy

2019 ◽  
Vol 74 (9) ◽  
pp. 2784-2787 ◽  
Author(s):  
Claudia Caucci ◽  
Guido Di Martino ◽  
Alessandro Dalla Costa ◽  
Manuel Santagiuliana ◽  
Monica Lorenzetto ◽  
...  
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Antimicrobial Resistance ◽  
Geographical Area ◽  
Antimicrobial Use ◽  
Poultry Production ◽  
Structural Interventions ◽  
Antimicrobial Prescribing ◽  
Prescribing Behaviour ◽  
Antimicrobial Treatments

Abstract Background Antimicrobial usage (AMU) in livestock plays a key role in the emergence and spread of antimicrobial resistance. Analysis of AMU data in livestock is therefore relevant for both animal and public health. Objectives To assess AMU in 470 broiler and 252 turkey farms of one of Italy’s largest poultry companies, accounting for around 30% of national poultry production, to identify trends and risk factors for AMU. Methods Antimicrobial treatments administered to 5827 broiler and 1264 turkey grow-out cycles in 2015–17 were expressed as DDDs for animals per population correction unit (DDDvet/PCU). A retrospective analysis was conducted to examine the effect of geographical area, season and prescribing veterinarian on AMU. Management and structural interventions implemented by the company were also assessed. Results AMU showed a 71% reduction in broilers (from 14 to 4 DDDvet/PCU) and a 56% reduction in turkeys (from 41 to 18 DDDvet/PCU) during the study period. Quinolones, macrolides and polymyxins decreased from 33% to 6% of total AMU in broilers, and from 56% to 32% in turkeys. Broiler cycles during spring and winter showed significantly higher AMU, as well as those in densely populated poultry areas. Different antimicrobial prescribing behaviour was identified among veterinarians. Conclusions This study evidenced a decreasing trend in AMU and identified several correlates of AMU in broilers and turkeys. These factors will inform the design of interventions to further reduce AMU and therefore counteract antimicrobial resistance in these poultry sectors.

scholarly journals 920. Use of the Web by State and Territorial Health Departments to Promote the Dissemination of State Antimicrobial Resistance Surveillance Data, United States

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S494-S495
Author(s):  
Xin Yin ◽  
Keith W Hamilton ◽  
Heather Tate ◽  
Nkuchia M M’ikanatha
Keyword(s):  
Public Health ◽  
United States ◽  
Antimicrobial Resistance ◽  
Health Professionals ◽  
One Health ◽  
Antimicrobial Use ◽  
Web Survey ◽  
Related Information ◽  
Appropriate Antimicrobial Use ◽  
The Web

Abstract Background Antimicrobial resistant (AMR) bacteria pose a serious threat to public health. The national response to this threat includes calls for promoting judicious use of antibiotics in humans and animals and strengthening integrated One Health surveillance of AMR bacteria in humans, animals, and environment. However, the extent to which public health jurisdictions are disseminating surveillance findings to promote judicious use of antimicrobials is unclear. Methods We used a standardized web audit tool to manually review and document the presence of AMR-related information on the websites of all public health jurisdictions that participate in national notifiable disease surveillance in the United States. We also emailed a survey to representatives in the 54 jurisdictions that participate in the National Antimicrobial Resistance Monitoring System (NARMS) activities coordinated by the Centers for Disease Control and Prevention. The survey asked questions about AMR-related information on their public health department website. Results Of the 37 (68.5%) jurisdictions that responded to the email survey, 26 (70.3%) indicated that their websites have information on appropriate antibiotic use for health professionals, veterinarians and general public, compared to 89.3% from the web survey (Figure). Eleven (29.7%) indicated that they have data on antimicrobial susceptibility for pathogens, or antibiograms, on their websites, compared to 48.2% from the web survey. While 11 (29.7%) jurisdictions indicated that they have highlighted appropriate antimicrobial use on the homepage, the web survey found no reference on the homepage. Comparison of results from email and web survey on public health jurisdictions’ website, United States - 2020 Conclusion Public health jurisdictions have begun to use websites to increase awareness about the threat of antimicrobial resistance. However, the limited presence of information on appropriate antimicrobial use for the public, health professionals and veterinarians suggest the need for improvement. Gaps exist between the awareness of the epidemiologists and laboratorians and the information reported on public health jurisdictions’ websites. Websites can be expanded and better leveraged to increase visibility of AMR and appropriate antimicrobial prescribing across One Health domains. Disclosures All Authors: No reported disclosures

Perspectives on Prevention: A Dialogue Between Public Health Officials and Community Psychologists

2002 ◽  
Author(s):  
Steven B. Pokorny ◽  
Peter Y. Ji ◽  
Jospeh L. Sherk ◽  
P. Jacob Rebus ◽  
Olga Rabin-Belyaev ◽  
...  
Keyword(s):  
Public Health ◽  
Public Health Officials

Managing the effectiveness of the regional health system

2020 ◽  
Vol 26 (3) ◽  
pp. 698-720
Author(s):  
E.V. Lobkova ◽  
A.S. Petrichenko
Keyword(s):  
Public Health ◽  
Health System ◽  
System Analysis ◽  
Health Indicators ◽  
Krasnoyarsk Krai ◽  
Regional Health ◽  
Luenberger Observer ◽  
Efficiency Assessment ◽  
Public Health Indicators

Subject. This article studies the mechanism of State health regulation and methods of management of efficiency of regional healthcare institutions. Objectives. The article aims to analyze the territorial health system in the context of the urgent need to optimize budget expenditures and address public health problems, as well as develop directions to improve the effectiveness of the regional health system of the Krasnoyarsk Krai. Methods. For the study, we used the method of index numbers and calculation of dynamics indicators using official statistics data. Results. We have developed and now present a system of indicators of regional health efficiency assessment, focused mainly on public health indicators and quality of medical services. We also offer our own version of the Luenberger observer modification adapted to the objectives of the regional health system analysis. Conclusions and Relevance. The article concludes that it is necessary to optimize the regional health system using the parameters of medical and social efficiency of the system. The proposed approach to assessing the effectiveness of regional health system can be used as a mechanism to develop recommendations for the management of the network of medical and prophylactic institutions of the region.

Assessing the quality of public health in the Russian Federation and Israel: Main problems and solutions

2020 ◽  
Vol 19 (4) ◽  
pp. 618-632
Author(s):  
A.S. Panchenko
Keyword(s):  
Public Health ◽  
Russian Federation ◽  
Population Based ◽  
The Public ◽  
Disability Adjusted Life ◽  
Problems And Solutions ◽  
The Russian Federation ◽  
Disability Adjusted Life Year ◽  
Practical Recommendations

Subject. The article addresses the public health in the Russian Federation and Israel. Objectives. The focus is on researching the state of public health in Russia and Israel, using the Global Burden of Disease (GBD) project methodology, identifying problem areas and searching for possible ways to improve the quality of health of the Russian population based on the experience of Israel. Methods. The study draws on the ideology of the GBD project, which is based on the Disability-Adjusted Life-Year (DALY) metric. Results. The paper reveals the main causes of DALY losses and important risk factors for cancer for Russia and Israel. The findings show that the total DALY losses for Russia exceed Israeli values. The same is true for cancer diseases. Conclusions. Activities in Israel aimed at improving the quality of public health, the effectiveness of which has been proven, can serve as practical recommendations for Russia. The method of analysis, using the ideology of the GBD project, can be used as a tool for quantitative and comparative assessment of the public health.

Sign in / Sign up

Export Citation Format

Share Document