scholarly journals Intervention with educational outreach at large scale to reduce antibiotics for respiratory tract infections: a controlled before and after study

2009 ◽  
Vol 26 (3) ◽  
pp. 183-187 ◽  
Author(s):  
H. Smeets ◽  
M. Kuyvenhoven ◽  
A. Akkerman ◽  
I Welschen ◽  
G. Schouten ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Large Scale ◽  
Educational Outreach ◽  
Before And After ◽  
Tract Infections ◽  
Before And After Study

Infection Rates Before and After Diagnosis of IgA Vasculitis in Childhood: A Population-wide Study Using Non-exposed Matched Controls

2019 ◽  
Vol 47 (3) ◽  
pp. 424-430 ◽  
Author(s):  
Johannes C. Nossent ◽  
Warren Raymond ◽  
Helen Keen ◽  
David B. Preen ◽  
Charles A. Inderjeeth
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Upper Respiratory Tract Infections ◽  
Iga Vasculitis ◽  
Upper Respiratory Tract ◽  
Serious Infection ◽  
Serious Infections ◽  
Before And After ◽  
Upper Respiratory ◽  
Tract Infections

Objective.Clinical data suggest that infections can trigger IgA vasculitis (IgAV), but longterm observations are lacking. We compared rates, types, and microorganisms for serious infection before and after diagnosis for children with IgAV and non-exposed controls.Methods.Using population-based administrative linked health datasets we estimated incidence rates (IR) for serious infection per 1000 person-months for patients with IgAV (n = 504, age 5 yrs, 59.1% males) and controls matched for age, sex, and year of presentation (n = 1281, age 6 yrs, 66% males). Time zero (T0) was the date of IgAV diagnosis or equivalent date in controls, lookback (median 38 mos) was the period prior to T0, and followup (median 239 mos) was the period after T0.Results.During lookback, prevalence of serious infection was similar in patients with IgAV and controls (11.5% vs 9.5%, respectively), but patients with IgAV had a higher rate of upper respiratory tract infections [incidence rate ratio (IRR) 1.79; 95% CI 1.39–2.31] with shorter time between first serious infection and T0 (27 vs 43 mos; p = 0.02). During followup, patients were at a constant increased risk for serious infections (IRR 1.46, 95% CI 1.35–1.58). These rates were higher during followup: sepsis (IRR 12.6), pneumonia (IRR 6.19), upper respiratory tract infections (IRR 2.36), and skin infections (IRR 1.85). There was little overlap between patients with serious infections in the lookback and followup periods.Conclusion.In patients with childhood IgAV there is an increased longterm risk for a broader spectrum of infections, which is unrelated to serious infections prior to diagnosis or treatment. This suggests disease-specific factors may have a lasting effect on immune competence in childhood IgAV.

scholarly journals The Potential Impact of Intensified Community Hand Hygiene Interventions on Respiratory tract Infections: A Modelling Study

2020 ◽  
Author(s):  
Thi Mui Pham ◽  
Yin Mo ◽  
Ben S. Cooper
Keyword(s):  
Hand Hygiene ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Large Scale ◽  
Fixed Time ◽  
Hand Washing ◽  
Hygiene Behaviour ◽  
Potential Impact ◽  
Tract Infections ◽  
Contamination Events

AbstractIncreased hand hygiene amongst the general public has been widely promoted as one of the most important non-pharmaceutical interventions for reducing transmission during the ongoing COVID-19 pandemic and is likely to continue to play a key role in long-term efforts to suppress transmission before a vaccine can be deployed. For other respiratory tract infections community hand hygiene interventions are supported by evidence from randomised trials, but information on how effectiveness in reducing transmission scales with achieved changes in hand hygiene behaviour is lacking. This information is of critical importance when considering the potential value of substantially enhancing community hand hygiene frequency to help suppress COVID-19. Here, we developed a simple model-based framework for understanding the key determinants of the effectiveness of changes in hand hygiene behaviour in reducing transmission and use it to explore the potential impact of interventions aimed at achieving large-scale population-wide changes in hand hygiene behaviour. Our analyses show that the effect of hand hygiene is highly dependent on the duration of viral persistence on hands and that hand washing needs to be performed very frequently or immediately after hand contamination events in order to substantially reduce the probability of infection. Hand washing at a lower frequency, such as every 30 minutes or with a delay of 15 minutes after contamination events, may be adequate to reduce the probability of infection when viral survival on hands is longer, such as when hands are contaminated with mucus. Immediate hand washing after contamination is more effective than hand washing at fixed-time intervals even when the total number of hand washing events is similar. This event-prompted hand washing strategy is consistently more effective than fixed-time strategy regardless of hand contamination rates and should be highlighted in hand hygiene campaigns.

scholarly journals Impact of Nasal Swabs on Empiric Treatment of Respiratory Tract Infections (INSERT-RTI)

Pharmacy ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 101
Author(s):  
Vanessa Huffman ◽  
Diana Carolina Andrade ◽  
Jared Ham ◽  
Kyle Brown ◽  
Leonid Melnitsky ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Hospital Length ◽  
Primary Objective ◽  
Hospital Length Of Stay ◽  
Significant Difference ◽  
Nasal Swabs ◽  
Before And After ◽  
The Difference ◽  
Tract Infections

Methicillin-resistant Staphylococcus aureus (MRSA) polymerase-chain-reaction nasal swabs (PCRNS) are a rapid diagnostic tool with a high negative predictive value. A PCRNS plus education “bundle” was implemented to inform clinicians on the utility of PCRNS for anti-MRSA therapy de-escalation in respiratory tract infections (RTI). The study included patients started on vancomycin with a PCRNS order three months before and after bundle implementation. The primary objective was the difference in duration of anti-MRSA therapy (DOT) for RTI. Secondary objectives included hospital length of stay (LOS), anti-MRSA therapy reinitiation, 30-day readmission, in-hospital mortality, and cost. We analyzed 62 of 110 patients screened, 20 in the preintervention and 42 in the postintervention arms. Mean DOT decreased after bundle implementation by 30.3 h (p = 0.039); mean DOT for patients with a negative PCRNS decreased by 39.7 h (p = 0.014). Median cost was lower after intervention [USD$51.69 versus USD$75.30 (p < 0.01)]. No significant difference in LOS, mortality, or readmission existed. The bundle implementation decreased vancomycin therapy and cost without negatively impacting patient outcomes.

scholarly journals Health Care Provision in a Swiss Urban Walk-In-Clinic. Is Advanced Nursing Practice a Solution for a New Model in Primary Care? / Gesundheitsversorgung in einer städtischen Walk-In-Praxis in der Schweiz. Ist Advanced Nursing Practice ein neues Modell in der Grundversorgung?

2015 ◽  
Vol 2 (1) ◽  
pp. 64-72 ◽  
Author(s):  
Katrin Kambli ◽  
Daniel Flach ◽  
René Schwendimann ◽  
Eva Cignacco
Keyword(s):  
Primary Care ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Large Scale ◽  
Nursing Practice ◽  
Primary Care Providers ◽  
Upper Respiratory Tract ◽  
Care Providers ◽  
Advanced Nursing Practice ◽  
Tract Infections

AbstractBackground: Changing demographic and economic factors are producing serious challenges to Switzerland’s primary care providers: meeting the population’s growing needs will require redevelopment and reorganization. Large-scale community-based care can be expanded via alternative care models, including walk-in-clinics (WIC) stuffed by interdisciplinary teams, with Advanced Practice Nurses (APNs) playing key roles in the treatment of minor complaints.Aims: To reveal the proportion of adult patients within five exemplary diagnostic groups (respiratory tract infections, earaches, hearing impairments, urinary tract infections and wounds) who could be treated by APNs in a Swiss urban WIC in order to develop a future model of multidisciplinary collaboration between APN and physicians. Methods: A retrospective data analysis was performed on WIC’s medical records. Reflecting seasonal variations, a one-month patient data sample was collected for each of four consecutive seasons (July and October 2010, January and April 2011). Data analyses included calculations of frequencies of individual diagnoses and of diagnostic groups.Results: Of a combined sample of 5,130 patient consultations, 53% (n=2,733) fit within the scope of APN competencies. The most common diagnoses concerned minor wounds (24%; n=1,240) and upper respiratory tract infections (18%; n=926).Conclusion: Based on this study’s results, we conclude that assigning APNs to primary care clinics would contribute a meaningful new professional role to Switzerlands healthcare system. Further research will be necessary to evaluate the effects of such implementation on inter-professional collaboration and patient outcomes.

scholarly journals Clinical Study of Azithromycin in Treatment of Respiratory Tract Infections in Children

2015 ◽  
Vol 4 (2) ◽  
pp. 4
Author(s):  
Fei Qian ◽  
Ershang Yang ◽  
Haoyuan Zheng
Keyword(s):  
Treatment Group ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Adverse Reactions ◽  
Clinical Symptoms ◽  
Control Group ◽  
Before And After ◽  
Chest X Ray ◽  
Grouping Method ◽  
Tract Infections

<p><strong>Objective: </strong>To observe the clinical efficacy and safety of azithromycin in the treatment of respiratory tract infections in children. <strong>Method: </strong>This study was select 110 cases of respiratory tract infection in our hospital from April 2013 to December 2014 as the research object. According to the random grouping method, the children were divided into two groups, 55 cases in the control group and 55 cases in the treatment group. On the basis of conventional treatment, the control group was treated with erythromycin 15 to 30 mg/kg per day for 1 week while for the treatment group was treated with Azithromycin 10 mg/kg per day by intravenous drip, and 8 mg/kg per day was administered orally for 4 days. To observe the clinical symptoms, signs, chest X-ray and adverse reactions of two groups before and after treatment. <strong>Results</strong><strong>: </strong>The treatment group cure rate was significantly higher than that of the control group (<em>p</em> &lt; 0.05), cough and fever disappearance time is shorter than that of the control group (<em>p</em> &lt; 0.05), adverse reactions occurred rate of treatment group was lower than that of the control group (<em>p</em> &lt; 0.05). <strong>Conclusion: </strong>The efficacy of azithromycin in the treatment of respiratory tract infections in children is reliable, less adverse reactions and it is worthy of promotion.</p>

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