scholarly journals Reduction of broad-spectrum antibiotic use with computerized decision support in an intensive care unit

2006 ◽  
Vol 18 (3) ◽  
pp. 224-231 ◽  
Author(s):  
Karin A. Thursky ◽  
Kirsty L. Buising ◽  
Narin Bak ◽  
Lachlan Macgregor ◽  
Alan C. Street ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Decision Support ◽  
Broad Spectrum ◽  
Antibiotic Use ◽  
Broad Spectrum Antibiotic ◽  
Computerized Decision Support

scholarly journals Outcomes and antibiotic use in patients with coronavirus disease 2019 (COVID-19) admitted to an intensive care unit

2022 ◽  
Vol 2 (1) ◽  
Author(s):  
Megan M. Petteys ◽  
Leigh Ann Medaris ◽  
Julie E. Williamson ◽  
Rohit S. Soman ◽  
Travis A. Denmeade ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Broad Spectrum ◽  
Bacterial Infections ◽  
Antibiotic Use ◽  
Antibiotic Overuse ◽  
Negative Culture ◽  
Broad Spectrum Antibiotics

Abstract Antibiotic overuse is high in patients hospitalized with coronavirus disease 2019 (COVID-19) despite a low documented prevalence of bacterial infections in many studies. In this study evaluating 65 COVID-19 patients in the intensive care unit, empiric broad-spectrum antibiotics were often overutilized with an inertia to de-escalate despite negative culture results.

Audit and Feedback to Reduce Broad-Spectrum Antibiotic Use among Intensive Care Unit Patients A Controlled Interrupted Time Series Analysis

2012 ◽  
Vol 33 (4) ◽  
pp. 354-361 ◽  
Author(s):  
Marion Elligsen ◽  
Sandra A. N. Walker ◽  
Ruxandra Pinto ◽  
Andrew Simor ◽  
Samira Mubareka ◽  
...  
Keyword(s):  
Time Series ◽  
Critical Care ◽  
Intensive Care ◽  
Broad Spectrum ◽  
Interrupted Time Series ◽  
Antibiotic Use ◽  
Audit And Feedback ◽  
Broad Spectrum Antibiotic ◽  
Days Of Therapy ◽  
Prospective Audit And Feedback

Objective.We aimed to rigorously evaluate the impact of prospective audit and feedback on broad-spectrum antimicrobial use among critical care patients.Design.Prospective, controlled interrupted time series.SettingSingle tertiary care center with 3 intensive care units.Patients and Interventions.A formal review of all critical care patients on their third or tenth day of broad-spectrum antibiotic therapy was conducted, and suggestions for antimicrobial optimization were communicated to the critical care team.Outcomes.The primary outcome was broad-spectrum antibiotic use (days of therapy per 1000 patient-days; secondary outcomes included overall antibiotic use, gram-negative bacterial susceptibility, nosocomial Clostridium difficile infections, length of stay, and mortality.Results.The mean monthly broad-spectrum antibiotic use decreased from 644 days of therapy per 1,000 patient-days in the preintervention period to 503 days of therapy per 1,000 patient-days in the postintervention period (P < .0001); time series modeling confirmed an immediate decrease (± standard error) of 119 ± 37.9 days of therapy per 1,000 patient-days (P = .0054). In contrast, no changes were identified in the use of broad-spectrum antibiotics in the control group (nonintervention medical and surgical wards) or in the use of control medications in critical care (stress ulcer prophylaxis). The incidence of nosocomial C. difficile infections decreased from 11 to 6 cases in the study intensive care units, whereas the incidence increased from 87 to 116 cases in the control wards (P = .04). Overall gram-negative susceptibility to meropenem increased in the critical care units. Intensive care unit length of stay and mortality did not change.Conclusions.Institution of a formal prospective audit and feedback program appears to be a safe and effective means to improve broad-spectrum antimicrobial use in critical care.

scholarly journals 1137. Variability of Antibiotic Use in Neonatal Intensive Care Units in the United States

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S404-S405
Author(s):  
Keerti Dantuluri ◽  
Hannah Griffith ◽  
Cary Thurm ◽  
Ritu Banerjee ◽  
Ritu Banerjee ◽  
...  
Keyword(s):  
United States ◽  
Intensive Care ◽  
Broad Spectrum ◽  
Neonatal Intensive Care ◽  
Antibiotic Use ◽  
The United States ◽  
Neonatal Intensive Care Units ◽  
Case Mix ◽  
Broad Spectrum Antibiotic ◽  
Research Grant

Abstract Background Although antibiotics are often indicated to treat early-life infections, such exposure may lead to serious adverse outcomes. Few studies have characterized patterns of antibiotic use among neonatal intensive care units (NICUs). Methods We performed a cross-sectional study of antibiotic use in 51 NICUs participating in the Pediatric Health Information System (PHIS), a database that includes clinical and resource utilization data for standalone children’s hospitals in the United States. Assessments were conducted on a single mid-week day of 2017. We examined the use of any antibiotic and broad-spectrum antibiotics using charge data in children admitted in each NICU on the study day. We compared antibiotic use among NICUs and geographical regions, and assessed its association with the NICU median case mix index (CMI) (as a surrogate for clinical complexity). Results 2813 infants were hospitalized in NICUs on the study day; the median number of patients at each study site was 47 (IQR = 34 – 62). 90% were <1 month old, 56% were male, 46% were white, and 62% were extremely/very preterm. Overall, 23% received at least one antibiotic and 6% received broad-spectrum antibiotics. Broad-spectrum antibiotic use was twice as prevalent in surgical compared with medical patients. Antibiotic use prevalence varied by region, ranging from 19% in the Midwest to 26% in the West (table). Ampicillin, gentamicin and vancomycin were the most common antibiotics used (25.2%, 18.8% and 9.9%, respectively). Antibiotic use prevalence varied substantially across NICUs (Figure 1). There was a moderate but significant positive correlation between overall or broad-spectrum antibiotic use and median NICU CMI (Figure 2). Conclusion There is substantial variability in antibiotic use among US NICUs, which seems partially explained by patient case-mix. Additional studies are needed to identify drivers of unwarranted variability in antibiotic use among NICUs. Disclosures Ritu Banerjee, MD, PhD, Accelerate Diagnostics: Grant/Research Support; BioFire: Research Grant; Biomerieux: Research Grant; Roche: Research Grant.

Risk of Clostridium difficile-Associated Disease Among Patients Receiving Proton-Pump Inhibitors in a Quebec Medical Intensive Care Unit

2007 ◽  
Vol 28 (11) ◽  
pp. 1305-1307 ◽  
Author(s):  
Mathieu Beaulieu ◽  
David Williamson ◽  
Gilbert Pichette ◽  
Jean Lachaine
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Clostridium Difficile ◽  
Gastric Acid ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Medical Intensive Care Unit ◽  
Antibiotic Use ◽  
Medical Intensive Care

Our study was conducted to determine whether use of gastric acid-suppressive agents increased the risk of Clostridium difficile-associated disease (CDAD) in a medical intensive care unit of one of the first hospitals to be threatened by the current CDAD epidemic in Quebec, Canada. Our findings suggest that efforts to determine risk factors for CDAD should focus on other areas, such as older age and antibiotic use.

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