Physician adherence to acute rhinosinusitis antibiotic treatment guidelines

2021 ◽  
pp. jim-2021-001934
Author(s):  
Esther Levi ◽  
Ohad Ronen
Keyword(s):  
Antibiotic Treatment ◽  
Medical Records ◽  
Treatment Guidelines ◽  
Medical Center ◽  
Duration Of Treatment ◽  
Acute Rhinosinusitis ◽  
Financial Expenditure ◽  
Proper Diagnosis ◽  
Recommended Guidelines ◽  
Physician Adherence

Antibiotic treatment guidelines promote proper diagnosis and treatment and optimize antibiotic treatment, minimizing both antimicrobial resistance to antibiotics and financial expenditure. This study aimed to investigate whether community physicians and emergency department (ED) physicians diagnose and treat acute rhinosinusitis according to accepted guidelines. This was a retrospective study of medical records and referrer letters of patients admitted to the medical center between 2014 and 2015. Physician adherence to antibiotic guidelines regarding indication, type and duration of treatment was assessed. Overall, the study included 84 patients diagnosed with acute rhinosinusitis and admitted to the ED. Fewer than 20% of doctors treating patients with rhinosinusitis at our institution followed the current recommended guidelines. In most cases, the type of treatment administered by ED physicians and by community physicians complied with the guidelines (90% and 96%, respectively, p=0.564). The duration of treatment prescribed by the ED physicians aligned with the guidelines in 37.7% of the cases. There was insufficient compliance with acute rhinosinusitis treatment guidelines among all treating physicians in this study, which was characterized by excessive antibiotic treatment. Therefore, ways to increase understanding and adherence to clinical guidelines, and to provide optimal settings in the clinics to carry out the guidelines should be investigated.

Clinical and epidemicological characteristics of acute rinosinusite by medical document recommended by multidisciplinary polyclinics

2018 ◽  
pp. 24-31
Author(s):  
Al Hariri Mahmoud Jomaa ◽  
S Semenenko ◽  
A Semenenko ◽  
Sergey Zaikov
Keyword(s):  
Statistical Analysis ◽  
Medical Care ◽  
Disease Duration ◽  
Inflammatory Diseases ◽  
Medical Center ◽  
Duration Of Treatment ◽  
Acute Rhinosinusitis ◽  
Diagnostic Center ◽  
Gender And Age ◽  
Clinical Variant

Introduction. Despite the world practice, the problem of inflammatory diseases of the paranasal sinuses is still relevant and has an important social meaning. Despite the fact that rhinosinusitis is one of the most common diseases, the reisvery little accurate data on its epidemiology. Therefore, our goal was to conduct a clinical epidemiological analysis with the establishment of the role of rhinosinusitis in the structure of requests for medical care in multidisciplinary polyclinics. Materials and methods. The data on the prevalence of various forms of sinusitis in the structure of ambulatory-polyclinic patients in the period 2011-2015 have been studied. In patients with acute rhinosinusitis, the following parameters were analyzed: gender and age of patients, duration, clinical variant of the disease, duration of treatment. Results. A clinical and statistical analysis of medical aid appeals at the level of the multidisciplinary outpatient clinic of the Vinnytsia City Clinical Hospital of ambulatory care and the Communal Medical Center "City Medical and Diagnostic Center" of Vinnytsia during 2011-2015. A statistical analysis based on the criterion approach included 896 patients with rinosunsitis. The following parameters have been analyzed: gender and age of patients, duration, clinical variant of the disease, duration of treatment. The conducted researches indicate that in the structure of appeals to the otolaryngologist rhinosinusitis is dominated by acute rhinosinusitis, the frequency of which remained relatively stable for five consecutive years: 133 cases - in 2011, 143 in 2012, 168 in 2013, 150 and 151 in 2014 and 2015, respectively. Among ambulatory polyclinic patients with different clinical variants of sinusitis prevailing persons of young working age. In general, patients with acute bacterial rhinosinusitis in the age group up to 60 years old make up 90.6%, which emphasizes the socioeconomic significance of this pathology. The frequency of treatment with rhinosinusitis is dominated by maxillary sinus lesions. The median duration of treatment was greatest in the case of hemi-sinusitis and polysynytes – 11.27±3.69 and 11.23±3.99 days, respectively, and the lowest in patients with frontal lobe was 9.48±3,76 days (p=0.032). A reduction in the mean duration of treatment for patients during the last three years of observation was observed (p<0.001). Conclusions: The study of the main clinical and epidemiological indicators of rhinosinusitis in the Ukrainian population can be the basis for the in for medplanning of medical care and social activities for this category of otolaryngological patients.

scholarly journals Adherence to International Empiric Antibiotic Treatment Guidelines in a Tertiary Teaching Hospital in Mexico City

2016 ◽  
Vol 3 (suppl_1) ◽  
Author(s):  
Marco Antonio Rodríguez-Cervera ◽  
Paulo Francisco Castañeda-Mendez ◽  
Luis Soto-Ramírez ◽  
Lorena Cabrera-Ruiz
Keyword(s):  
Mexico City ◽  
Antibiotic Treatment ◽  
Teaching Hospital ◽  
Treatment Guidelines ◽  
Tertiary Teaching ◽  
Empiric Antibiotic ◽  
Tertiary Teaching Hospital ◽  
Empiric Antibiotic Treatment

scholarly journals Review of Systemic Antibiotic Treatments in Children with Rhinosinusitis

2019 ◽  
Vol 8 (8) ◽  
pp. 1162 ◽  
Author(s):  
Sara Torretta ◽  
Lorenzo Drago ◽  
Paola Marchisio ◽  
Lorenzo Gaini ◽  
Claudio Guastella ◽  
...  
Keyword(s):  
Antibiotic Treatment ◽  
Controlled Trials ◽  
Duration Of Treatment ◽  
Microbiological Profile ◽  
Clinical Benefits ◽  
Therapeutic Protocols ◽  
Randomised Controlled ◽  
Systemic Antibiotics ◽  
Current Guidelines

Antibiotic treatment in paediatric rhinosinusitis is still a matter of debate, as the current guidelines have been drafted mainly based on clinical studies published before 2013. Recent modifications in the epidemiological basis of the disease might mean that current treatments are not completely adequate considering the evolving microbiological profile of the disease. The present paper reviews the role of systemic antibiotics in children with acute (ARS), chronic (CRS), recurrent (RARS), and complicated acute (CoARS) rhinosinusitis. A total of 14 studies (including 3 prospective non-randomised studies, 8 retrospective studies, and 3 prospective randomised studies) of the 115 initially identified papers were included in this review, corresponding to 13,425 patients. Five papers dealt with ARS, four papers with RARS or CRS, and five papers with CoARS; the remaining papers included patients with either ARS or CRS. Data about the effectiveness of antibiotic treatment in children with ARC, CRS, and CoARS is scarce, as only three randomised controlled trials have been published in the last decade, with contrasting results. There is an urgent need for dedicated controlled trials not only to test the actual clinical benefits deriving from the routine use of systemic antibiotics in different categories of patients but also to compare the effectiveness of various therapeutic protocols in terms of the type of antibacterial molecules and the duration of treatment.

Prophylactic Antibiotic Reduces the Risk of Peritonitis after Invasive Gynecologic Procedures

2019 ◽  
Vol 39 (4) ◽  
pp. 356-361
Author(s):  
Pei-Yi Fan ◽  
Ming-Jen Chan ◽  
Sheng-Hsuan Lin ◽  
Hsin-Hsu Wu ◽  
Ming-Yang Chang ◽  
...  
Keyword(s):  
Antibiotic Treatment ◽  
Medical Center ◽  
Demographic Data ◽  
Group B Streptococcus ◽  
Prophylactic Antibiotic ◽  
Antibiotic Use ◽  
Streptococcus Group ◽  
Prophylactic Antibiotic Treatment ◽  
Group B ◽  
Invasive Techniques

BackgroundPeritonitis is a serious complication after invasive procedures in patients undergoing peritoneal dialysis (PD). Most studies that have investigated peritonitis following invasive gynecologic procedures enrolled small patient populations. This study focuses on the clinical presentation, outcomes, and effects of prophylactic antibiotic use before invasive techniques.MethodsA retrospective study was conducted on patients who underwent invasive gynecologic procedures between 2005 and 2015 in a tertiary medical center. Eligible patients were identified and enrolled and their demographic data were collected. The use of prophylactic antibiotics and the outcomes of peritonitis were recorded.ResultsTwenty-six gynecologic procedures were performed on 18 PD patients. Seven episodes of peritonitis occurred in 6 patients after invasive gynecologic procedures. Eleven procedures were preceded by prophylactic antibiotic treatment (6 oral cefadroxil, 1 oral cefuroxime, 1 oral clindamycin, 1 intravenous [IV] ceftriaxone, 1 IV ceftazidime, and 1 IV cefazolin). The pathogens were diverse (group B Streptococcus, group D Streptococcus, E. coli, and Enterococcus). All episodes of peritonitis were successfully treated using intraperitoneal antibiotics without recurrence, technique failure, or mortality. The odds ratio of peritonitis in the non-prophylaxis group was 20.29 (95% confidence interval 1.01 – 406.35, p = 0.0103).ConclusionThe use of prophylactic antibiotic treatment considerably reduced the risk of peritonitis after invasive gynecologic procedures.

Effective Treatment of Peritoneal Dialysis-Associated Peritonitis with Cefazolin and Ceftazidime in Children

2001 ◽  
Vol 21 (4) ◽  
pp. 386-389 ◽  
Author(s):  
Esther Rusthoven ◽  
Leo A.H. Monnens ◽  
Cornelis H. Schröder
Keyword(s):  
Peritoneal Dialysis ◽  
Medical Records ◽  
Pediatric Patients ◽  
Medical Center ◽  
Initial Therapy ◽  
Loading Dose ◽  
Dialysis Fluid ◽  
Causative Microorganism ◽  
The University ◽  
Antibiotic Combination

Objective To evaluate the use of the combination of cefazolin and ceftazidime for initial treatment of peritoneal dialysis (PD)-related peritonitis in pediatric patients. Design Retrospective nonrandomized study. Setting Pediatric dialysis units of the University Medical Center of Utrecht and Nijmegen, The Netherlands. Patients 40 children (median age 5.4 years) who were treated with PD during the study period of 4.5 years. Interventions All 50 episodes of peritonitis that occurred during the study period were evaluated by review of medical records. Patients were given intraperitoneal ceftazidime 500 mg/L dialysis fluid, and cefazolin 500 mg/L as a loading dose, followed by a maintenance dose of ceftazidime 125 mg/L and cefazolin 100 mg/L, intraperitoneally, 4 times daily. Antibiotics were continued for 14 days. Results After identification of the causative microorganism, one of the antibiotics was discontinued in 34 cases, and the antibiotic schedule was adapted in 2 cases. All cases were initially cured within 3 days. In 5 cases (10%), there was a peritonitis with the same organism recurring within 2 weeks after completion of treatment. There were 4 cases of PD-related peritonitis caused by pseudomonas, all of which were cured. Conclusions The antibiotic combination of cefazolin and ceftazidime is effective for the initial therapy of PD-related peritonitis in children. The toxic complications of aminoglycosides are avoided with this combination.

scholarly journals Strategies for the Prevention of the Intra-Hospital Transmission of COVID-19: A Retrospective Cohort Study

Healthcare ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 195 ◽  
Author(s):  
Min Cheol Chang ◽  
Jian Hur ◽  
Donghwi Park
Keyword(s):  
Cohort Study ◽  
Electronic Medical Records ◽  
Retrospective Cohort Study ◽  
Medical Records ◽  
Retrospective Cohort ◽  
Hospital Staff ◽  
University Hospital ◽  
Actual Situation ◽  
Recommended Guidelines ◽  
Hospital Transmission

Coronavirus disease (COVID-19) has spread rapidly worldwide. We aimed to review the strategies used by our university hospital in Daegu (South Korea) to prevent the transmission of COVID-19 within our institution. We also investigated the actual situation at our hospital against the recommended guidelines. We conducted a survey among patients and staff in our hospital. Additionally, patients’ electronic medical records were reviewed along with closed-circuit television (CCTV) recordings. Various strategies and guidelines developed by our hospital have been implemented. A total of 303 hospital staff and patients had exposure to 29 confirmed COVID-19 patients. Of them, three tested positive for COVID-19 without further transmission. The intra-hospital infection of the disease occurred when the recommended strategies and guidelines such as wearing a mask and isolating for 2 weeks were not followed. In conclusion, the implementation of robust guidelines for preventing the intra-hospital transmission of COVID-19 is essential.

scholarly journals Applying Convolutional Neural Networks to Predict the ICD-9 Codes of Medical Records

Sensors ◽  
2020 ◽  
Vol 20 (24) ◽  
pp. 7116
Author(s):  
Jia-Lien Hsu ◽  
Teng-Jie Hsu ◽  
Chung-Ho Hsieh ◽  
Anandakumar Singaravelan
Keyword(s):  
Medical Records ◽  
Learning Algorithm ◽  
Text Processing ◽  
Medical Center ◽  
Clinical Information ◽  
Self Report ◽  
Diagnostic Code ◽  
Evaluation Tool ◽  
Deep Learning Algorithm ◽  
International Statistical Classification

The International Statistical Classification of Disease and Related Health Problems (ICD) is an international standard system for categorizing and reporting diseases, injuries, disorders, and health conditions. Most previously-proposed disease predicting systems need clinical information collected by the medical staff from the patients in hospitals. In this paper, we propose a deep learning algorithm to classify disease types and identify diagnostic codes by using only the subjective component of progress notes in medical records. In this study, we have a dataset, consisting of about one hundred and sixty-eight thousand medical records, from a medical center, collected during 2003 and 2017. First, we apply standard text processing procedures to parse the sentences and word embedding techniques for vector representations. Next, we build a convolution neural network model on the medical records to predict the ICD-9 code by using a subjective component of the progress note. The prediction performance is evaluated by ten-fold cross-validation and yields an accuracy of 0.409, recall of 0.409 and precision of 0.436. If we only consider the “chapter match” of ICD-9 code, our model achieves an accuracy of 0.580, recall of 0.580, and precision of 0.582. Since our diagnostic code prediction model is solely based on subjective components (mainly, patients’ self-report descriptions), the proposed approach could serve as a remote and self-diagnosis assistance tool, prior to seeking medical advice or going to the hospital. In addition, our work may be used as a primary evaluation tool for discomfort in the rural area where medical resources are restricted.

Cellulitis: Home or Inpatient Intravenous Therapy in a Veteran Population

2019 ◽  
Vol 32 (3) ◽  
pp. 127-133
Author(s):  
Rebekah A. Wahking ◽  
Bonnie Clark ◽  
Tasha Cheatham-Wilson
Keyword(s):  
Treatment Failure ◽  
Antibiotic Treatment ◽  
Inpatient Treatment ◽  
Medical Center ◽  
Retrospective Chart Review ◽  
Primary Diagnosis ◽  
Primary Objective ◽  
Outpatient Parenteral Antimicrobial Therapy ◽  
Inpatient Settings ◽  
Inpatient Group

There are few studies describing outpatient parenteral antimicrobial therapy (OPAT) for cellulitis treatment. The Hospital in Home (HIH) program is a multidisciplinary team at the Cincinnati VA Medical Center (CVAMC) that provides acute care in patients’ homes similar to inpatient hospital care for a variety of indications, including cellulitis. Efficacy of OPAT for cellulitis treatment in the HIH program has not been directly compared with inpatient treatment. The primary objective of this retrospective review is to compare the rates of efficacy of intravenous (IV) antibiotics for cellulitis treatment for patients followed by HIH and inpatient settings. Treatment failure was defined as a change in IV antibiotic medications prescribed. A retrospective chart review was completed at CVAMC for patients enrolled in HIH ( n = 111) and patients who received inpatient treatment at CVAMC ( n = 111) with IV antibiotics for a primary diagnosis of cellulitis from January 1, 2014, through June 30, 2018. Six patients in the HIH group experienced IV antibiotic treatment failure compared with 11 in the inpatient group. The HIH group showed non-inferiority in rates of treatment failure compared with the inpatient group ( p = .21). OPAT with the HIH program appears to be non-inferior to inpatient IV antibiotic treatment for cellulitis infections. Tolerance issues and rates of adverse events do not appear to be worse in patients treated with OPAT in the Veteran population.

scholarly journals Deterrence approach on the compliance with electronic medical records privacy policy: the moderating role of computer monitoring

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Kuang-Ming Kuo ◽  
Paul C. Talley ◽  
Tain-Junn Cheng
Keyword(s):  
Electronic Medical Records ◽  
Medical Records ◽  
Survey Methodology ◽  
Medical Center ◽  
Hierarchical Regression ◽  
Privacy Policy ◽  
Healthcare Facilities ◽  
Hospital Employees ◽  
Computer Monitoring ◽  
Minimum Requirements

Abstract Background This study explored the possible antecedents that will motivate hospital employees’ compliance with privacy policy related to electronic medical records (EMR) from a deterrence perspective. Further, we also investigated the moderating effect of computer monitoring on relationships among the antecedents and the level of hospital employees’ compliance intention. Methods Data was collected from a large Taiwanese medical center using survey methodology. A total of 303 responses was analyzed via hierarchical regression analysis. Results The results revealed that sanction severity and sanction certainty significantly predict hospital employees’ compliance intention, respectively. Further, our study found external computer monitoring significantly moderates the relationship between sanction certainty and compliance intention. Conclusions Based on our findings, the study suggests that healthcare facilities should take proactive countermeasures, such as computer monitoring, to better protect the privacy of EMR in addition to stated privacy policy. However, the extent of computer monitoring should be kept to minimum requirements as stated by relevant regulations.

Sign in / Sign up

Export Citation Format

Share Document