Infectious diseases hot-line with smartphone monitoring, a convenient way to trace medical activities and promote antibiotic stewardship

2016 ◽  
Author(s):  
Benjamin Davido
Keyword(s):  
Infectious Diseases ◽  
Antibiotic Stewardship

scholarly journals Pharmacist-Driven Antibiotic Stewardship Program in Febrile Neutropenic Patients: A Single Site Prospective Study in Thailand

Antibiotics ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 456
Author(s):  
Kittiya Jantarathaneewat ◽  
Anucha Apisarnthanarak ◽  
Wasithep Limvorapitak ◽  
David J. Weber ◽  
Preecha Montakantikul
Keyword(s):  
Infectious Diseases ◽  
Antibiotic Stewardship ◽  
Empirical Therapy ◽  
University Hospital ◽  
Control Group ◽  
Great Opportunity ◽  
Stewardship Program ◽  
Determine Role ◽  
Neutropenic Patients ◽  
Infectious Diseases Consultation

The antibiotic stewardship program (ASP) is a necessary part of febrile neutropenia (FN) treatment. Pharmacist-driven ASP is one of the meaningful approaches to improve the appropriateness of antibiotic usage. Our study aimed to determine role of the pharmacist in ASPs for FN patients. We prospectively studied at Thammasat University Hospital between August 2019 and April 2020. Our primary outcome was to compare the appropriate use of target antibiotics between the pharmacist-driven ASP group and the control group. The results showed 90 FN events in 66 patients. The choice of an appropriate antibiotic was significantly higher in the pharmacist-driven ASP group than the control group (88.9% vs. 51.1%, p < 0.001). Furthermore, there was greater appropriateness of the dosage regimen chosen as empirical therapy in the pharmacist-driven ASP group than in the control group (97.8% vs. 88.7%, p = 0.049) and proper duration of target antibiotics in documentation therapy (91.1% vs. 75.6%, p = 0.039). The multivariate analysis showed a pharmacist-driven ASP and infectious diseases consultation had a favorable impact on 30-day infectious diseases-related mortality in chemotherapy-induced FN patients (OR 0.058, 95%CI:0.005–0.655, p = 0.021). Our study demonstrated that pharmacist-driven ASPs could be a great opportunity to improve antibiotic appropriateness in FN patients.

scholarly journals A Statewide Assessment of Antifungal Stewardship Activities in Acute-Care Hospitals in Connecticut

2020 ◽  
Vol 41 (S1) ◽  
pp. s105-s105
Author(s):  
Romina Bromberg ◽  
Vivian Leung ◽  
Meghan Maloney ◽  
Anu Paranandi ◽  
David Banach
Keyword(s):  
Infectious Diseases ◽  
Acute Care ◽  
Antifungal Therapy ◽  
Antibiotic Stewardship ◽  
Susceptibility Testing ◽  
Antifungal Susceptibility ◽  
Acute Care Hospitals ◽  
Antifungal Susceptibility Testing ◽  
Antifungal Stewardship ◽  
Infectious Diseases Consultation

Background: Morbidity and mortality associated with invasive fungal infections and concerns of emerging antifungal resistance have highlighted the importance of optimizing antifungal therapy among hospitalized patients. Little is known about antifungal stewardship (AFS) practices among acute-care hospitals. We sought to assess AFS activities within Connecticut and to identify opportunities for improvement. Methods: An electronic survey assessing AFS practices was distributed to infectious disease physicians or pharmacy antibiotic stewardship program leaders in Connecticut hospitals. Survey questions evaluated AFS activities based on antibiotic stewardship principles, including several CDC Core Elements. Questions assessed antifungal restriction, prospective audit and feedback practices, antifungal utilization measurements, and the perceived utility of a local or statewide antifungal antibiogram. Results: Responses were received from 15 respondents, which represented 20 of 31 hospitals (65%); these hospitals made up the majority of the acute-care hospitals in Connecticut. Furthermore, 18 of these hospitals (58%) include antifungals in their stewardship programs. Also, 16 hospitals (52%) conduct routine review of antifungal ordering and provide feedback to providers for some antifungals, most commonly for amphotericin B, voriconazole, micafungin, isavuconazole, and flucytosine. All hospitals include guidance on intravenous (IV) to oral (PO) conversions, when appropriate. Only 14 of hospitals (45%) require practitioners to document indication(s) for systemic antifungal use. Most hospitals (17, 55%) provide recommendations for de-escalation of therapy in candidemia, though only 4 (13%) have institutional guidelines for candidemia treatment, and only 11 hospital mandates an infectious diseases consultation for candidemia. Assessing outcomes pertaining to antifungal utilization is uncommon; only 8 hospitals (26%) monitor days of therapy and 5 (16%) monitor antifungal expenditures. Antifungal susceptibility testing on Candida bloodstream isolates is performed routinely at 6 of the hospitals (19%). Most respondents (19, 95%) support developing an antibiogram for Candida bloodstream isolates at the statewide level. Conclusions: Although AFS interventions occur in Connecticut hospitals, there are opportunities for enhancement, such as providing institutional guidelines for candidemia treatment and mandating infectious diseases consultation for candidemia. The Connecticut Department of Public Health implemented statewide Candida bloodstream isolate surveillance in 2019, which includes antifungal susceptibility testing. The creation of a statewide antibiogram for Candida bloodstream infections is underway to support empiric antifungal therapy.Funding: NoneDisclosures: None

scholarly journals Urgent, Comprehensive Federal Action Needed To Stem Mortality and Medicare Costs Associated With Antimicrobial Resistance

2021 ◽  
Author(s):  
Vance G Fowler ◽  
Amanda Jezek ◽  
Emily S Spivak ◽  
Kathy Talkington
Keyword(s):  
Antimicrobial Resistance ◽  
Infectious Diseases ◽  
Antibiotic Stewardship ◽  
Infection Prevention ◽  
Call To Action ◽  
Global Coordination ◽  
Medicare Costs ◽  
Stem Mortality

Abstract This paper is a call to action for the policies necessary to reduce the burden of antimicrobial resistance, including federal investments in antibiotic stewardship, antibiotic innovation, surveillance, research, diagnostics, infection prevention, the infectious diseases workforce, and global coordination.

scholarly journals How to Pitch an Antibiotic Stewardship Program to the Hospital C-Suite

2016 ◽  
Vol 3 (4) ◽  
Author(s):  
Brad Spellberg ◽  
John G. Bartlett ◽  
David N. Gilbert
Keyword(s):  
Infectious Diseases ◽  
Antibiotic Stewardship ◽  
Hospital Costs ◽  
Business Plan ◽  
Business Plans ◽  
Hospital Leadership ◽  
Stewardship Program ◽  
Regulatory Standards ◽  
Revenue Models ◽  
The Cost

Abstract Hospitals will soon require antibiotic stewardship programs. Infectious diseases specialists must craft business plans to engage hospital leadership to fund such programs. In this article, we review key cost and revenue elements that should be covered in such plans. Society is placing increasing emphasis on the importance of antimicrobial stewardship programs (ASPs). New regulatory standards require hospitals to implement ASPs. Infectious Diseases (ID) specialists will need to help design and implement such programs at hospitals. A critical component of establishing such programs is submitting a business plan to hospital leadership justifying the cost and structure of the ASP and explaining what benefits the hospital will gain in return. In this article, we explore typical elements of such business plans and describe how hospital leadership may evaluate and determine the value of such plans. Understanding hospital costs and revenue models is critical to creating a viable and realistic business plan to support ASPs.

scholarly journals Executive Summary: Implementing an Antibiotic Stewardship Program: Guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America

2016 ◽  
Vol 62 (10) ◽  
pp. 1197-1202 ◽  
Author(s):  
Tamar F. Barlam ◽  
Sara E. Cosgrove ◽  
Lilian M. Abbo ◽  
Conan MacDougall ◽  
Audrey N. Schuetz ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Antibiotic Stewardship ◽  
Expert Panel ◽  
Executive Summary ◽  
Term Care ◽  
Stewardship Program ◽  
Care Surgery ◽  
Evidence Based Guidelines ◽  
Healthcare Epidemiology

Abstract Evidence-based guidelines for implementation and measurement of antibiotic stewardship interventions in inpatient populations including long-term care were prepared by a multidisciplinary expert panel of the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. The panel included clinicians and investigators representing internal medicine, emergency medicine, microbiology, critical care, surgery, epidemiology, pharmacy, and adult and pediatric infectious diseases specialties. These recommendations address the best approaches for antibiotic stewardship programs to influence the optimal use of antibiotics.

scholarly journals Effectiveness and Acceptance of Multimodal Antibiotic Stewardship Program: Considering Progressive Implementation and Complementary Strategies

Antibiotics ◽  
2020 ◽  
Vol 9 (12) ◽  
pp. 848
Author(s):  
Flavien Bouchet ◽  
Vincent Le Moing ◽  
Delphine Dirand ◽  
François Cros ◽  
Alexi Lienard ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Infectious Diseases ◽  
Antibiotic Therapy ◽  
Antibiotic Stewardship ◽  
Antibiotic Use ◽  
Stewardship Program ◽  
Microbiological Laboratory ◽  
Combined Actions ◽  
One Year

Multiple modes of interventions are available when implementing an antibiotic stewardship program (ASP), however, their complementarity has not yet been assessed. In a 938-bed hospital, we sequentially implemented four combined modes of interventions over one year, centralized by one infectious diseases specialist (IDS): (1) on-request infectious diseases specialist consulting service (IDSCS), (2) participation in intensive care unit meetings, (3) IDS intervention triggered by microbiological laboratory meetings, and (4) IDS intervention triggered by pharmacist alert. We assessed the complementarity of the different cumulative actions through quantitative and qualitative analysis of all interventions traced in the electronic medical record. We observed a quantitative and qualitative complementarity between interventions directly correlating to a decrease in antibiotic use. Quantitatively, the number of interventions has doubled after implementation of IDS intervention triggered by pharmacist alert. Qualitatively, these kinds of interventions led mainly to de-escalation or stopping of antibiotic therapy (63%) as opposed to on-request IDSCS (32%). An overall decrease of 14.6% in antibiotic use was observed (p = 0.03). Progressive implementation of the different interventions showed a concrete complementarity of these actions. Combined actions in ASPs could lead to a significant decrease in antibiotic use, especially regarding critical antibiotic prescriptions, while being well accepted by prescribers.

scholarly journals A Qualitative Study of the Real-world Experiences of Infectious Diseases Fellows Regarding Antibiotic Stewardship

2018 ◽  
Vol 5 (9) ◽  
Author(s):  
Jake R Morgan ◽  
Tamar F Barlam ◽  
Mari-Lynn Drainoni
Keyword(s):  
Public Health ◽  
Qualitative Study ◽  
Infectious Diseases ◽  
Antibiotic Stewardship ◽  
Bacterial Infections ◽  
Fellowship Training ◽  
Complex Problem ◽  
Public Health Importance ◽  
Stewardship Program ◽  
Physician Leaders

Abstract Background Antibiotic-resistant bacterial infections are a major threat to public health, yet improper use of antibiotics remains high. Infectious Diseases (ID) fellows play a major role in antibiotic stewardship efforts, but there is little research on how they view stewardship activities. We performed a qualitative study to explore ID fellows’ experiences and perspectives regarding their antibiotic stewardship training and their role as future antibiotic stewards. Methods We conducted 17 in-depth interviews with ID fellows across the country. The interviews were transcribed verbatim by the study team, and we used grounded theory to generate themes from these interviews Results Fellows focused on concrete tasks of stewardship such as performing antibiotic approvals, didactic and case-based education, and interactions with other physicians and pharmacists. There was little focus on the broader public health relevance of antibiotic stewardship. Pharmacists, not ID physician leaders, were identified as fellows’ primary resource for antibiotic teaching. Several fellows suggested that stewardship programs should be led by pharmacists. Conclusions ID fellowship training is not successfully conveying the public health importance of antibiotic stewardship or the role of ID physicians as leaders of antibiotic stewardship programs. Fellows are more focused on concrete tasks related to stewardship. ID training programs and societies should consider developing robust curricula involving fellows in the operation of the stewardship program itself, not solely in antibiotic approvals, emphasizing aspects of the program such as complex problem solving that fellows find most compelling, and emphasizing the important role these programs serve in improving public health.

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