scholarly journals A Descriptive View on Prescription audit of prescribing patterns in primary, secondary, tertiary healthcare facilities in India

2020 ◽  
Author(s):  
Debraj Mukhopadhyay ◽  
Dattatreya Mukherjee
Keyword(s):  
Health Service ◽  
Health Professionals ◽  
Bacterial Infections ◽  
Improve Patient Care ◽  
Prescribing Patterns ◽  
Resistant Bacteria ◽  
Healthcare Facilities ◽  
Quality Improvement Process ◽  
Prescription Audit ◽  
Service Managers

Prescription audit is a tool as well as a technique and its application is science as well as an art. Quality of life can be improved by enhancing the standards of medical treatment and that can only be assessed by prescription audit, because it is based on documented evidences to support diagnosis, treatment and justified utilization of hospital facilities. Effective prescription audit is important for health professionals, health service managers, patients, and the public. It supports health professionals in making sure their patients receive the best possible care. It can inform health service managers about the need for organizational changes, or new investment to support health professionals in their practice. Prescription audit is a quality improvement process that seeks to improve patient care. Antibiotic resistance is a global problem which is threatening, particularly in developing countries where the infectious disease burden is more and cost constrains the replacement of older antibiotics with newer which are more expensive ones. Management of common and lethal bacterial infections has been critically compromised by the appearance and rapid spread of antibiotic – resistant bacteria.

scholarly journals Audit on Infection Control Practices Among Health Care Workers: Perspective by a Infection Prevention Nurse

2019 ◽  
Vol 4 (3) ◽  
Keyword(s):  
Infection Control ◽  
Health And Safety ◽  
Improve Patient Care ◽  
Resistant Bacteria ◽  
Quality Improvement Process ◽  
Drug Resistant Bacteria ◽  
Care Workers ◽  
Hospital Infection Control ◽  
Invasive Techniques ◽  
Improve Patient

Hospital Infection control is very essential for the safety and wellbeing of patients, hospital staffs and visitors of the hospital. It affects various Departments of the hospital and it also involves problems of quality risk management, clinical governance of health and safety. Many factors stimulate infections among hospitalized patients – ‘decreased resistance among patients’; ‘increasing variation of medical procedures’ and ‘invasive techniques crafting potential routes of infection’; and ‘the transmission of drug-resistant bacteria’ are packed among hospital populations’, where poor practice in infection control may facilitate transmission. Audit means checking actual practice against a standard; it should permit reporting of noncompliance or issues of concern by either healthcare workers (HCW) or the Infection Control Team (ICT). Providing results of the audit to staff enables them to identify where improvement is needed.1 Audit is a quality improvement process that seeks to improve patient care and outcomes through systematic review of care compared with explicit criteria and the subsequent implementation of change.

scholarly journals Understanding Health Professional Responses to Service Disinvestment: A Qualitative Study

2019 ◽  
Vol 8 (7) ◽  
pp. 403-411
Author(s):  
Deb Mitchel ◽  
Lisa O’Brien ◽  
Anne Bardoel ◽  
Terry Haines
Keyword(s):  
Health Service ◽  
Qualitative Study ◽  
Health Services ◽  
Health Professionals ◽  
Quality Of Patient Care ◽  
Professional Responses ◽  
Hospital Wards ◽  
The Impact ◽  
Service Managers

Background: Disinvestment from inefficient health services may be a potential solution to rising healthcare costs, but there has been poor uptake of disinvestment recommendations. This Australian study aims to understand how health professionals react when confronted with a plan to disinvest from a health service they previously provided to their patients. Methods: This qualitative study took place prior to the disinvestment phase of a trial which removed weekend allied health services from acute hospital wards, to evaluate the effectiveness and cost effectiveness of the service. Observations and focus groups were used to collect data from 156 participants which was analysed thematically. Results: Initial reactions to the disinvestment were almost universally negative, with staff extremely concerned about the impact on the safety and quality of patient care and planning ways to circumvent the trial. Removal of existing services was perceived as a loss and created a direct threat to some clinicians’ professional identity. With time, discussion, and understanding of the project’s context, some staff moved towards acceptance and perceived the trial as an opportunity, particularly given the service was to be reinstated after the disinvestment. Conclusion: Clinicians and health service managers are protective of the services they deliver and can create barriers to disinvestment. Even when services are removed to ascertain their value, health professionals may continue to provide services to their patients. Measuring the impact of the disinvestment may assist staff to accept the removal of a service.

scholarly journals Prescription audit of outpatients in tertiary care government hospital

2018 ◽  
Vol 7 (4) ◽  
pp. 636
Author(s):  
Nuthan Kumar U. S. ◽  
Nalini G. K. ◽  
Deepak P. ◽  
Prema M. ◽  
Geeta Rathod ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Essential Medicine ◽  
General Medicine ◽  
Improve Patient Care ◽  
Quality Improvement Process ◽  
Prescription Audit ◽  
Quality Of Prescribing ◽  
Almost All ◽  
Improve Patient

Background: Prescription audit is a tool as well as a technique by its application,all professionals will improve the quality of prescribing drugs. Standards of medical treatment can be assessed by prescription audit. It is based on documented evidences to support diagnosis, treatment and justified utilization of hospital facilities. Prescription audit is a quality improvement process that seeks to improve patient care. In this background the present study was conducted. The objectives of the study were to know the frequently prescribed drugs in OPD, number of the drugs used per prescription and to find out the rationality.Methods: Study was conducted at Sri Chamarajendra Hospital, HIMS, Hassan in OPD of General Medicine.1000 prescriptions were collected and noted down the frequently used medication, number of drugs prescribed and their type of formulations for the particular diagnosis.Results: From the study it is noted that 1910 drugs out of 1000 prescriptions were prescribed which is approximately 1.91 drugs per prescription about 55% of the prescriptions contained single drug. Very few received 4-5 drugs (7%). Almost all the drugs in prescriptions were in Generic names. Around 95% of prescriptions doses were mentioned in mg, ml etc. The most commonly prescribed drugs in order are Antibiotics, antidiabetics antihypertensives, bronchodilators, steroids antiemetics and ORS were prescribed.Conclusions: Polypharmacy was not found in our prescriptions which indicates our prescriptions improved the patient conditions. This type of study will ensure to know the ‘P’ drug development and select the essential medicine list for various levels of health care.

Microbiome in Chronic Obstructive Pulmonary Disease: Role of Natural Products Against Microbial Pathogens

2020 ◽  
Vol 27 (18) ◽  
pp. 2931-2948
Author(s):  
Alessia Santoro ◽  
Carlo Tomino ◽  
Giulia Prinzi ◽  
Vittorio Cardaci ◽  
Massimo Fini ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Microbial Communities ◽  
Pulmonary Disease ◽  
Bacterial Infections ◽  
Microbial Pathogens ◽  
Resistant Bacteria ◽  
Chronic Obstructive ◽  
Detection Rates ◽  
Obstructive Pulmonary Disease ◽  
Lung Microbiome

The “microbiome” is the operative term to refer to a collection of all taxa constituting microbial communities, such as bacteria, archaea, fungi and protists (originally microbiota). The microbiome consists of the indigenous microbial communities and of the host environment that they inhabit. Actually, it has been shown that there is a close relationship between the microbiome and human health and disease condition. Although, initially, the lung was considered sterile, actually, the existence of a healthy lung microbiome is usually accepted. Lung microbiome changes are reported in Chronic Obstructive Pulmonary Disease (COPD) and in its exacerbation. Viral and bacterial infections of the respiratory system are a major cause of COPD exacerbations (AECOPD) leading to increased local and systemic inflammation. Detection rates of virus in AECOPD are variable between 25-62% according to the detection method. The study of human airway and lung disease virome is quite recent and still very limited. The purpose of this review is to summarize recent findings on the lung microbiome composition with a special emphasis on virome in COPD and in AECOPD. Some drugs of natural origins active against resistant bacteria and virus are described.

Development of Peptides that Inhibit Aminoglycoside-Modifying Enzymes and β-Lactamases for Control of Resistant Bacteria

2020 ◽  
Vol 21 (10) ◽  
pp. 1011-1026
Author(s):  
Bruna O. Costa ◽  
Marlon H. Cardoso ◽  
Octávio L. Franco
Keyword(s):  
Drug Target ◽  
Bacterial Infections ◽  
Antimicrobial Agents ◽  
Treatment Strategies ◽  
Resistance Mechanisms ◽  
Resistant Bacteria ◽  
Specific Chemical ◽  
Target Interaction ◽  
Multiresistant Bacteria ◽  
Acute Bacterial Infections

: Aminoglycosides and β-lactams are the most commonly used antimicrobial agents in clinical practice. This occurs because they are capable of acting in the treatment of acute bacterial infections. However, the effectiveness of antibiotics has been constantly threatened due to bacterial pathogens producing resistance enzymes. Among them, the aminoglycoside-modifying enzymes (AMEs) and β-lactamase enzymes are the most frequently reported resistance mechanisms. AMEs can inactivate aminoglycosides by adding specific chemical molecules in the compound, whereas β-lactamases hydrolyze the β-lactams ring, preventing drug-target interaction. Thus, these enzymes provide a scenario of multidrug-resistance and a significant threat to public health at a global level. In response to this challenge, in recent decades, several studies have focused on the development of inhibitors that can restore aminoglycosides and β-lactams activity. In this context, peptides appear as a promising approach in the field of inhibitors for future antibacterial therapies, as multiresistant bacteria may be susceptible to these molecules. Therefore, this review focused on the most recent findings related to peptide-based inhibitors that act on AMEs and β-lactamases, and how these molecules could be used for future treatment strategies.

Re-challenging antibiotic resistance with Daniel Berman

2020 ◽  
Author(s):  
Daniel Berman
Keyword(s):  
Bacterial Infections ◽  
Point Of Care ◽  
Healthcare Setting ◽  
Rapid Diagnostic Tests ◽  
Resistant Bacteria ◽  
Drug Resistant ◽  
Drug Resistant Bacteria ◽  
Global Threat ◽  
The Right ◽  
Point Of Care Tests

How can we prevent the rise of resistance to antibiotics? In this video, Daniel Berman,  Nesta Challenges, discusses the global threat of AMR and how prizes like the Longitude Prize can foster the development of rapid diagnostic tests for bacterial infections, helping to contribute towards reducing the global threat of drug resistant bacteria. Daniel outlines how accelerating the development of rapid point-of-care tests will ensure that bacterial infections are treated with the most appropriate antibiotic, at the right time and in the right healthcare setting.

scholarly journals 1758. Impact of Accelerate Pheno™ Rapid Blood Culture Detection System on Laboratory and Clinical Outcomes in Bacteremic Patients

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S61-S61 ◽  
Author(s):  
Ryan Dare ◽  
Kelsey McCain ◽  
Katherine Lusardi ◽  
Kay Daniels ◽  
Jacob Painter ◽  
...  
Keyword(s):  
Blood Culture ◽  
Clinical Outcomes ◽  
Bacterial Infections ◽  
Detection System ◽  
Positive Culture ◽  
Retrospective Chart Review ◽  
Improve Patient Care ◽  
Standard Of Care ◽  
Historical Cohort ◽  
Stewardship Program

Abstract Background Molecular-based automated systems for the rapid diagnosis of bacterial infections have potential to improve patient care. The Accelerate Pheno™ blood culture detection system (ACCEL) is an FDA approved platform that allows for identification (ID) and antimicrobial susceptibility testing (AST) 8 hours following growth in routine culture. Methods This is a single-center retrospective chart review of bacteremic adult inpatients before and after implementation of ACCEL. Laboratory and clinical data were collected February–March 2018 (intervention) and compared with a January–April 2017 historical cohort (standard of care). Standard of care ID and AST were performed using VITEK® MS (MALDI-TOF MS) and VITEK®2, respectively. An active antimicrobial stewardship program was in place during both study periods. Patients with polymicrobial cultures, off-panel isolates, previous positive culture, or who were discharged prior to final AST report were excluded. Primary outcome was length of stay (LOS). Secondary outcomes were inpatient antibiotic duration of therapy (DOT) and time to optimal therapy (TTOT). Nonparametric unadjusted analyses were performed due to non-normal distributions. Statistics were performed using SAS 9.4. Results Of the 143 positive cultures performed on ACCEL during intervention, 118 (83%) were identified as on-panel organisms. Seventy-five (64%) of these 118 cultures and 79 (70%) of 113 reviewed standard of care cultures met inclusion criteria. Patient comorbidities (P = NS), MEWS severity score (P = 0.10), source of bacteremia (P = NS), and pathogen detected (P = 0.30) were similar between cohorts. Time from collection to ID (28.2 ± 12.7 hours vs. 53.8 ± 20.9 hours; P < 0.001) and AST (31.9 ± 11 hours vs. 71.8 ± 20 hours; P < 0.001) were shorter in the intervention arm. Conclusion Compared with standard of care, ACCEL shortens laboratory turn-around-time and improves clinical outcomes. The use of this system has resulted in decreased mean antibiotic DOT, TTOT, and LOS. Further studies are needed to verify these findings. Disclosures All authors: No reported disclosures.

scholarly journals Bacteremia Among Febrile Patients Attending Selected Healthcare Facilities in Ibadan, Nigeria

2019 ◽  
Vol 69 (Supplement_6) ◽  
pp. S466-S473 ◽  
Author(s):  
Oluwafemi Popoola ◽  
Aderemi Kehinde ◽  
Veronica Ogunleye ◽  
Oluwafemi J Adewusi ◽  
Trevor Toy ◽  
...  
Keyword(s):  
Antimicrobial Susceptibility ◽  
Bacterial Infections ◽  
Common Species ◽  
Epidemiological Studies ◽  
Multidrug Resistant ◽  
African Countries ◽  
Healthcare Facilities ◽  
Relative Contribution ◽  
Polymerase Chain ◽  
Ibadan Nigeria

Abstract Background The relative contribution of bacterial infections to febrile disease is poorly understood in many African countries due to diagnostic limitations. This study screened pediatric and adult patients attending 4 healthcare facilities in Ibadan, Nigeria, for bacteremia and malaria parasitemia. Methods Febrile patients underwent clinical diagnosis, malaria parasite testing, and blood culture. Bacteria from positive blood cultures were isolated and speciated using biochemical and serological methods, and Salmonella subtyping was performed by polymerase chain reaction. Antimicrobial susceptibility was tested by disk diffusion. Results A total of 682 patients were recruited between 16 June and 16 October 2017; 467 (68.5%) were <18 years of age. Bacterial pathogens were cultured from the blood of 117 (17.2%) patients, with Staphylococcus aureus (69 [59.0%]) and Salmonella enterica (34 [29.1%]) being the most common species recovered. Twenty-seven (79.4%) of the Salmonella isolates were serovar Typhi and the other 7 belonged to nontyphoidal Salmonella serovarieties. Thirty-four individuals were found to be coinfected with Plasmodium falciparum and bacteria. Five (14.7%) of these coinfections were with Salmonella, all in children aged <5 years. Antimicrobial susceptibility testing revealed that most of the Salmonella and Staphylococcus isolates were multidrug resistant. Conclusions The study demonstrates that bacteria were commonly recovered from febrile patients with or without malaria in this location. Focused and extended epidemiological studies are needed for the introduction of typhoid conjugate vaccines that have the potential to prevent a major cause of severe community-acquired febrile diseases in our locality.

scholarly journals Antibiotic-Resistant Bacteria in Clams—A Study on Mussels in the River Rhine

Antibiotics ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 571
Author(s):  
Nicole Zacharias ◽  
Iris Löckener ◽  
Sarah M. Essert ◽  
Esther Sib ◽  
Gabriele Bierbaum ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Sewage Treatment ◽  
Sewage Treatment Plant ◽  
Treatment Plant ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
River Rhine ◽  
Antibiotic Resistant Bacteria ◽  
Surrounding Water ◽  
Antibiotic Resistant

Bacterial infections have been treated effectively by antibiotics since the discovery of penicillin in 1928. A worldwide increase in the use of antibiotics led to the emergence of antibiotic resistant strains in almost all bacterial pathogens, which complicates the treatment of infectious diseases. Antibiotic-resistant bacteria play an important role in increasing the risk associated with the usage of surface waters (e.g., irrigation, recreation) and the spread of the resistance genes. Many studies show that important pathogenic antibiotic-resistant bacteria can enter the environment by the discharge of sewage treatment plants and combined sewage overflow events. Mussels have successfully been used as bio-indicators of heavy metals, chemicals and parasites; they may also be efficient bio-indicators for viruses and bacteria. In this study an influence of the discharge of a sewage treatment plant could be shown in regard to the presence of E. coli in higher concentrations in the mussels downstream the treatment plant. Antibiotic-resistant bacteria, resistant against one or two classes of antibiotics and relevance for human health could be detected in the mussels at different sampling sites of the river Rhine. No multidrug-resistant bacteria could be isolated from the mussels, although they were found in samples of the surrounding water body.

scholarly journals The Potential of Human Peptide LL-37 as an Antimicrobial and Anti-Biofilm Agent

Antibiotics ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 650
Author(s):  
Kylen E. Ridyard ◽  
Joerg Overhage
Keyword(s):  
Bacterial Infections ◽  
Antimicrobial Properties ◽  
Cross Resistance ◽  
Resistant Bacteria ◽  
Peptide Antibiotic ◽  
Adaptive Responses ◽  
Antibiotic Resistant ◽  
Structural Modifications ◽  
Immobilization Techniques ◽  
Conventional Antibiotics

The rise in antimicrobial resistant bacteria threatens the current methods utilized to treat bacterial infections. The development of novel therapeutic agents is crucial in avoiding a post-antibiotic era and the associated deaths from antibiotic resistant pathogens. The human antimicrobial peptide LL-37 has been considered as a potential alternative to conventional antibiotics as it displays broad spectrum antibacterial and anti-biofilm activities as well as immunomodulatory functions. While LL-37 has shown promising results, it has yet to receive regulatory approval as a peptide antibiotic. Despite the strong antimicrobial properties, LL-37 has several limitations including high cost, lower activity in physiological environments, susceptibility to proteolytic degradation, and high toxicity to human cells. This review will discuss the challenges associated with making LL-37 into a viable antibiotic treatment option, with a focus on antimicrobial resistance and cross-resistance as well as adaptive responses to sub-inhibitory concentrations of the peptide. The possible methods to overcome these challenges, including immobilization techniques, LL-37 delivery systems, the development of LL-37 derivatives, and synergistic combinations will also be considered. Herein, we describe how combination therapy and structural modifications to the sequence, helicity, hydrophobicity, charge, and configuration of LL-37 could optimize the antimicrobial and anti-biofilm activities of LL-37 for future clinical use.

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