A syndrome-based approach to antimicrobial stewardship in an Arizona skilled nursing facilityMoving the needle through quality improvement. American journal of infection control 48(12): 1537-1539
In 2015, an intervention to reduce unnecessary antibiotic prescribing for suspect urinary tract infection (UTI) was implemented in an Arizona skilled nursing facility. • Intervention included use of a 48[HYPHEN]hour enhanced observation protocol instead of urine culturing in low infection likelihood scenarios (eg, confusion without localizing signs of infection) and monthly feedback to providers on culturing and prescribing patterns. • In the 2 years following implementation of the intervention, antibiotic prescribing for suspect UTIs decreased by 85%, and C. difficile incidence by 86%, with no associated urosepsis eve...
Source: Current Awareness Service for Health (CASH) - January 15, 2021 Category: Consumer Health News Source Type: news
There is no association between weekend admissions and delays in antibiotic administration for patients admitted to the emergency department with suspicion of sepsis: A retrospective cohort study. Medicine 99(47): e23256.
This study was conducted to evaluate whether weekend admissions to the ED increases the time to antibiotic administration in septic patients.A retrospective cohort study of adult patients who were included in the sepsis protocol at a tertiary ED between January 2015 and December 2017 was performed. The sepsis protocol was activated for all patients with suspected severe infection.A total of 831 patients with a mean age of 59 ± 21 years were evaluated, of whom 217 (26.1%) were admitted on weekends. In addition, 391 (47.1%) patients were male, and 84 (10.1%) died in the hospital. Overall, the mean sequential organ failure a...
Source: Current Awareness Service for Health (CASH) - January 8, 2021 Category: Consumer Health News Source Type: news
Resistant Infections in Emergency Department Patients with Suspected Sepsis. The American journal of the medical sciences 360(6): 650-655.
Background: Inappropriate antibiotic therapy in sepsis is associated with poor outcomes, clinicians often provide routine coverage for multidrug resistant (MDR) bacteria. However, these regimens may contribute to problems related to antibiotic overuse. To understand the incidence and related factors of multidrug resistant bacterial infections in ED patients with sepsis, we examined how often patients with sepsis in our emergency department had MDR infections. We also explored risk factors for, and outcomes from, MDR bacterial infections.; Methods: We reviewed records of patients presenting to our emergency department (ED) ...
Source: Current Awareness Service for Health (CASH) - January 8, 2021 Category: Consumer Health News Source Type: news
Empiric Antibiotic Prescribing for Suspected Sepsis: A Stewardship Balancing Act. The American journal of the medical sciences 360(6): 613-614.
The optimal approach to empiric antibiotic prescribing for suspected sepsis in the emergency department (ED), specifically timing and spectrum of therapy, is a matter of significant ongoing controversy.1 −3 The debate hinges on interpretation of the ratio between benefit from prompt, active antibiotic therapy for patients with bacterial sepsis and the established societal (e.g. selective pressure towards bacterial resistance) and patient level harms associated with unnecessary antibiotic therapy ( e.g. adverse drug reactions, Clostridiodes difficile infection). (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - January 8, 2021 Category: Consumer Health News Source Type: news
Updates in Sepsis Resuscitation
Sepsis care has evolved significantly since the initial early goal-directed therapy (EGDT) trials. Early fluid resuscitation, source control, and antibiotic therapy remain cornerstones of care but overall understanding is more nuanced, particularly regarding fluid selection, vasopressors, and inotropic support. Timely nutrition therapy and ventilatory support tend to receive less attention but also are important. Recent research has explored immunomodulation, β-blockade, and vitamin supplementation. A renewed emphasis on early, aggressive resuscitation reaffirms the importance of emergency medicine providers knowledgeable...
Source: Current Awareness Service for Health (CASH) - December 10, 2020 Category: Consumer Health News Source Type: news
Recent updates on antimicrobial therapy
(Bentham Science Publishers) This book provides updates on the most recent studies about anti-infective agents, their mechanism of action, the relevant molecular targets and their implication in the development of novel antibiotics that have properties similar to their corresponding compounds of natural origin. (Source: EurekAlert! - Infectious and Emerging Diseases)
Source: EurekAlert! - Infectious and Emerging Diseases - November 30, 2020 Category: Infectious Diseases Source Type: news
Biomarkers for antimicrobial stewardship: a reappraisal in COVID-19 times?
On initial presentation, differentiation between earlystage coronavirus disease 2019 COVID-19) and classical bacterial community-acquired pneumonia can be challenging. Furthermore, COVID-19 patients may develop a hyperinflammatory phase later in their disease process, which is particularly difficult to distinguish from a secondary bacterial infection. As a consequence, 72% of COVID-19 patients receive empirical antibiotic therapy during hospital stay. Antibiotic overuse undoubtedly leads to an exacerbation of another —slowly progressive—pandemic: antimicrobial resistance. Procalcitonin (PCT) has proven useful in the ea...
Source: Current Awareness Service for Health (CASH) - November 18, 2020 Category: Consumer Health News Source Type: news
Antibiotic Therapy Before Age 2 May Affect Child Health
TUESDAY, Nov. 17, 2020 -- Exposure to antibiotics in the first two years of life is associated with an increased risk for several health conditions during childhood, according to a study published online Nov. 15 in the Mayo Clinic... (Source: Drugs.com - Pharma News)
Source: Drugs.com - Pharma News - November 17, 2020 Category: Pharmaceuticals Source Type: news
Coronavirus Disease 2019 Sepsis: A Nudge Toward Antibiotic Stewardship
COVID-19 is sepsis caused by SARS-CoV-2, a virus for which there is little in the way of antimicrobial therapy. Because it is sepsis, known tenets of sepsis care and organ support must be our guiding principles. Surprisingly, a key lesson that we must take from the war on this viral sepsis is that we must redouble our efforts to be stewards of antimicrobials and ensure that we have adequate means to control bacterial and fungal infection. Moreover, it is critical that high priority be given to randomized controlled trials that are testing drugs to treat SARS-CoV-2 and the ensuing sepsis. As we face subsequent waves of this...
Source: Current Awareness Service for Health (CASH) - November 13, 2020 Category: Consumer Health News Source Type: news
Infectious Disease PICC Approval Tied to Fewer Complications Infectious Disease PICC Approval Tied to Fewer Complications
When peripherally inserted central catheters (PICCs) are placed for antimicrobial therapy, infectious disease physician approval is associated with more appropriate device use and a lower risk of complications, a new study found.Reuters Health Information (Source: Medscape Critical Care Headlines)
Source: Medscape Critical Care Headlines - November 10, 2020 Category: Intensive Care Tags: Infectious Diseases News Source Type: news
Effect of IV Push Antibiotic Administration on Antibiotic Therapy Delays in Sepsis
Conclusion(s): Use of an IV push strategy may safely facilitate more rapid administration of beta-lactam antibiotics and may allow for better compliance with sepsis management guidelines. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 9, 2020 Category: Consumer Health News Source Type: news
Antibiotics in the first hour: is there new evidence?
International guidelines have recommended for many years to start antimicrobials as early as possible in sepsis and shock. This concept has been challenged by the controversial results of experimental studies and clinical cohorts and resulted in intense debate in the literature. This review aims to summarize the available knowledge on early antimicrobial therapy and to consider perspectives. Areas covered: First, after a research using MEDLINE, we reviewed the studies that advocated the implementation of early antimicrobial therapy. We then discussed the drawbacks of these studies. Finally, we suggested possible explanatio...
Source: Current Awareness Service for Health (CASH) - September 3, 2020 Category: Consumer Health News Source Type: news
Discontinuation of glycopeptides in patients with culture negative severe sepsis or septic shock: A propensity-matched retrospective cohort study
Implementation of antibiotic stewardship is difficult in patients with sepsis because of severity of disease. We evaluated the impact of glycopeptide discontinuation (GD) in patients with culture negative severe sepsis or septic shock who received glycopeptides as initial empiric antibiotic therapy at admission. We conducted a single center retrospective cohort study between January 2010 and March 2018. GD was defined as discontinuation of initial empiric glycopeptides on availability of culture results, revealing the absence of identified pathogens. In 92 included patients, the leading causes of sepsis were pneumonia (34....
Source: Current Awareness Service for Health (CASH) - July 1, 2020 Category: Consumer Health News Source Type: news
Duration of antibiotic therapy in critically ill patients: A randomized controlled trial of a clinical and C-reactive protein-based protocol versus an evidence-based best practice strategy without biomarkers
Conclusion(s): Daily monitoring of CRP levels may allow early interruption of antibiotic therapy in a higher proportion of patients, without an effect on total antibiotic consumption. The clinical and microbiological relevance of this finding remains to be demonstrated. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 1, 2020 Category: Consumer Health News Source Type: news
Benefits of prolonged infusion of beta-lactam antibiotics in patients with sepsis: personal perspectives
INTRODUCTION: In the current era of relatively scarce antibiotic production and significant levels of antimicrobial resistance, optimization of pharmacokinetics and pharmacodynamics of antibiotic therapy is mandatory. Prolonged infusion of beta-lactam antibiotics in comparison to the intermittent infusion has the theoretical advantage of better patient outcomes. Apparently, conflicting data in the literature possibly underestimate the benefits of prolonged infusion of antibiotic treatment. AREAS COVERED: We provide our perspective on the subject based on our experience and by critically evaluating literature data. EXPERT O...
Source: Current Awareness Service for Health (CASH) - July 1, 2020 Category: Consumer Health News Source Type: news
