scholarly journals 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. e51-e77 ◽  
Author(s):  
Tamar F. Barlam ◽  
Sara E. Cosgrove ◽  
Lilian M. Abbo ◽  
Conan MacDougall ◽  
Audrey N. Schuetz ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Antibiotic Stewardship ◽  
Expert Panel ◽  
Evidence Based ◽  
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 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.

Changes in antibiotic use following implementation of a telehealth stewardship pilot program

2019 ◽  
Vol 40 (7) ◽  
pp. 810-814 ◽  
Author(s):  
Brigid M. Wilson ◽  
Richard E. Banks ◽  
Christopher J. Crnich ◽  
Emma Ide ◽  
Roberto A. Viau ◽  
...  
Keyword(s):  
Antibiotic Stewardship ◽  
Long Term Care ◽  
Antibiotic Use ◽  
Veterans Affairs ◽  
Term Care ◽  
Medical Centers ◽  
Stewardship Program ◽  
Days Of Therapy ◽  
Veterans Affairs Medical Centers

AbstractStarting in 2016, we initiated a pilot tele-antibiotic stewardship program at 2 rural Veterans Affairs medical centers (VAMCs). Antibiotic days of therapy decreased significantly (P < .05) in the acute and long-term care units at both intervention sites, suggesting that tele-stewardship can effectively support antibiotic stewardship practices in rural VAMCs.

scholarly journals Impact of an Antibiotic Stewardship Program in Long-term Care Facilities: A Nursing Home Network Experience

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S63-S63
Author(s):  
Fabian Andres Romero ◽  
Evette Mathews ◽  
Ara Flores ◽  
Susan Seo
Keyword(s):  
Nursing Home ◽  
Antibiotic Stewardship ◽  
Long Term Care ◽  
Post Intervention ◽  
Term Care ◽  
Stewardship Program ◽  
Days Of Therapy ◽  
Care Facilities ◽  
The Impact

Abstract Background Antibiotic stewardship program (ASP) implementation is paramount across the healthcare spectrum. Nursing homes represent a challenge due to limited resources, complexity of medical conditions, and less controlled environments. National statistics on ASP for long-term care facilities (LTCF) are sparse. Methods A pilot ASP was launched in August 2016 at a 270-bed nursing home with a 50-bed chronic ventilator-dependent unit. The program entailed a bundle of interventions including leadership engagement, a tracking and reporting system for intravenous antibiotics, education for caregivers, Infectious Disease (ID) consultant availability, and implementation of nursing protocols. Data were collected from pharmacy and medical records between January 2016 and March 2017, establishing pre-intervention and post-intervention periods. Collected data included days of therapy (DOT), antibiotic costs, resident-days, hospital transfers, and Clostridium difficile infection (CDI) rates. Variables were adjusted to 1,000 resident-days (RD) and findings between periods were compared by Mann–Whitney U test. Results A total of 47,423 resident-days and 1,959 DOT were analyzed for this study. Antibiotic use decreased from 54.5 DOT/1000 RD pre-intervention to 27.6 DOT/1000 RD post-intervention (P = 0.017). Antibiotic costs were reduced from a monthly median of US $17,113 to US $7,073 but was not statistically significant (P = 0.39). Analysis stratified by individual antibiotic was done for the five most commonly used antibiotics and found statistically significant reduction in vancomycin use (14.4 vs. 6.5; P = 0.023). Reduction was also found for cefepime/ceftazidime (6.9 vs. 1.3; P = 0.07), ertapenem (6.8 vs. 3.6; P = 0.45), and piperacillin/tazobactam (1.8 vs. 0.6; P = 0.38). Meropenem use increased (1.3 vs. 3.2; P = 0.042). Hospital transfers slightly trended up (6.73 vs. 7.77; P = 0.065), and there was no change in CDI (1.1 s 0.94; P = 0.32). Conclusion A bundle of standardized interventions tailored for LTCF can achieve successful reduction of antibiotic utilization and costs. Subsequent studies are needed to further determine the impact on clinical outcomes such as transfers to hospitals and CDI in these settings. Disclosures All authors: No reported disclosures.

scholarly journals Clinical Practice Guidelines for the Management of Blastomycosis: 2008 Update by the Infectious Diseases Society of America

2008 ◽  
Vol 46 (12) ◽  
pp. 1801-1812 ◽  
Author(s):  
Stanley W. Chapman ◽  
William E. Dismukes ◽  
Laurie A. Proia ◽  
Robert W. Bradsher ◽  
Peter G. Pappas ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Health Care Providers ◽  
Antifungal Agents ◽  
Expert Panel ◽  
Evidence Based ◽  
Care Providers ◽  
Management Guidelines ◽  
New Information ◽  
Immunosuppressed Patients ◽  
Evidence Based Guidelines

Abstract Evidence-based guidelines for the management of patients with blastomycosis were prepared by an Expert Panel of the Infectious Diseases Society of America. These updated guidelines replace the previous management guidelines published in the April 2000 issue of Clinical Infectious Diseases. The guidelines are intended for use by health care providers who care for patients who have blastomycosis. Since 2000, several new antifungal agents have become available, and blastomycosis has been noted more frequently among immunosuppressed patients. New information, based on publications between 2000 and 2006, is incorporated in this guideline document, and recommendations for treating children with blastomycosis have been noted.

scholarly journals Barriers and facilitators to implementing evidence-based guidelines in long-term care: a qualitative evidence synthesis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Caitlin McArthur ◽  
Yuxin Bai ◽  
Patricia Hewston ◽  
Lora Giangregorio ◽  
Sharon Straus ◽  
...  
Keyword(s):  
Knowledge Translation ◽  
Long Term Care ◽  
Barriers And Facilitators ◽  
Care Staff ◽  
Evidence Based ◽  
Term Care ◽  
Translation Strategies ◽  
Knowledge Translation Strategies ◽  
Evidence Based Guidelines

Abstract Background The long-term care setting poses unique challenges and opportunities for effective knowledge translation. The objectives of this review are to (1) synthesize barriers and facilitators to implementing evidence-based guidelines in long-term care, as defined as a home where residents require 24-h nursing care, and 50% of the population is over the age of 65 years; and (2) map barriers and facilitators to the Behaviour Change Wheel framework to inform theory-guided knowledge translation strategies. Methods Following the guidance of the Cochrane Qualitative and Implementation Methods Group Guidance Series and the ENTREQ reporting guidelines, we systematically reviewed the reported experiences of long-term care staff on implementing evidence-based guidelines into practice. MEDLINE Pubmed, EMBASE Ovid, and CINAHL were searched from the earliest date available until May 2021. Two independent reviewers selected primary studies for inclusion if they were conducted in long-term care and reported the perspective or experiences of long-term care staff with implementing an evidence-based practice guideline about health conditions. Appraisal of the included studies was conducted using the Critical Appraisal Skills Programme Checklist and confidence in the findings with the GRADE-CERQual approach. Findings After screening 2680 abstracts, we retrieved 115 full-text articles; 33 of these articles met the inclusion criteria. Barriers included time constraints and inadequate staffing, cost and lack of resources, and lack of teamwork and organizational support. Facilitators included leadership and champions, well-designed strategies, protocols, and resources, and adequate services, resources, and time. The most frequent Behaviour Change Wheel components were physical and social opportunity and psychological capability. We concluded moderate or high confidence in all but one of our review findings. Conclusions Future knowledge translation strategies to implement guidelines in long-term care should target physical and social opportunity and psychological capability, and include interventions such as environmental restructuring, training, and education.

scholarly journals Implementation of an Infectious Diseases Telehealth Consultation and Antibiotic Stewardship Program for 16 Small Community Hospitals

2021 ◽  
Vol 8 (6) ◽  
Author(s):  
Todd J Vento ◽  
John J Veillette ◽  
Stephanie S Gelman ◽  
Angie Adams ◽  
Peter Jones ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Program Implementation ◽  
Antibiotic Stewardship ◽  
Antibiotic Use ◽  
Small Community ◽  
Community Hospitals ◽  
Phone Calls ◽  
Stewardship Program ◽  
Intermountain Healthcare

Abstract Background Telehealth improves access to infectious diseases (ID) and antibiotic stewardship (AS) services in small community hospitals (SCHs), but the optimal model has not been defined. We describe implementation and impact of an integrated ID telehealth (IDt) service for 16 SCHs in the Intermountain Healthcare system. Methods The Intermountain IDt service included a 24-hour advice line, eConsults, telemedicine consultations (TCs), daily AS surveillance, long-term AS program (ASP) support by an IDt pharmacist, and a monthly telementoring webinar. We evaluated program measures from November 2016 through April 2018. Results A total of 2487 IDt physician interactions with SCHs were recorded: 859 phone calls (35% of interactions), 761 eConsults (30%), and 867 TCs (35%). Of 1628 eConsults and TCs, 1400 (86%) were SCH provider requests, while 228 (14%) were IDt pharmacist generated. Six SCHs accounted for &gt;95% of interactions. Median consultation times for each initial telehealth interaction type were 5 (interquartile range [IQR], 5–10) minutes for phone calls, 20 (IQR, 15–25) minutes for eConsults, and 50 (IQR, 35–60) minutes for TCs. Thirty-two percent of consults led to in-person ID clinic follow-up. Bacteremia was the most common reason for consultation (764/2487 [31%]) and Staphylococcus aureus the most common organism identified. ASPs were established at 16 facilities. Daily AS surveillance led to 2229 SCH pharmacist and 1305 IDt pharmacist recommendations. Eight projects were completed with IDt pharmacist support, leading to significant reductions in meropenem, vancomycin, and fluoroquinolone use. Conclusions An integrated IDt model led to collaborative ID/ASP interventions and improvements in antibiotic use at 16 SCHs. These findings provide insight into clinical and logistical considerations for IDt program implementation.

scholarly journals 1148. Antimicrobial Stewardship Program at a Long-term Care Hospital for Severely Handicapped Children and Adults

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S409-S410
Author(s):  
Sho Ishii ◽  
Kazuhiro Uda ◽  
Yasuko Kudo ◽  
Koji Fukano ◽  
Masako Igari ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Antimicrobial Stewardship ◽  
Long Term Care ◽  
Antimicrobial Use ◽  
Antimicrobial Stewardship Program ◽  
Post Intervention ◽  
Term Care ◽  
Level Change ◽  
Stewardship Program

Abstract Background Although antimicrobial stewardship program (ASP) is also recommended for a long-term care facility (LTCF), research on ASP in LTCFs is still limited. Our study was conducted at an LTCF offering chronic medical care for pediatric and adult patients with extensive medical needs since childhood. Our aim of this study was to evaluate the impacts of ASP in an LTCF. Methods A quasi-experimental study was conducted at Tokyo Metropolitan Fuchu Ryoiku Medical Center (250 beds) in Japan. The pre- and post-intervention periods were from April 2013 to March 2017 and April 2017 to March 2019, respectively. Periodic educational interventions were conducted throughout study period. ASP in post-intervention period consisted of mandatory consultation with infectious diseases service at an outside children’s hospital for prescription of restricted drugs. Fluoroquinolones, cefepimes, carbapenems and vancomycin were listed as restricted drugs. Intravenous and oral antimicrobial use was calculated by day of therapy (DOT) per 1,000 patient-days. Interrupted time series analysis was used for level and trend change for pre- and post-intervention periods. Results Oral agents comprised 89% of the total antimicrobial use. Oral antimicrobials were decreased by 39% in post-intervention with significant level change (P < 0.01) and without trend change (P = 0.61) (Figure 1). Among oral antimicrobials, macrolides, fluoroquinolones and third-generation cephalosporins were decreased by 72% in post-intervention with significant level change (P < 0.01) and without trend change (P = 0.42) (Figure 2). Intravenous antimicrobials were decreased by 40% without level change (P = 0.15) and trend change (P = 0.65) (Figure 3). Conclusion Combining education and mandatory consultation with infectious diseases service for restricted drug enhanced in decreasing total oral antimicrobials at an LTCF. Disclosures All authors: No reported disclosures.

scholarly journals Diagnosis and Management of Complicated Intra-abdominal Infection in Adults and Children: Guidelines by the Surgical Infection Society and the Infectious Diseases Society of America

2010 ◽  
Vol 50 (2) ◽  
pp. 133-164 ◽  
Author(s):  
Joseph S. Solomkin ◽  
John E. Mazuski ◽  
John S. Bradley ◽  
Keith A Rodvold ◽  
Ellie J.C. Goldstein ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Expert Panel ◽  
Evidence Based ◽  
Surgical Infection ◽  
Abdominal Infection ◽  
New Information ◽  
Guideline Document ◽  
Adults And Children ◽  
Intra Abdominal Infection ◽  
Evidence Based Guidelines

Abstract Evidence-based guidelines for managing patients with intra-abdominal infection were prepared by an Expert Panel of the Surgical Infection Society and the Infectious Diseases Society of America. These updated guidelines replace those previously published in 2002 and 2003. The guidelines are intended for treating patients who either have these infections or may be at risk for them. New information, based on publications from the period 2003–2008, is incorporated into this guideline document. The panel has also added recommendations for managing intra-abdominal infection in children, particularly where such management differs from that of adults; for appendicitis in patients of all ages; and for necrotizing enterocolitis in neonates.

scholarly journals Interventions to Decrease Inappropriate Antibiotic Use for Non-acute Respiratory Illness in Long-Term Care Settings

2019 ◽  
Vol 4 (3) ◽  
pp. 28
Author(s):  
Joy M. Barnes ◽  
Pamela Bradshaw
Keyword(s):  
Health Care Professionals ◽  
Antibiotic Stewardship ◽  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Improvement Project ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Stewardship Program

Background: The life-saving power of antibiotics could be lost forever if leaders fail to implement effective antibiotic stewardship programs at all healthcare levels. Grahams’ Knowledge to Action theory guided the development of an antibiotic stewardship program in a long-term care facility that had received a citation for having no active antibiotic stewardship program as required by federal regulations. Purpose: The purpose of this project was to develop and implement an evidence-based antibiotic stewardship program into one long-term care facility. Methods and Materials: This quality improvement project was a population-based systems charter development. The implementation intervention was designed to change the way health care professionals treat non-acute episodes of upper respiratory infections in a long-term care setting. This project utilized the suspected lower respiratory infection (LRI) Situation, Background, Assessment, Recommendation (SBAR) form to reduce the number of antibiotics given during the early part of cold and influenza season of 2018. An antibiotic stewardship policy was developed by multidisciplinary team members and then implemented into the facilities daily practice. Results: The point-prevalence rate of antibiotics within this facility dropped from 24% in 2017 to 6% in 2018 after implementation of the antibiotic stewardship program. Conclusion: This project demonstrates how long-term care facilities can successfully implement an antibiotic stewardship program and potentially improve overall healthcare outcomes for the residents.

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