scholarly journals Treatment of methicillin-resistant Staphylococcus aureus (MRSA): updated guidelines from the UK

2021 ◽  
Author(s):  
Nicholas M Brown ◽  
Erwin M Brown ◽  
Nicholas M Brown ◽  
Anna L Goodman ◽  
Carolyne Horner ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Antimicrobial Agents ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Superior Efficacy ◽  
Published Evidence ◽  
Impact On Treatment ◽  
The Uk ◽  
The Impact ◽  
New Evidence ◽  
Current Guidelines

Abstract The UK guidelines for the treatment of infections caused by MRSA have been updated and are published in JAC-Antimicrobial Resistance. The update reviews new evidence published since the previous UK guidelines were published over 10 years ago. It includes evidence relating to antimicrobial agents that have been licensed since then for the treatment of Gram-positive bacterial infections including MRSA. It also considers the impact on treatment of the changing epidemiology of MRSA in the UK, especially relating to circulating community strains. A striking finding from the current literature review was the paucity of good quality evidence. The current guidelines therefore represent a hybrid of varying degrees of evidence and expert opinion. Where there was no new published evidence, we have retained some of the existing recommendations. We were unable to find strong evidence of the superior efficacy of newer agents compared with that of vancomycin.

scholarly journals The Effect of Antimicrobial Drugs Tylocolinum, Tetragold and Cidisept-o on Escherichia coli Ultrastructure

2013 ◽  
Vol 2 (3) ◽  
pp. 65
Author(s):  
A. G. Shakhov ◽  
D. V. Fedosov ◽  
L. Y. Sashnina ◽  
O. V. Kazimirov
Keyword(s):  
Escherichia Coli ◽  
Bacterial Infections ◽  
Antimicrobial Agents ◽  
Water Solution ◽  
Uranyl Acetate ◽  
Chemotherapeutic Agents ◽  
Control Culture ◽  
New Drugs ◽  
Ultrastructural Changes ◽  
The Impact

<p>As a result of wide antibiotics, sulfonamides and other antimicrobial agents usage for the therapy of the animals with the bacterial infections caused by various causative agents including <em>Escherichia coli</em>, many microorganisms gained resistance to the chemotherapeutic agents. New combined drugs are being worked out during recent years, the components of which have various influence mechanisms on the bacterial cell that helps to provide resistance forming control. The results of the researches of the new antimicrobial agents, containing antibiotics in their composition, and non-antibiotic agent influence on the ultrastructure of <em>Escherichia coli</em> are represented in this study.</p> <p>5-hour <em>Escherichia coli 866</em> culture was processed by the drugs of the minimum bactericidal (Tylocolinum-0.39 µg/ml, Tetragold-6.25 µg/ml, Cidisept-o-25 µg/ml) and 4-time concentrations during 3 hours. Samples and control culture (without drugs) were fixed by the 2.5% glutaricdialdehyde on the s-Collidine Buffer, dehydrated in the ethanol with rising concentration, filled in epoxies. Ultrathin slices were stained by 2% water solution of uranyl acetate and lead citrate for 10 minutes. Then they were examined with the use of the electron microscope JEM-100 CX II by JEOL.</p> <p>The research showed deep ultrastructural changes in <em>Escherichia coli</em> cells under the antimicrobial agent influence determined by synergistic effect of combined Tylocolinum and Tetragold drugs components, possessing various bacteria influencing mechanisms, and aldehyde that is a component of Cidisept-o.</p> The electron microscopy usage allows to get unique information about the impact consequences of the traditional improved drugs and new drugs with antimicrobial activity on the bacterial infectious agents.

OP29 The Impact Of Individual Patient Input; Strengthening The Evidence

2018 ◽  
Vol 34 (S1) ◽  
pp. 12-12
Author(s):  
Heidi Livingstone ◽  
Chloe Kastoryano ◽  
Lizzie Thomas ◽  
Vassilia Verdiel ◽  
Kevin Harris ◽  
...  
Keyword(s):  
Decision Making ◽  
Interventional Procedures ◽  
Public Involvement ◽  
Electronic System ◽  
Efficacy And Safety ◽  
Published Evidence ◽  
Committee Decision Making ◽  
The Impact ◽  
New Evidence ◽  
Patient Opinion

Introduction:The National Institute of Health and Care Excellence (NICE) assesses the efficacy and safety of interventional procedures for use in the National Health Service (NHS). Since 2006, NICE's Public Involvement Programme (PIP) has obtained ‘patient commentary’ to inform committee decisions, using a questionnaire asking patients about their experience of the procedure including benefits, disadvantages and side effects. Commentary is considered by the committee alongside other evidence. The PIP has piloted a project to: capture the impact of the patient commentary on the committee's decision-making; explore patterns of impact; and identify criteria that indicate when patient commentary may not be required.Methods:The pilot included all interventional procedures guidance started between February 2016 and February 2017. Committee members’ views were captured using a form completed whenever patient commentary was considered. Responses were anonymized, entered into an electronic system, analyzed, and correlated against ‘committee comments’ in the published guidance. After twelve months, there was an unrepresentatively narrow spread of conditions, and most topics were updating previously published guidance rather than novel topics. The pilot was therefore extended by six months.Results:Patient commentary commonly had an impact on decision-making; however, no discernible patterns have yet been identified, nor criteria for when it may not be required. Key findings were: (i) patient commentary is equally useful for guidance updates as novel guidance, and (ii) interpretation and assessment of ‘impact’ varied across committee members but the majority agreed it reinforced the other evidence.Conclusions:Patient commentary has a measurable impact on committee decision-making. Very occasionally it provides new evidence and routinely provides reassurance that the published evidence is substantiated by real-world patient opinion. Measuring the impact of commentary seems to have raised its profile, with more committee comments about patient issues included in guidance during the pilot than in preceding years. The project needs to be extended to identify which procedures are least likely to benefit from patient commentary and why.

scholarly journals The impact of story: measuring the impact of story for organisational change

2017 ◽  
Vol 9 (2) ◽  
pp. 170-184 ◽  
Author(s):  
Lisa Rossetti ◽  
Tony Wall
Keyword(s):  
Organisational Change ◽  
Evaluation Framework ◽  
Service Improvement ◽  
Organisational Development ◽  
Structured Interviews ◽  
Content Type ◽  
Health And Social Care ◽  
The Uk ◽  
The Impact ◽  
New Evidence

Purpose The role of dialogue has recently been identified as being important in generating impact in organisations, but the purposeful use of narrative or story-based approaches to effect organisational change and service improvement is still relatively innovative. The purpose of this paper is to document and examine two projects in health and social care settings which aim to generate organisational development and service improvement. Design/methodology/approach The paper evaluates and compares two case studies of story-based organisational development and service improvement projects in the UK. This involved developing an appropriate evaluation framework and assessing the impacts in each case using semi-structured interviews and thematic content analysis. Findings This paper reports the diversity of impacts and outcomes that were generated by the projects. Specifically, it is argued that there is a strong indication that story-based projects best achieve their objectives when clearly linked to key organisational strategic drivers or pathways, as evidenced by robust evaluation. Practical implications This paper recommends that researchers and practitioners, working with story-based methods, design credible and robust evaluative practices, in order to evidence how their work supports organisations to meet current sector challenges. The paper recommends a flexible evaluation framework for evaluating story-based projects in the workplace. Originality/value This paper offers new evidence and insight into the impacts and outcomes of using story-based approaches, and a new evaluation framework for these sorts of projects.

Advice-giving in Community Pharmacies in the UK

1997 ◽  
Vol 2 (1) ◽  
pp. 38-50 ◽  
Author(s):  
Mary P. Tully ◽  
Karen Hassell ◽  
Peter R. Noyce
Keyword(s):  
Pharmacy Practice ◽  
Community Pharmacists ◽  
Subjective Assessment ◽  
Community Pharmacies ◽  
Common Definition ◽  
Advice Giving ◽  
Published Evidence ◽  
Design Consistency ◽  
The Uk ◽  
The Impact

Objectives: To review (1) the published evidence on the information provided with prescribed and purchased medicines by pharmacists and pharmacy assistants, (2) clients' expectations of advice about medicines from community pharmacies and their experience and use of it, and (3) appropriateness and rigour of study methods used. Methods: Papers, published between 1980 and 1995 inclusively, were identified based on searches of on-line databases, a published literature index, key pharmacy practice journals and cited references in the bibliographies of published papers. Those papers selected reported research findings on any aspect of medicines-related communications and the provision of advice about medicines to members of the public who visited pharmacies in the UK. The comparatively small volume of work and lack of design consistency meant that a subjective assessment, rather than a criteria-based objective review, was deemed appropriate. Results: Forty-two suitable studies were identified and are reviewed. No common definition of ‘advice’ has emerged. Most studies reported were quantitative, concentrating on the frequency of advice-giving in community pharmacies and only one study considered the impact of advice on outcome. The quality of advice given was judged highly variable, although pharmacists' referrals, where made, were considered appropriate. Given that pharmacy assistants appear to make most of the medicine sales, remarkably few studies addressed their contribution to advicegiving. The review can provide little insight into what determines when advice is provided, but it does illuminate the disparity between the advice that clients say they want and what they actually seek. Conclusions: Where there appears to be a consensus that advice-giving in community pharmacies is wanted, this review reveals a lack of shared understanding between consumer bodies and the pharmacy profession about who needs advice and when and how it should be given. The need for unsolicited advice-giving associated with the sale of medicines is particularly contentious. With the current programme of deregulation of medicines, this is an increasingly important issue to resolve. The authors suggest a need for a consensus-building forum to generate guidelines that meet shared expectations between clients, community pharmacists, government and the pharmaceutical industry.

scholarly journals Assessment of Workers’ Personal Vulnerability to COVID-19 Using “COVID-AGE”

2020 ◽  
Author(s):  
David Coggon ◽  
Peter Croft ◽  
Paul Cullinan ◽  
Anthony Williams
Keyword(s):  
Risk Factor ◽  
Risk Model ◽  
White Male ◽  
Summary Measure ◽  
Occupational Risks ◽  
Individual Vulnerability ◽  
Personal Vulnerability ◽  
The Uk ◽  
The Impact ◽  
New Evidence

AbstractDecisions on fitness for employment that entails a risk of contracting Covid-19 require an assessment of the worker’s personal vulnerability should infection occur. Using recently published UK data, we have developed a risk model that provides estimates of personal vulnerability to Covid-19 according to sex, age, ethnicity, and various comorbidities. Vulnerability from each risk factor is quantified in terms of its equivalence to added years of age. Addition of the impact from each risk factor to an individual’s true age generates their “Covid-age”, a summary measure representing the age of a healthy UK white male with equivalent vulnerability. We discuss important limitations of the model, including current scientific uncertainties and limitations on generalisability beyond the UK setting and its use beyond informing assessments of individual vulnerability in the workplace. As new evidence becomes available, some of these limitations can be addressed. The model does not remove the need for clinical judgement or for other important considerations when managing occupational risks from Covid-19.

scholarly journals Assessing the Impact of COVID-19 on Antimicrobial Stewardship Activities/Programs in the United Kingdom

Antibiotics ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 110
Author(s):  
Diane Ashiru-Oredope ◽  
Frances Kerr ◽  
Stephen Hughes ◽  
Jonathan Urch ◽  
Marisa Lanzman ◽  
...  
Keyword(s):  
United Kingdom ◽  
Antimicrobial Stewardship ◽  
Bacterial Infections ◽  
Audit Quality ◽  
Negative Impact ◽  
The United Kingdom ◽  
Ward Rounds ◽  
Long Term Impact ◽  
The Uk ◽  
The Impact

Since first identified in late 2019, the acute respiratory syndrome coronavirus (SARS-CoV2) and the resulting coronavirus disease (COVID-19) pandemic has overwhelmed healthcare systems worldwide, often diverting key resources in a bid to meet unprecedented challenges. To measure its impact on national antimicrobial stewardship (AMS) activities, a questionnaire was designed and disseminated to antimicrobialstewardship leads in the United Kingdom (UK). Most respondents reported a reduction in AMS activity with 64% (61/95) reporting that COVID-19 had a negative impact on routine AMS activities. Activities reported to have been negatively affected by the pandemic include audit, quality improvement initiatives, education, AMS meetings, and multidisciplinary working including ward rounds. However, positive outcomes were also identified, with technology being increasingly used as a tool to facilitate stewardship, e.g., virtual meetings and ward rounds and increased the acceptance of using procalcitonin tests to distinguish between viral and bacterial infections. The COVID-19 pandemic has had a significant impact on the AMS activities undertaken across the UK. The long-term impact of the reduced AMS activities on incidence of AMR are not yet known. The legacy of innovation, use of technology, and increased collaboration from the pandemic could strengthen AMS in the post-pandemic era and presents opportunities for further development of AMS.

scholarly journals Studying bacterial infections through culture-independent approaches

2009 ◽  
Vol 58 (11) ◽  
pp. 1401-1418 ◽  
Author(s):  
Geraint B. Rogers ◽  
Mary P. Carroll ◽  
Kenneth D. Bruce
Keyword(s):  
Human Body ◽  
Bacterial Infections ◽  
Antimicrobial Agents ◽  
Bone Biopsy ◽  
Clinical Samples ◽  
Diagnostic Systems ◽  
Independent Manner ◽  
Culture Independent ◽  
The Impact ◽  
The Way

The ability to characterize accurately the cause of infection is fundamental to effective treatment. The impact of any antimicrobial agents used to treat infection will, however, always be constrained by both the appropriateness of their use and our ability to determine their effectiveness. Traditional culture-based diagnostic microbiology is, in many cases, unable to provide this information. Molecular microbiological approaches that assess the content of clinical samples in a culture-independent manner promise to change dramatically the types of data that are obtained routinely from clinical samples. We argue that, in addition to the technical advance that these methodologies offer, a conceptual advance in the way that we reflect on the information generated is also required. Through the development of both of these advances, our understanding of infection, as well as the ways in which infections can be treated, may be improved. In the analysis of the microbiological content of certain clinical samples, such as blood, cerebrospinal fluid, brain and bone biopsy, culture-independent approaches have been well documented. Herein, we discuss how extensions to such studies can shape our understanding of infection at the many sites of the human body where a mixed flora, or in more ecological terms, a community of microbes, is present. To do this, we consider the underlying principles that underpin diagnostic systems, describe the ways in which these systems can be applied to community characterization, and discuss the significance of the data generated. We propose that at all locations within the human body where infection is routinely initiated within the context of a community of microbes, the same principles will apply. To consider this further, we take insights from areas such as the gut, oral cavity and skin. The main focus here is understanding respiratory tract infection, and specifically the infections of the cystic fibrosis lung. The impact that the use of culture-independent, molecular analyses will have on the way we approach the treatment of infections is also considered.

Understanding Store Development Programmes in Post-Property-Crisis UK Food Retailing

1998 ◽  
Vol 30 (1) ◽  
pp. 15-35 ◽  
Author(s):  
N Wrigley
Keyword(s):  
Land Use Planning ◽  
Capital Investment ◽  
Food Retailing ◽  
Critical Dimensions ◽  
Retail Development ◽  
Town Development ◽  
The Uk ◽  
Policy Guidance ◽  
The Impact ◽  
New Evidence

This paper contrasts conflicting interpretations of the UK food store development process in the late 1990s. In particular, an attempt is made to unpack critical dimensions of the debate which surrounds the Department of the Environment's Planning Policy Guidance Notes 6 and 13 and the so-called ‘Gummer effect’ which is seen as having actively discouraged green-field out-of-town development and provided a mandate for reinvestment in town centre retail development. By exploring new evidence on the changing economics of superstore development, the impact of tightened land-use planning regulation, and shifting patterns of capital investment, I provide a conceptual framework in which to understand a radically transformed retail development picture.

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