scholarly journals Critical evaluation of antimicrobial use - A Turkish university hospital example

2013 ◽  
Vol 7 (11) ◽  
pp. 873-879 ◽  
Author(s):  
Salih Hosoglu ◽  
Zafer Parlak ◽  
Mehmet Faruk Geyik ◽  
Yilmaz Palanci
Keyword(s):  
Infectious Diseases ◽  
Critical Evaluation ◽  
Positive Culture ◽  
Antimicrobial Treatment ◽  
Influential Factors ◽  
University Hospital ◽  
Antimicrobial Use ◽  
Tract Infections ◽  
Appropriate Antimicrobial Use

Introduction: Antimicrobials are being used unnecessarily for different reasons. The aims of this study were: assessment of the quality of antimicrobial use and determination of the factors related to correct use. Method: Antimicrobial practice at Dicle University Hospital (DUH) was evaluated with a point prevalence approach. Using a standardized data collection form, the patients’ data (clinic, epidemiology, laboratory and antimicrobial use) was collected. Possible influential factors on antimicrobial use were examined. Results: In the surveillance study 1,350 inpatients were evaluated; 461 (34.1%) of them were using antimicrobials for treatment and 187 (13.9%) for prophylaxis. Antimicrobial indication was found in 355 of 461 patients (77.0%), and the number of antimicrobials was 1.8 per patient in the treatment group. The most common reason for antimicrobial use was community-acquired infection (57.9%). Pneumonia (20.4%), skin and soft tissue infections (9.11%) and urinary tract infections (7.9%) were the most common infectious diseases. Positive culture results were available for 39 patients (8.5.0%) when antimicrobial treatment started. All steps of antimicrobial use were found appropriate  in 243 patients (52.7%). In multivariate analyses, clinical manifestation of infection at the beginning (p<0.001), presence of leukocyte counting (p<0.001) and prescription by an infectious disease specialist were found significantly positive factors for wholly appropriate antimicrobial use. Hospitalization with a diagnosis other than infection was found a significantly negative factor for appropriate antimicrobial use (p=0.001). Conclusion: The quality of antimicrobial use could be improved with better clinical and laboratory diagnosis and consultation with infectious diseases specialists

scholarly journals Effects of a Paediatric Antimicrobial Stewardship Program on Antimicrobial Use and Quality of Prescriptions in Patients with Appendix-Related Intraabdominal Infections

Antibiotics ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 5
Author(s):  
Sílvia Simó ◽  
Eneritz Velasco-Arnaiz ◽  
María Ríos-Barnés ◽  
María Goretti López-Ramos ◽  
Manuel Monsonís ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Broad Spectrum ◽  
Case Fatality ◽  
University Hospital ◽  
Antimicrobial Use ◽  
Stewardship Program ◽  
Days Of Therapy ◽  
Length Of Therapy ◽  
Intraabdominal Infections

The effectiveness of antimicrobial stewardship programs (ASP) in reducing antimicrobial use (AU) in children has been proved. Many interventions have been described suitable for different institution sizes, priorities, and patients, with surgical wards being one of the areas that may benefit the most. We aimed to describe the results on AU and length of stay (LOS) in a pre-post study during the three years before (2014–2016) and the three years after (2017–2019) implementation of an ASP based on postprescription review with feedback in children and adolescents admitted for appendix-related intraabdominal infections (AR-IAI) in a European Referral Paediatric University Hospital. In the postintervention period, the quality of prescriptions (QP) was also evaluated. Overall, 2021 AR-IAIs admissions were included. Global AU, measured both as days of therapy/100 patient days (DOT/100PD) and length of therapy (LOT), and global LOS remained unchanged in the postintervention period. Phlegmonous appendicitis LOS (p = 0.003) and LOT (p < 0.001) significantly decreased, but not those of other AR-IAI diagnoses. The use of piperacillin–tazobactam decreased by 96% (p = 0.044), with no rebound in the use of other Gram-negative broad-spectrum antimicrobials. A quasisignificant (p = 0.052) increase in QP was observed upon ASP implementation. Readmission and case fatality rates remained stable. ASP interventions were safe, and they reduced LOS and LOT of phlegmonous appendicitis and the use of selected broad-spectrum antimicrobials, while increasing QP in children with AR-IAI.

Principles of Judicious Use of Antimicrobial Agents for Pediatric Upper Respiratory Tract Infections

PEDIATRICS ◽  
1998 ◽  
Vol 101 (Supplement_1) ◽  
pp. 163-165 ◽  
Author(s):  
Scott F. Dowell ◽  
S. Michael Marcy ◽  
William R. Phillips ◽  
Michael A. Gerber ◽  
Benjamin Schwartz
Keyword(s):  
Respiratory Tract ◽  
Antimicrobial Agents ◽  
Respiratory Infections ◽  
The United States ◽  
Antimicrobial Treatment ◽  
Antimicrobial Use ◽  
Upper Respiratory Tract ◽  
Oral Agents ◽  
Upper Respiratory ◽  
Tract Infections

This article introduces a set of principles to define judicious antimicrobial use for five conditions that account for the majority of outpatient antimicrobial use in the United States. Data from the National Center for Health Statistics indicate that in recent years, approximately three fourths of all outpatient antibiotics have been prescribed for otitis media, sinusitis, bronchitis, pharyngitis, or nonspecific upper respiratory tract infection.1Antimicrobial drug use rates are highest for children1; therefore, the pediatric age group represents the focus for the present guidelines. The evidence-based principles presented here are focused on situations in which antimicrobial therapy could be curtailed without compromising patient care. They are not formulated as comprehensive management strategies. For most upper respiratory infections that require antimicrobial treatment, there are several appropriate oral agents from which to choose. Although the general principles of selecting narrow-spectrum agents with the fewest side effects and lowest cost are important, the principles that follow include few specific antibiotic selection recommendations.

scholarly journals Measuring Appropriate Antimicrobial Use: Attempts at Opening the Black Box

2016 ◽  
Vol 63 (12) ◽  
pp. 1-6 ◽  
Author(s):  
Emily S. Spivak ◽  
Sara E. Cosgrove ◽  
Arjun Srinivasan
Keyword(s):  
Public Health ◽  
Black Box ◽  
Antimicrobial Use ◽  
Reference Standard ◽  
Consensus Definition ◽  
Antimicrobial Prescribing ◽  
Life Saving ◽  
Public Health Officials ◽  
Appropriate Antimicrobial Use

Abstract Indiscriminate antimicrobial use has plagued medicine since antibiotics were first introduced into clinical practice &gt;70 years ago. Infectious diseases physicians and public health officials have advocated for preservation of these life-saving drugs for many years. With rising burden of antimicrobial-resistant organisms and Clostridium difficile infections, halting unnecessary antimicrobial use has become one of the largest public health concerns of our time. Inappropriate antimicrobial use has been quantified in various settings using numerous definitions; however, no established reference standard exists. With mounting national efforts to improve antimicrobial use, a consensus definition and standard method of measuring appropriate antimicrobial use is imperative. We review existing literature on systematic approaches to define and measure appropriate antimicrobial use, and describe a collaborative effort at developing standardized audit tools for assessing the quality of antimicrobial prescribing.

scholarly journals Overview and Evaluation of Existing Guidelines for Rational Antimicrobial Use in Small-Animal Veterinary Practice in Europe

Antibiotics ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 409
Author(s):  
Fergus Allerton ◽  
Cameron Prior ◽  
Arzu Funda Bagcigil ◽  
Els Broens ◽  
Bénédicte Callens ◽  
...  
Keyword(s):  
Guideline Development ◽  
Small Animal ◽  
Antimicrobial Treatment ◽  
Antimicrobial Use ◽  
Inclusion Criteria ◽  
European Network ◽  
Agree Ii ◽  
Organ Systems ◽  
Structured Approach

Antimicrobial stewardship guidelines (ASGs) represent an important tool to help veterinarians optimize their antimicrobial use with the objective of decreasing antimicrobial resistance. The aim of this study was to map and qualitatively assess the ASGs for antimicrobial use in cats and dogs in Europe. Country representatives of the European Network for Optimization of Veterinary Antimicrobial Treatment (ENOVAT) were asked to identify ASGs published in their countries. All collated ASGs updated since January 2010 containing recommendations on antimicrobial therapy for at least three conditions affecting different organ systems in cats and dogs underwent detailed review including AGREE II analysis. Out of forty countries investigated, fifteen ASGs from eleven countries met the inclusion criteria. Several critical principles of antimicrobial use were identified, providing a framework that should assist development of stewardship guidance. The AGREE II analysis highlighted several methodological limitations of the currently available ASGs. This study sheds light on the lack of national ASGs for dogs and cats in multiple European countries and should encourage national bodies to prioritize guideline development in small animals. A greater awareness of the need to use a structured approach to guideline development could improve the quality of ASGs in the future.

scholarly journals Comparison of antimicrobial prescription patterns in calves in Switzerland before and after the launch of online guidelines for prudent antimicrobial use

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Alina Hubbuch ◽  
Ruth Peter ◽  
Barbara Willi ◽  
Sonja Hartnack ◽  
Cedric Müntener ◽  
...  
Keyword(s):  
Private Practice ◽  
Bacterial Resistance ◽  
Clinical Findings ◽  
Antimicrobial Treatment ◽  
University Hospital ◽  
Antimicrobial Use ◽  
First Line ◽  
Private Practices ◽  
Third Line ◽  
The University

Abstract Background The increasing threat of bacterial resistance promotes the need for antibiotic stewardship programs to foster responsible antimicrobial use. Therefore, guidelines for prudent use supported by an online stewardship tool (AntibioticScout.ch) were introduced in Switzerland in December 2016. They recommend (with decreasing preference) a first, second or third line antimicrobial for treatment. The objective of this study was to evaluate antimicrobial prescriptions for Swiss calves before (2016) and after (2018) the launch of these guidelines. Cases of calves with pneumonia, diarrhea and otitis from a university hospital and eight private practices in Switzerland were included. Data on anamnesis, clinical findings, diagnostic work-up and treatment were collected. Type and percentages [95% confidence interval] of antimicrobial prescriptions were compared between 2016 and 2018. Results Of the total number of calves, 88.2% [85.4–90.6] in 2016 (n = 625) and 88.4% [85.7–90.7] in 2018 (n = 655) were treated with antibiotics. The use of highest priority critically important antimicrobials (HPCIAs) decreased from 52.7% [48.6–56.9] in 2016 to 38.0% [34.2–41.9] in 2018; this decrease was found at the university hospital and in private practice and in cases with pneumonia and diarrhea. Particularly the use of fluoroquinolones decreased (2016: 43.1% [39.2–47.2]; 2018: 31.1% [27.6–34.8]). Overall, the number of first line treatments increased from 12.8% [10.4–15.6] in 2016 to 20.2% [17.3–23.4] in 2018. In cases of pneumonia, first line treatments increased (2016: 15.3% [11.6–19.9]; 2018: 26.5% [21.8–31.9]) and third line treatments decreased (2016: 43.5% [38.0–49.3]; 2018: 27.9% [23.1–33.3]); this was seen at the university hospital, whereas in private practice only a decrease of third line treatments was observed. In cases of diarrhea, more second line at the expense of unlisted antimicrobials were prescribed at the university hospital in 2018. Antimicrobial treatment of calves with otitis did not change from 2016 to 2018. Conclusions After the introduction of AntibioticScout.ch, more prudent use was observed in the treatment of calves with pneumonia and diarrhea as less HPCIAs, particularly fluoroquinolones, and more first line antimicrobials were prescribed. However, the overall frequency of antimicrobial treatment did not change and the use of HPCIAs was still common in 2018, especially in private practices. Therefore, further antimicrobial stewardship activities are necessary.

scholarly journals A Cohort Study of Risk Factors That Influence Empirical Treatment of Patients with Acute Pyelonephritis

2017 ◽  
Vol 61 (12) ◽  
Author(s):  
Pau Bosch-Nicolau ◽  
Vicenç Falcó ◽  
Belén Viñado ◽  
Antonia Andreu ◽  
Oscar Len ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Antimicrobial Resistance ◽  
Acute Pyelonephritis ◽  
Demographic Data ◽  
Antibiotic Use ◽  
Antimicrobial Treatment ◽  
University Hospital ◽  
Content Type ◽  
Tract Infections

ABSTRACT The aim of the current study was to compare community-acquired acute pyelonephritis (CA-APN) with health care-associated acute pyelonephritis (HCA-APN), describe the outcomes, and identify variables that could predict antimicrobial susceptibility. We conducted an observational study that included all consecutive episodes of acute pyelonephritis (APN) in adults during 2014 at a Spanish university hospital. From each episode, demographic data, comorbidities, clinical presentation, microbiological data, antimicrobial therapy, and outcome were recorded. A multivariable logistic regression model was performed to define the variables associated with antimicrobial resistance. A total of 607 patients, 503 (82.9%) with CA-APN and 104 (17.1%) with HCA-APN, were included in the study. Patients with HCA-APN were older than patients with CA-APN (70.4 versus 50.6 years; P < 0.001) and had higher rates of previous urinary tract infections (UTIs) (56.5% versus 24.5%; P < 0.001) and previous antibiotic use (56.8% versus 22.8%; P < 0.001). Escherichia coli was more frequently isolated from patients with CA-APN than from patients with HCA-APN (79.9% versus 50.5%; P < 0.001). The rates of resistance of Escherichia coli strains from CA-APN patients versus HCA-APN patients were as follows: amoxicillin-clavulanic acid, 22.4% versus 53.2% (P = 0.001); cefuroxime, 7.7% versus 43.5% (P = 0.001); cefotaxime, 4.3% versus 32.6% (P < 0.001); ciprofloxacin, 22.8% versus 74.5% (P < 0.001); and co-trimoxazole, 34.5% versus 58.7% (P = 0.003). The site of acquisition, recurrent UTIs, and previous antibiotic use were independent risk factors for antimicrobial resistance. Relapse rates were significantly higher when definitive antimicrobial treatment was not adequate (37.1% versus 9.3% when definitive antimicrobial treatment was adequate; P < 0.001). Our study reflects the rise of resistance to commonly used antibiotics in acute pyelonephritis. In order to choose the adequate empirical antibiotic therapy, risk factors for resistance should be considered.

scholarly journals Infectious morbidity and mortality in the infectious diseases department of the CHU Yalgado Ouédraogo in Burkina Faso in 2019

2021 ◽  
Vol 7 (1) ◽  
pp. 097-100
Author(s):  
Mamoudou Savadogo ◽  
Ismaël Diallo ◽  
K Apoline Sondo
Keyword(s):  
Infectious Diseases ◽  
Hiv Infection ◽  
Public Health Problem ◽  
University Hospital ◽  
Major Public Health Problem ◽  
Pulmonary Infections ◽  
Cross Sectional ◽  
Duration Of Hospitalization ◽  
One Year ◽  
Tract Infections

Introduction: Infectious diseases remain a major public health problem in developing countries. The objective of this study was to determine the epidemiological and clinical profile of infectious pathology in the infectious diseases department of CHU Yalgado Ouédraogo in Ouagadougou. Patients and method: This was a cross-sectional and retrospective study that took place in the infectious diseases department of the Yalgado Ouédraogo University Hospital from January 1, 2019 to December 31, 2019. Were included all patients hospitalized in the said service during the study period. For each patient retained sociodemographic, clinical and diagnostic data were collected. Results: In one year, 159 patients had been hospitalized in the infectious diseases department of the YO UHC. The mean age of the patients was 42±9 years with extremes of 15 and 80 years. The female sex was the most represented (55.5%) with a sex ratio of 0.8. The majority of patients (64%) came from the province of Kadiogo. The most frequently diagnosed infectious diseases were HIV infection (24%), pulmonary infections (21.8%), malaria (14%), dengue fever (9%), urinary tract infections (7.5%), meningitis (3.8%), typhoid fever (3%), rabies (3%), chicken pox (3%), tetanus (3.8%), toxoplasmosis (3.8%), and cutaneous leishmaniosis (3%). The signs of severity presented by our patients were dominated by dyspnea, severe anemia, and severe dehydration. The delay of consultation was 13.5 days and the average duration of hospitalization was 9.8 days, with a hospital mortality of 24%. Conclusion: HIV infection, malaria and pulmonary infections were the most frequent reasons for hospitalization. It is therefore important to strengthen the technical facilities of hospitals for early diagnosis and appropriate management of infectious pathology

Faktor-Faktor yang Berpengaruh dalam Mendapatkan Pekerjaan bagi Lulusan Statistika IPB dengan Menggunakan Metode CHAID

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Aulia Dwi Oktavia ◽  
Aam Alamudi ◽  
Budi Susetyo
Keyword(s):  
College Graduates ◽  
Influential Factors ◽  
Classification Model ◽  
Statistical Software ◽  
Waiting Period ◽  
Level Of Education ◽  
Economic Problems ◽  
Factors Influencing

Unemployment is one of the economic problems in Indonesia. Judging from the level of education that was completed there were unemployment from the level of college graduates. This encourages the level of competition in getting jobs to be more stringent, so that college graduates (bachelor of Statistics in IPB) must have the preparation of various factors to maintain the quality of their graduates. The quality of college graduates can be seen from the length of time waiting to get a job. This study aims to determine the influential factors in getting a job for graduates of the IPB Statistics degree, so that the CHAID method can be used in this study. The results of CHAID's analysis in this study in the form of tree diagrams using α = 10% explained that the factors influencing the waiting period variables were sex, internship, and the ability to master statistical software, where the accuracy value generated by the classification model was 79.3 %.

URINARY INFECTION AT DEPARTMENT OF UROLOGY OF HUE UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL

2018 ◽  
pp. 100-108
Author(s):  
Dinh Khanh Le ◽  
Dinh Dam Le ◽  
Khoa Hung Nguyen ◽  
Xuan My Nguyen ◽  
Minh Nhat Vo ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
Clinical Manifestations ◽  
University Hospital ◽  
E Coli ◽  
Positive Urine ◽  
Tract Infections

Objectives: To investigate clinical characteristics, bacterial characteristics, drug resistance status in patients with urinary tract infections treated at Department of Urology, Hue University Hospital. Materials and Method: The study was conducted in 474 patients with urological disease treated at Department of Urology, Hue Universiry Hospital from July 2017 to April 2018. Urine culture was done in the patients with urine > 25 Leu/ul who have symptoms of urinary tract disease or infection symptoms. Patients with positive urine cultures were analyzed for clinical and bacterial characteristics. Results: 187/474 (39.5%) patients had symptoms associated with urinary tract infections. 85/474 (17.9%) patients were diagnosed with urinary tract infection. The positive urine culture rate was 45.5%. Symptoms of UTI were varied, and no prominent symptoms. E. coli accounts for the highest proportion (46.67%), followed by, Staphycoccus aureus (10.67%), Pseudomonas aeruginsa (8,0%), Streptococcus faecali and Proteus (2.67%). ESBL - producing E. coli was 69.23%, ESBL producing Enterobacter spp was 33.33%. Gram-negative bacteria are susceptible to meropenem, imipenem, amikacin while gram positive are vancomycin-sensitive. Conclusions: Clinical manifestations of urinary tract infections varied and its typical symptoms are unclear. E.coli is a common bacterium (46.67%). Isolated bacteria have a high rate of resistance to some common antibiotics especially the third generation cephalosporins and quinolones. Most bacteria are resistant to multiple antibiotics at the same time. Gram (+) bacteria are susceptible to vancomycin, and gram (-) bacteria are susceptible to cefoxitin, amikacin, and carbapenem. Key words: urinary tract infection

HOSPITAL INFECTION IN SURGICAL DEPARTMENTS AT HUE UNIVERSITY HOSPITAL IN 2015

2016 ◽  
pp. 39-43
Author(s):  
Dinh Binh Tran ◽  
Dinh Tan Tran
Keyword(s):  
Surgical Site Infection ◽  
Surgical Intervention ◽  
University Hospital ◽  
Hospital Infections ◽  
Site Infection ◽  
Cross Sectional ◽  
Surgical Interventions ◽  
Hospital Acquired Infections ◽  
Tract Infections ◽  
Hospital Acquired

Objective: To study nosocomial infections and identify the main agents causing hospital infections at Hue University Hospital. Subjects and Methods: A cross-sectional descriptive study of 385 patients with surgical interventions. Results: The prevalence of hospital infections was 5.2%, surgical site infection was the most common (60%), followed by skin and soft tissue infections (35%), urinary tract infections (5%). Surgical site infection (11.6%) in dirty surgery. There were 3 bacterial pathogens isolated, including Staphylococcus aureus (50%), Pseudomonas aeruginosa and Enterococcusspp (25%). Conclusion: Surgical site infection was high in hospital-acquired infections. Key words: hospital infections, surgical intervention, surgical site infection, bacteria

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