A decision support system for antibiotic prescription based on local cumulative antibiograms

Morales, Antonio; Canovas-Segura, Bernardo; Palácios, Francisco; Marín, Rafael Luis Hernández

doi:10.1016/j.jbi.2018.07.003

Cited by 17 publications

(9 citation statements)

References 16 publications

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“…Potential ways forward to improve antimicrobial use include the instigation of ASPs, which have been successful across countries to enhance the appropriate use of antibiotics in hospitals including LMICs 72,73,78,79,90 . Future activities should also include encouraging prescribing where pertinent according to local antibiograms to improve empiric use along with the instigation of ASPs 91,92 . These combined activities should also reduce the prescribing of 'Watch antibiotics in favour of increased prescribing of Access antibiotics 93,94 .…”

Section: Discussionmentioning

confidence: 99%

Pilot Study on the Current Management of Children with COVID-19 In Hospitals in Bangladesh; Findings and Implications

Nusrat

Haque

Chowdhury

et al. 2021

Bangladesh J Med Sci

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Objective: The focus on COVID-19 in children in low- and middle-income countries including Bangladesh has been on addressing key issues including poor vaccination rates as well as mental health issues, domestic violence and child labour. However, the focus on optimally managing children in hospitals is changing with new variants and concerns with the development of hyperinflammatory syndromes. There are also concerns with the overuse of antimicrobials to treat patients with COVID-19 in hospitals enhancing resistance rates. The Bangladesh Paediatric Association have developed guidelines to improve patient care building on national guidance. Consequently, there is a need to document the current management of children with COVID-19 in Bangladesh and use the findings for future guidance. Methods: Rapid analysis of the management of children with COVID-19 among eight private and public hospitals in Bangladesh with varying numbers of in-patient beds using purposely developed case report forms (CRFs). The CRFs were piloted before full roll-out. Results: Overall low numbers of children in hospital with COVID-19 (4.3% of in-patient beds). The majority were male (59.6%) and aged 5 years or under (63.5%). Reasons for admission included respiratory distress/ breathing difficulties with 94.2% of COVID-19 cases confirmed. All children were prescribed antibiotics empirically, typically those on the Watch list of antibiotics and administered parenterally, with only a small minority switched to oral therapy before discharge. There was appreciable prescribing of Vitamins (C and D) and zinc and encouragingly limited prescribing of other antimicrobials (antivirals, antimalarials and antiparasitic medicines). Length of stay was typically 5 to 10 days. Conclusion: Encouraging to see low hospitalisation rates and limited use of antimicrobials apart from antibiotics. Concerns with high empiric use of antibiotics and limited switching to oral formulations can be addressed by instigating antimicrobial stewardship programmes. We will be monitoring this. Bangladesh Journal of Medical Science Vol.20(5) 2021 p.188-198

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Section: Discussionmentioning

confidence: 99%

Pilot Study on the Current Management of Children with COVID-19 In Hospitals in Bangladesh; Findings and Implications

Nusrat

Haque

Chowdhury

et al. 2021

Bangladesh J Med Sci

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“…At initial manifestation of symptoms, iPSCs and iNs could be generated and the methylome of olfactory neurons obtained. Similar to antibiotic algorithms ( Morales et al, 2018 ), treatment might be started “empirically” as soon as all necessary information has been obtained. In the meantime, the cell cultures would be tested for their reactiveness to different classes of drugs.…”

Section: Implications and Future Perspectivesmentioning

confidence: 99%

Making Sense of Patient-Derived iPSCs, Transdifferentiated Neurons, Olfactory Neuronal Cells, and Cerebral Organoids as Models for Psychiatric Disorders

Unterholzner

Millischer

Wotawa

et al. 2021

International Journal of Neuropsychopharmacology

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The improvement of experimental models for disorders requires a constant approximation towards the dysregulated tissue. In psychiatry, where an impairment of neuronal structure and function is assumed to play a major role in disease mechanisms and symptom development, this approximation is an ongoing process implicating various fields. These include genetic, animal, and post-mortem studies. To test hypotheses generated through these studies in vitro models using non-neuronal cells such as fibroblasts and lymphocytes have been developed. For brain network disorders, cells with neuronal signatures would, however, represent a more adequate tissue. Considering the limited accessibility of brain tissue, research has thus turned towards neurons generated from induced pluripotent stem cells, as well as directly induced neurons, cerebral organoids, and olfactory neuroepithelium. Regarding the increasing importance and amount of research using these neuronal cells, this review aims to provide an overview of all these models, to make sense of the current literature. The development of each model system and its use as models for the various psychiatric disorder categories will be laid out. Also, advantages and limitations of each model will be discussed including a reflection on implications and future perspectives.

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“…The efficacy of each antibiotic is computed under those criteria, from 1 (less effective) to 100 (fully effective), based on the number needed to fail measure [30]. Finally, a list with the available antibiotics ranked by efficacy and confidence interval is proposed to the physician.…”

Section: Antibiotic Prescriptionmentioning

confidence: 99%

WASPSS: A Clinical Decision Support System for Antimicrobial Stewardship

Canovas-Segura¹,

Morales²,

Juárez³

et al. 2021

Recent Advances in Digital System Diagnosis and Management of Healthcare

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The increase of infections caused by resistant bacteria has become one of the major health-care problems worldwide. The creation of multidisciplinary teams dedicated to the implementation of antimicrobial stewardship programmes (ASPs) is encouraged by all clinical institutions to cope with this problem. In this chapter, we describe the Wise Antimicrobial Stewardship Program Support System (WASPSS), a CDSS focused on providing support for ASP teams. WASPSS gathers the required information from other hospital systems in order to provide decision support in antimicrobial stewardship from both patient-centered and global perspectives. To achieve this, it combines business intelligence techniques with a rule-based inference engine to integrate the data and knowledge required in this scenario. The system provides functions such as alerts, recommendations, antimicrobial prescription support and global surveillance. Furthermore, it includes experimental modules for improving the adoption of clinical guidelines and applying prediction models related with antimicrobial resistance. All these functionalities are provided through a multiuser web interface, personalized for each role of the ASP team.

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A decision support system for antibiotic prescription based on local cumulative antibiograms

Abstract: This extensive study on real empiric therapies shows that the proposed method is a valuable alternative to traditional antibiograms as regards developing clinical decision support systems for antimicrobial stewardship.

Cited by 17 publications

References 16 publications

Pilot Study on the Current Management of Children with COVID-19 In Hospitals in Bangladesh; Findings and Implications

Pilot Study on the Current Management of Children with COVID-19 In Hospitals in Bangladesh; Findings and Implications

Making Sense of Patient-Derived iPSCs, Transdifferentiated Neurons, Olfactory Neuronal Cells, and Cerebral Organoids as Models for Psychiatric Disorders

WASPSS: A Clinical Decision Support System for Antimicrobial Stewardship

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