Antibiotic stewardship in the retail clinic setting: Implementation in 1100 clinics nationwide

Harmon, Sandra; Henderson, Kimberly J.; Barker, Tobias; Sussman, Andrew J.; Gagliano, Nancy

doi:10.1016/j.hjdsi.2017.06.007

Cited by 7 publications

(5 citation statements)

References 7 publications

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“…However, the average age of patients in these studies was 40 years. One national chain of retail clinics has reported on the implementation of a centralized multifaceted stewardship program across more than 1100 sites with associated low rates of inappropriate antibiotic prescribing . However, critics have pointed out that the ease of accessibility of retail clinics may promote healthcare use and subsequent antibiotic prescriptions for patients who have low‐acuity conditions and require only supportive care …”

Section: Ambulatory Care Stewardship Interventionsmentioning

confidence: 99%

Antibiotic Stewardship for Older Adults in Ambulatory Care Settings: Addressing an Unmet Challenge

Pulia

Keller

Crnich

et al. 2019

J American Geriatrics Society

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Inappropriate antibiotic use is common in older adults (aged >65 y), and they are particularly vulnerable to serious antibiotic-associated adverse effects such as cardiac arrhythmias, delirium, aortic dissection, drug-drug interactions, and Clostridioides difficile. Antibiotic prescribing improvement efforts in older adults have been primarily focused on inpatient and long-term care settings. However, the ambulatory care setting is where the vast majority of antibiotic prescribing to older adults occurs. To help improve the clinical care of older adults, we review drivers of antibiotic prescribing in this population, explore systems aspects of ambulatory care that can create barriers to optimal antibiotic use, discuss existing stewardship interventions, and provide guidance on priority areas for future inquiry. J Am Geriatr Soc 68:244-249, 2020.

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Section: Ambulatory Care Stewardship Interventionsmentioning

confidence: 99%

Antibiotic Stewardship for Older Adults in Ambulatory Care Settings: Addressing an Unmet Challenge

Pulia

Keller

Crnich

et al. 2019

J American Geriatrics Society

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“…The major stakeholders of ASPs include infectious disease (ID) physicians [21], clinical pharmacists [22,23], infection control practitioners [24], and nurses [25] who are playing their defined and expanded roles in preventing and treating infectious diseases. Numerous countries have implemented ASPs in different healthcare settings to get optimal health benefits in terms of reduction in AMR as well as cost-effectiveness in drug therapy [26,27,28,29,30].…”

Section: Introductionmentioning

confidence: 99%

Perspective of Pakistani Physicians towards Hospital Antimicrobial Stewardship Programs: A Multisite Exploratory Qualitative Study

Hayat

Rosenthal

Gillani

et al. 2019

IJERPH

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Background: Antimicrobial resistance (AMR) is a global threat and the antimicrobial stewardship program (ASP) is a globally used tool to combat AMR. There is little information on the views among Pakistani physicians regarding AMR and the benefits of hospital antimicrobial stewardship implementation. This study was designed to explore the physicians’ views about ASP. Methods: Qualitative face-to-face and telephonic interviews were conducted by using purposive sampling method with 22 physicians working in seven tertiary care public hospitals of Punjab, Pakistan. All interviews were audio recorded and transcribed verbatim. Qualitative software was used, and a thematic analysis was conducted. Results: Three broad themes were identified: (1) the growing concern of antimicrobial resistance in Pakistan, (2) the role(s) of healthcare professionals in antibiotic prescribing, and (3) managing antibiotic resistance in hospitals. Inadequate resources, poor healthcare facilities, and insufficiently trained medical staff were the major hurdles in ASP implementation in Pakistan. Conclusions: Our study found a poor familiarity of hospital ASP among physicians working in public sector tertiary care teaching hospitals, and a number of distinct themes emerged during this study that could be helpful in establishing the concept of hospital ASP in Pakistan. Overall, physicians showed a positive attitude towards the enforcement of ASP in all healthcare settings, including teaching hospitals.

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“…Our findings showed E. coli (22,42%) as the prevalent Gram-negative bacteria, 45,45% ESBLs and AmpC 37,71% producers in the same group, which resembles the previous mentioned study and others from countries with similar socio-demographic conditions in which predominated E. coli (22,2% Sudan, 28% Cuba) 4,24,25 and ESBLs production of 49,2% 4 ; whereas a research conducted in Spain to assessed multi-resistant gram-negative bacteremia exposed production rates of 80% ESBLs and 8% AmpC 8 . Made an impression the low rate of isolation of carbapenemase-producing gramnegative bacilli and that there is no previous report of it in our region 26 .…”

Section: Discussionmentioning

confidence: 78%

“…Empirical use of beta-lactams with extended spectrum or cephalosporins of 1 to 3 generation is not recommended due to the high resistance found. Alternatively, if resistance to an antibiotic group already exists, we would suggest to start a cyclic replacement, which is performed with antibiotics of different mode of action until the resistance to the former relapses 5,7,10,26,30,31 .…”

Section: Discussionmentioning

confidence: 99%

Microbiological characteristics of infections in a group of colombian patients with oncological diagnosis, 2014 – 2016

Martínez

Gutiérrez‐Ocampo

Valencia-Arango

et al. 2020

Infect

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Objective:We aimed to describe the microbiological characteristics of infections in patients from an oncological center during 2.014-2.016. Methods: In this cross-sectional descriptive study, a total of 7.837 cultures corresponding to 1.216 patients were included. Microbiological and sociodemographic data were taken from cancer diagnosed patients admitted to Oncólogos de Occidente S.A. in Pereira, Armenia, Manizales and Cartago from January 2.014 to December 2.016. The bacterial resistance profiles were defined according to the CLSI guideline. Culture foci were blood, urine, tissue biopsies, skin and soft tissues, mucous membranes and feces. Results: The culture-positive rate was 27,94%. Amongst 2.190 isolates, Escherichia coli (22,42%) was the most frequent, followed by Klebsiella pneumonia (21,27%), Pseudomona aeruginosa (13,83%) and Staphylococcus aureus (5,11%). The most common mechanisms of antimicrobial resistance in Gram-negatives were Extended-Spectrum β-Lactamase (45,45%) and AmpC-type β-lactamases (37,71%). Discussion: Up to nearly one-third of our participants' cultures were positive and a vast majority were gram-negatives, provided with ESBLs or AmpCs which in oncological patients it is a catastrophic outcome. We recommend to establish antibiotic dispensing policies thus achieving a microbiological risk control and improve the epidemiological surveillance. Empirical use of beta-lactams with extended spectrum or cephalosporins of 1 to 3 generation is not recommended due to the high resistance found.

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Antibiotic stewardship in the retail clinic setting: Implementation in 1100 clinics nationwide

Cited by 7 publications

References 7 publications

Antibiotic Stewardship for Older Adults in Ambulatory Care Settings: Addressing an Unmet Challenge

Antibiotic Stewardship for Older Adults in Ambulatory Care Settings: Addressing an Unmet Challenge

Perspective of Pakistani Physicians towards Hospital Antimicrobial Stewardship Programs: A Multisite Exploratory Qualitative Study

Microbiological characteristics of infections in a group of colombian patients with oncological diagnosis, 2014 – 2016

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