Antimicrobial Stewardship: A Review for Internal Medicine Physicians

Sahra, Syeda; Jahangir, Abdullah; Chavez, Vincent De

doi:10.7759/cureus.14385

Cited by 6 publications

(5 citation statements)

References 24 publications

(11 reference statements)

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“…The issue of ABR has not been sufficiently acknowledged by society and it has often been ignored by physicians, who go against the scientifically sound recommendations for prescribers—intentionally or not [ 37 , 38 , 39 , 40 ]. That is why various methods meant to improve physicians’ knowledge and decision-making patterns, considering indications for antibiotic therapy, its goals, benefits and side effects, have been so important [ 6 , 41 , 42 , 43 ]. Already during their studies, young adepts of medicine across the world have the opportunity to familiarize themselves with specific recommendations for the treatment of most common infections, such as those affecting the respiratory system or genitourinary tract [ 44 , 45 , 46 , 47 ].…”

Section: Discussionmentioning

confidence: 99%

Polish Medical Doctors’ Opinions on Available Resources and Information Campaigns concerning Antibiotics and Antibiotic Resistance, a Cross-Sectional Study

et al. 2022

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Background: Antibiotic resistance (ABR) is at the top of global health threats. This paper aims to assess Polish physicians’ readiness to impact ABR through prescribing routines. Methods: Surveying Polish physicians participating in specialization courses at the Center for Postgraduate Medical Education in Warsaw, Poland from October 2019 to March 2020. Results: Information was obtained from 504 physicians aged 25–59, mean 32.8 ± 5.9 years, mainly women (65%). Most doctors (78%) prescribed antibiotics at least once a week. Physicians indicated clinical practice guidelines as resources most often consulted in the management of infections (90%). However, clinical experience was also declared a powerful resource. In total, 54% of respondents recalled receiving information about the prudent use of antibiotics within 12 months, which partially translated into changing views (56%) and practice (42%). Physicians disagreed that national campaigns provide good promotion of prudent antibiotics use (75%) or that they are effective (61%). Only 40% of doctors were aware of the national campaign promoting responsible antibiotics use, 24% had heard about the European Antibiotic Awareness Day and 20% knew about the World Antimicrobial Awareness Week. Conclusions: Prescribers most often rely on clinical practice guidelines and their own experience as resources for antibiotics use. Doctors’ awareness of available resources and information campaigns concerning antibiotics and antibiotic resistance should be improved.

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Section: Discussionmentioning

confidence: 99%

Polish Medical Doctors’ Opinions on Available Resources and Information Campaigns concerning Antibiotics and Antibiotic Resistance, a Cross-Sectional Study

et al. 2022

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“…The model does not consider costs of "missed" bacterial infections because delaying antibiotics or using a "watchful waiting" approach does not significantly increase complication rates in most acute respiratory infections managed in an outpatient setting. [43][44][45][46] Pneumonia, which accounts for approximately 2% of outpatient ARI visits, [24][25][26] is an exception in some cases because severe infection can be life-threatening, particularly for older or chronically ill patients. 47 The model also does not consider the costs associated with antiviral medications because most cases of viral respiratory infection are self-limiting and do not require antiviral medications.…”

Section: Discussionmentioning

confidence: 99%

Economic Evaluation of FebriDx®: A Novel Rapid, Point-of-Care Test for Differentiation of Viral versus Bacterial Acute Respiratory Infection in the United States

Dick

Schneider

2021

Journal of Health Economics and Outcomes Research

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Background: Acute respiratory infections (ARIs) are commonly treated with antibiotics in outpatient settings, but many infections are caused by viruses and antibiotic treatment is therefore inappropriate. FebriDx®, a rapid point-of-care test that can differentiate viral from bacterial infections, can inform antibiotic treatment decisions. Objectives:The primary aim of this study is to conduct a literature-based US economic evaluation of a novel rapid point-of-care test, FebriDx®, that simultaneously measures two key infection biomarkers, C-reactive protein (CRP) and Myxovirus resistance protein A (MxA), to accurately differentiate viral from bacterial infection.Methods: A budget impact model was developed based on a review of published literature on antibiotic prescribing for ARIs in the United States. The model considers the cost of antibiotic treatment, antibiotic resistant infections, antibiotic-related adverse events, and point-of-care testing. These costs were extrapolated to estimate savings on a national level. Results:The expected national cost to treat ARIs under standard of care was US$8.25 billion, whereas the expected national cost of FebriDx point-of-care-guided ARI treatment was US$5.74 billion. Therefore, the expected national savings associated with FebriDx® rapid point-of-care testing was US$2.51 billion annually.Conclusions: FebriDx, a point of care test that can reliably aid in the differentiation of viral and bacterial infections, can reduce antibiotic misuse and, therefore, antibiotic resistant infections. This results in significant cost savings, driven primarily by the reduction in antibiotic resistant infections.

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“…Senior physicians are to influence the prescribing of other physicians and facilitate peer-to-peer learning for improved adherence to established guidelines. Physicians are to take co-leadership of ASPs and communicate with facility leadership and stakeholders on the importance and impact of ASPs [40,41].…”

Section: Role Of a Physician In A Stewardship Teammentioning

confidence: 99%

Implementing Antimicrobial Stewardship in Various Healthcare Settings

O. Popoola

2024

Antimicrobial Stewardship - New Insights

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Antimicrobial resistance is a global health problem associated with mortality, morbidity, and socioeconomic losses. Given the rapid evolution of microorganisms and the scarcity of novel antimicrobials, it is important to implement strategies that promote appropriate, evidence-based use of antimicrobials to preserve their efficacy. These strategies and interventions are collectively referred to as antimicrobial stewardship (AMS). AMS interventions are focused on ensuring that the right antimicrobials are given at the right dose to the right patient, through the right route and for the right duration of time in order to improve patient outcomes, reduce side effects from inappropriate antimicrobial use and reduce the cost of therapy. AMS interventions include providing patient and public education; educating health professionals; ensuring evidence-based antimicrobial use; strengthening infection prevention and control practices; and prioritizing “one health” focused strategies to mitigate AMR in humans, animals, and the environment. Successful antimicrobial stewardship programs possess seven core elements as recommended by the CDC- leadership commitment, education of health professionals, accountability, drug expertise, action-oriented implementations, regular tracking of adherence to stewardship processes, and reporting. Stewardship interventions are successfully implemented when healthcare workers and stakeholders perceive the benefits of the program to be more than the effort required to implement the change.

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Antimicrobial Stewardship: A Review for Internal Medicine Physicians

Cited by 6 publications

References 24 publications

Polish Medical Doctors’ Opinions on Available Resources and Information Campaigns concerning Antibiotics and Antibiotic Resistance, a Cross-Sectional Study

Polish Medical Doctors’ Opinions on Available Resources and Information Campaigns concerning Antibiotics and Antibiotic Resistance, a Cross-Sectional Study

Economic Evaluation of FebriDx®: A Novel Rapid, Point-of-Care Test for Differentiation of Viral versus Bacterial Acute Respiratory Infection in the United States

Implementing Antimicrobial Stewardship in Various Healthcare Settings

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