Engaging hospitalists in antimicrobial stewardship: The CDC perspective

Srinivasan, Arjun

doi:10.1002/jhm.863

Cited by 29 publications

(20 citation statements)

References 9 publications

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“…This was seen in both recent preventive studies, where proportion of patients receiving treatment antibiotics for SAP was as much as three times greater than the proportion of patients with SAP 9 10. Although many patients misdiagnosed as SAP may have sepsis elsewhere, antibiotics need to be used cautiously, not only because of the risk of antibiotic resistance or Clostridium difficile infections,19 but also because of the possibility of worse 90-day outcomes and longer hospitalisation in patients who had stroke with excessive antibiotic use 10…”

Section: Discussionmentioning

confidence: 98%

Comparison of the diagnostic utility of physician-diagnosed with algorithm-defined stroke-associated pneumonia

Kalra

Hodsoll

Irshad

et al. 2016

J Neurol Neurosurg Psychiatry

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Section: Discussionmentioning

confidence: 98%

Comparison of the diagnostic utility of physician-diagnosed with algorithm-defined stroke-associated pneumonia

Kalra

Hodsoll

Irshad

et al. 2016

J Neurol Neurosurg Psychiatry

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“…Antibiotic stewardship is an integrated and multidisciplinary approach that includes the selection of appropriate antibiotic, enhanced surveillance of prescribing and use, implementation of prescribing guidelines and policies, inclusion of infection prevention and control strategies, and increased efforts on audit and education (Cisneros et al, 2014;Roca et al, 2015). The development of antibiotic stewardship programmes (ASPs) in the hospital/veterinary setting has been encouraged by scientific societies worldwide (Dellit et al, 2007;Srinivasan, 2011;Cisneros et al, 2014;Bowater, 2015), and they have proved to be an essential measure in controlling the rise of ABR and antibiotic expenditures (Moody et al, 2012;Cisneros et al, 2014;File et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Veterinarians’ Perception, Knowledge and Practices of Antibiotic Stewardship in Enugu State Southeast, Nigeria

Anyanwu¹,

Kolade²

2017

Not Sci Biol

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A cross-sectional survey utilizing structured questionnaires was used to study the veterinarians' perception, knowledge and practices of antibiotic stewardship (ABS) in Enugu State, Southeastern Nigeria. Data obtained were analyzed using chi-square on SPSS (Version 15.0) at a significance level of P < 0.05 to determine possible associations between variables and perceptions/knowledge about ABS. Out of 280 respondents, 41 (17.1%) had heard about ABS. Minority of the respondents perceived/knew that using antibiotics only when necessary (6.4%, 18), administering antibiotics at the appropriate dose (6.4%, 18) and administering antibiotics for appropriate duration in every case (4.3%, 12) were among the principles of ABS. The study also showed that age, gender, qualification, years of practice and locations did not exert any influence (P > 0.05) on the awareness of respondents about ABS. More than one-third of the respondents wrongly perceived that increasing the use of broad-spectrum antibiotics (35.4%, 99) is one of the goals of ABS, whereas the minority of the respondents rightly perceived/knew that minimizing toxicity and other adverse effects (16.8%, 47) and reducing antibiotic resistance (ABR) (43.2%, 121) are also goals of ABS. Only 21.4% (60) had overall knowledge of ABS. Prescribing antibiotics without seeing/examining the patient, prescribing antibiotics for any case suspected to be infectious, prescribing broad-spectrum antibiotics despite availability of narrow-spectrum antibiotics, prescribing different classes/types of antibiotics concurrently to ensure therapeutic efficacy, prescribing overdose of antibiotics to ensure efficacy and non-consultation of the veterinary formulary/other resources when in doubt during prescription, are some of inappropriate/untoward ABS practices/behaviors/attitudes amongst the respondents. No significant association (P > 0.05) was found between practices of ABS and age, gender, qualification, years of practice and location. In conclusion, the veterinarians' awareness/perception and practices of ABS is abysmally poor in the study area, thus education of Nigerian veterinarians about ABS and the teaching of the principles and practices of ABS during veterinary schools are recommended.

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“…24,25 At the forefront of inpatient care, internists are well positioned as champions of the principles and practices of ASP. Internists can participate in ASP at a number of levels.…”

Section: Stewardship Teammentioning

confidence: 99%

Antibiotic stewardship programs and the internist’s role

Giusti¹,

Cerutti²

2016

Ital J Med

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Antimicrobial resistance (AMR) is a worldwide issue, but with significant epidemiological diversity in different countries. A recently observed phenomenon is represented by the diffusion of AMR, initially confined to intensive-care units, to medical wards. This was predictable, since patients hospitalized in medical units are made up of more than 70% of elderly people (over 75 years of age in 1 case out of 2). They are fragile patients, with significant comorbidity (over a half with at least 3 diseases), weakened immune systems, and consequently a higher risk of infection. Given such a scenario, it becomes therefore both necessary and urgent to adopt a multifaceted approach of antimicrobial stewardship programs in order to prevent, detect and control the emergence of antimicrobial resistant organisms. The ideal antimicrobial program is led by an infectious diseases (ID) physician and clinical pharmacist with ID training, together with a list of other important staff: clinical microbiologist, information systems specialist, infection control professional, and hospital epidemiologist. In real life, not all the Italian hospitals have got an ID physician and therefore the best canditates for antimicrobial management practices are internists if provided with a specific expertise in ID and antibiotic therapy. Adhering to the principles of optimal antimicrobial therapy in their clinical practice, the internist is able to improve the care and help to reduce the resistance of a patient at his bedside. At the same time, he can achieve other key goals reducing the length of stay and reducing the cost and utilization of health care resources.

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Engaging hospitalists in antimicrobial stewardship: The CDC perspective

Cited by 29 publications

References 9 publications

Comparison of the diagnostic utility of physician-diagnosed with algorithm-defined stroke-associated pneumonia

Comparison of the diagnostic utility of physician-diagnosed with algorithm-defined stroke-associated pneumonia

Veterinarians’ Perception, Knowledge and Practices of Antibiotic Stewardship in Enugu State Southeast, Nigeria

Antibiotic stewardship programs and the internist’s role

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