To see the other types of publications on this topic, follow the link: Antibiotic policy.
Journal articles on the topic 'Antibiotic policy'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Antibiotic policy.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Gyssens, Inge C. "Antibiotic policy." International Journal of Antimicrobial Agents 38 (December 2011): 11–20. http://dx.doi.org/10.1016/j.ijantimicag.2011.09.002.
Full text
2
Hoiby, N. "Ecological antibiotic policy." Journal of Antimicrobial Chemotherapy 46, no. 90001 (August 1, 2000): 59–62. http://dx.doi.org/10.1093/jac/46.suppl_1.59.
Full text
3
Adamu, Abdu A., Muktar A. Gadanya, Rabiu I. Jalo, Olalekan A. Uthman, and Charles S. Wiysonge. "Factors influencing non-prescription sales of antibiotics among patent and proprietary medicine vendors in Kano, Nigeria: a cross-sectional study." Health Policy and Planning 35, no. 7 (June 12, 2020): 819–28. http://dx.doi.org/10.1093/heapol/czaa052.
Full textAbstract:
Abstract Patent and proprietary medicine vendors (PPMVs) increase access to antibiotics through non-prescription sales in their drug retail outlets. This fosters irrational antibiotic use among people, thus contributing to the growing burden of resistance. Although training programmes on antibiotic use and resistance exist, they have disproportionately targeted health workers in hospital settings. It’s unclear if there is a relationship between such trainings and non-prescription sales of antibiotics among PPMVs which are more embedded in communities. Therefore, a cross-sectional study was conducted to elicit the determinants of non-prescription antibiotic sales among PPMVs in Kano metropolis, Nigeria. Through brainstorming, causal loop diagrams (CLDs) were used to illustrate the dynamics of factors that are responsible for non-prescription antibiotic sales. Multilevel logistic regression model was used to determine the relationship between training on antibiotic use and resistance and non-prescription antibiotic sales, after controlling for potential confounders. We found that two-third (66.70%) of the PPMVs reported that they have sold non-prescribed antibiotics. A total of three CLDs were constructed to illustrate the complex dynamics of the factors that are related to non-prescription antibiotic sales. After controlling for all factors, PPMVs who reported that they had never received any training on antibiotic use and resistance were twice as more likely to sell antibiotic without prescription compared with those who reported that they have ever received such training (OR = 2.07, 95% CI: 1.27–3.37). This finding suggests that there is an association between training on antibiotic use and resistance and non-prescription sales of antibiotics. However, the complex dynamics of the factors should not be ignored as it can have implications for the development of intervention programmes. Multifaceted and multicomponent intervention packages (incorporating trainings on antibiotic use and resistance) that account for the inherent complexity within the system are likely to be more effective for this setting.
4
Meenal, Kulkarni. "Compliance of antibiotic prescriptions to the antibiotic policy in surgical cases at an Indian tertiary care hospital." Indian Journal of Science and Technology 13, no. 36 (September 26, 2020): 3772–77. http://dx.doi.org/10.17485/ijst/v13i36.1340.
Full textAbstract:
Background/ Objectives: The use of antibiotics in all kinds of medical treatments has increased tremendously in the past few years. Many tertiary care hospitals have developed guidelines and protocols on antibiotic usage but are unable to achieve targeted compliance and the desired outcome. This study aims to assess the status of antibiotic prescription and compliance with the hospital antibiotic policy during surgical cases. Methods: A retrospective study was carried out for a period of 2 months by passive file auditing of the patients’ record. Findings: The results obtained show 84.8 % compliance with respect to the choice of antibiotic, 90.4 % to indication, and prophylactic antibiotic was given in only 51.2 % amongst the 122 surgical cases. With respect to the time within which antibiotics were given it was found that in 10.4 % it was given more than 2 hours of surgery being started, in 26.4 % it was given in less than one hour and for the remaining 63.2 % that data was not recorded properly. The mean duration of administering the antibiotic was 6.29 hours with SD of 5.20 hours with a median of 4 hours. Novelty: The study highlights the lacunae and flaws amounting to the non-compliance to the antibiotic policy in surgical cases and suggests that most of the tertiary care hospitals too need an implementable policy than a perfect policy. Keywords: Antibiotic; assessment; compliance; prescription; surgical cases
5
Wiley, Kenneth C., and Hendel J. Villamizar. "Antibiotic Resistance Policy and the Stewardship Role of the Nurse." Policy, Politics, & Nursing Practice 20, no. 1 (December 12, 2018): 8–17. http://dx.doi.org/10.1177/1527154418819251.
Full textAbstract:
Government policy, at all levels, should reflect current scientific evidence to curb the spread of multidrug-resistant organisms (MDROs) and to promote healthier lives for citizens and the global community. The World Health Organization estimates that approximately 63,000 Americans die annually of infections from MDROs. Annual spending in the United States used to combat MDRO infections surpassed $35 billion in 2015. This article is a review of U.S. policy regarding MDROs and focuses on several means with which nurses can implement antibiotic stewardship within their practices to stall the creation and global spread of antibiotic-resistant organisms. Nurses are vital to successfully implementing methods of antibiotic stewardship as they are at the center of multidisciplinary health care teams and have the greatest direct patient contact of all members within the team. Methods of antibiotic stewardship include limiting the use of antibiotics within animal husbandry industries, promotion of health care policy in line with antibiotic stewardship standards, and adopting more stringent clinical prescribing practices of antibiotics used in human therapies. Application of these improvements to U.S. federal, state, and local facility policies is in line with current scientific evidence and will provide a framework for cohesive partnerships with nations and institutions abroad that also struggle with the spread of MDROs in their own communities.
6
Kraemer, Susanne A., Arthi Ramachandran, and Gabriel G. Perron. "Antibiotic Pollution in the Environment: From Microbial Ecology to Public Policy." Microorganisms 7, no. 6 (June 22, 2019): 180. http://dx.doi.org/10.3390/microorganisms7060180.
Full textAbstract:
The ability to fight bacterial infections with antibiotics has been a longstanding cornerstone of modern medicine. However, wide-spread overuse and misuse of antibiotics has led to unintended consequences, which in turn require large-scale changes of policy for mitigation. In this review, we address two broad classes of corollaries of antibiotics overuse and misuse. Firstly, we discuss the spread of antibiotic resistance from hotspots of resistance evolution to the environment, with special concerns given to potential vectors of resistance transmission. Secondly, we outline the effects of antibiotic pollution independent of resistance evolution on natural microbial populations, as well as invertebrates and vertebrates. We close with an overview of current regional policies tasked with curbing the effects of antibiotics pollution and outline areas in which such policies are still under development.
7
Antony, Anatte, Seema P. Mohamedali, and Anuradha M. "A cross sectional study to assess knowledge, attitude and practice of rational antibiotic prescription among resident doctors." International Journal of Basic & Clinical Pharmacology 8, no. 4 (March 23, 2019): 704. http://dx.doi.org/10.18203/2319-2003.ijbcp20191104.
Full textAbstract:
Background: Irrational prescription is a major contributor to the antimicrobial resistance. Resident doctors are the major focus of interventional programs aimed at rational prescription of antibiotics. So, their knowledge, attitude and practice regarding rational antibiotic prescription need to be assessed to plan future strategies.Methods: A questionnaire based cross sectional study among interns and resident doctors of a Government Medical College was conducted. Questionnaire consisted of questions to assess knowledge, attitude and practice of resident doctors in rational antibiotic prescriptions and multiple-choice questions to assess practice of hospital antibiotic policy.Results: 80 participants were enrolled in the study. All participants responded to yes or no questions and 47 answered multiple choice questions. 40% were aware of the current hospital antibiotic policy and 29% knew the term antibiotic stewardship. Only 15% were confident in their knowledge on antimicrobial resistance. 87.5% think there is no use in prescribing an antibiotic in common cold. 36.3% overprescribes antibiotics in their daily practice. Only 32.5% practiced de-escalation. 90% were educating patients regarding correct use of antibiotics. 90% send samples for culture and sensitivity but only 22.2% waited for results to start antibiotics.Conclusions: There is a need for approaches that includes implementation of antibiotic policy and to plan for effective teaching programs regarding antibiotic resistance and importance of rational prescription of antibiotics which can improve the quality of antibiotic prescription and minimize antibiotic resistance.
8
Kale-Pradhan, Pramodini, Martin Manuel, and Leonard B. Johnson. "49. Clinical Utility of Oseltamivir Restriction Policy." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S47. http://dx.doi.org/10.1093/ofid/ofaa439.094.
Full textAbstract:
Abstract Background Inappropriate use of oseltamivir and antibiotics for upper respiratory tract infections may increase risk of microbial resistance. Restriction policies have been used to curtail inappropriate use of oseltamivir and antimicrobials in suspected or confirmed influenza patients. We assessed the impact of Infectious Diseases (ID) consult on the management of oseltamivir and concomitant antibiotics. Methods A single-center, retrospective study of patients ≥ 17 years, admitted for greater than 24 hours who received oseltamivir from October 1, 2018 to May 1, 2019 were evaluated. Demographics, Charlson Weighted Index of Comorbidity (CWIC), length of hospital stay (LOS), discharge disposition, rapid flu test, respiratory viral panel, sputum and blood cultures, antibiotic regimen and duration were collected. Continuous variables were analyzed using Students t-test and categorical variables with Chi square test. Results 298 patients were screened and 182 patients met the inclusion criteria. Please see table below for results. Oseltamivir was appropriately continued in 92.9% in the ID consult group compared to 89.3% in the non-ID consult group (p = 0.51). Antibiotic interventions were appropriate in 63.2% of the ID consult group compared to 40% in non-ID group (p = 0.36). Results Summary Conclusion Oseltamivir interventions were appropriate and similar in between groups. Further, there was higher percentage of appropriate antibiotic interventions in the ID physician group. Duration of antibiotics was longer in the ID physicians consulted group which may be due to higher severity of illness in the group. Disclosures All Authors: No reported disclosures
9
McCubbin, Kayley D., John W. Ramatowski, Esther Buregyeya, Eleanor Hutchinson, Harparkash Kaur, Anthony K. Mbonye, Ana L. P. Mateus, and Sian E. Clarke. "Unsafe “crossover-use” of chloramphenicol in Uganda: importance of a One Health approach in antimicrobial resistance policy and regulatory action." Journal of Antibiotics 74, no. 6 (March 19, 2021): 417–20. http://dx.doi.org/10.1038/s41429-021-00416-3.
Full textAbstract:
AbstractSince the introduction of antibiotics into mainstream health care, resistance to these drugs has become a widespread issue that continues to increase worldwide. Policy decisions to mitigate the development of antimicrobial resistance are hampered by the current lack of surveillance data on antibiotic product availability and use in low-income countries. This study collected data on the antibiotics stocked in human (42) and veterinary (21) drug shops in five sub-counties in Luwero district of Uganda. Focus group discussions with drug shop vendors were also employed to explore antibiotic use practices in the community. Focus group participants reported that farmers used human-intended antibiotics for their livestock, and community members obtain animal-intended antibiotics for their own personal human use. Specifically, chloramphenicol products licensed for human use were being administered to Ugandan poultry. Human consumption of chloramphenicol residues through local animal products represents a serious public health concern. By limiting the health sector scope of antimicrobial resistance research to either human or animal antibiotic use, results can falsely inform policy and intervention strategies. Therefore, a One Health approach is required to understand the wider impact of community antibiotic use and improve overall effectiveness of intervention policy and regulatory action.
10
Banerjee, Tuhina, Shampa Anupurba, and Dinesh K. Singh. "Poor compliance with the antibiotic policy in the intensive care unit (ICU) of a tertiary care hospital in India." Journal of Infection in Developing Countries 7, no. 12 (December 15, 2013): 994–98. http://dx.doi.org/10.3855/jidc.3077.
Full textAbstract:
Introduction: Most developing countries are adopting antibiotic policies to contain the acute problem of drug resistance; however, several obstacles prevent their fulfillment. This study was undertaken to prospectively determine the compliance with the antibiotic policy in the intensive care unit (ICU) of a tertiary care hospital and possible reasons for non-compliance. Methodology: Compliance with the newly introduced antibiotic policy was studied for a period of six months. A total of 170 cases from the ICU were included. Relevant information regarding patient characteristics, treatment details, infection control, and antibiotic prescribing practices in the ICU with reference to the antibiotic policy was collected. Reasons for non-compliance were studied. Results: The rate of compliance with the antibiotic policy was 21.18%. Heavy use of antibiotics prior to the time of admission in the ICU was the major cause of non-compliance. Microbiological investigation had been sent in only 51.17% of the cases and change in treatment protocol based on culture report was done in 53.3%. The rate of use of third-generation cephalosporins was 76.78%. Conclusions: We found non-compliance with the antibiotic policy in the ICU mainly due to improper and inappropriate antibiotic usage in other indoor units of the hospital. In our case, a policy covering the entire hospital is required to meet the goals of antibiotic usage restriction. An effective surveillance, review, and evaluation process should be an integral part of the policy, even in developing countries, to measure the effects of such policies.
11
Tunger, O., Y. Karakaya, C. B. Cetin, G. Dine, and H. Borand. "P12.37 Rational Antibiotic Use After an Antibiotic Restriction Policy." Journal of Hospital Infection 64 (January 2006): S70. http://dx.doi.org/10.1016/s0195-6701(06)60231-4.
Full text
12
Bolten, Bailey C., J. Lacie Bradford, Brittany N. White, Gregory W. Heath, James M. Sizemore, and Cyle E. White. "Effects of an automatic discontinuation of antibiotics policy: A novel approach to antimicrobial stewardship." American Journal of Health-System Pharmacy 76, Supplement_3 (August 16, 2019): S85—S90. http://dx.doi.org/10.1093/ajhp/zxz144.
Full textAbstract:
Abstract Purpose A novel automatic discontinuation policy implemented within an antimicrobial stewardship program (ASP) is described, and results of an evaluation of the policy’s effects on antibiotic usage are reported. Methods A retrospective, before-and-after study was conducted at an 800-bed, tertiary care, academic teaching hospital to evaluate selected antibiotic usage outcomes in both intensive care unit (ICU) and non-ICU adult patients targeted for ASP interventions before and after implementation of an automatic discontinuation of antibiotics policy (ADAP) authorizing the ASP team to automatically halt antibiotic therapy in cases involving inappropriate duplicate antimicrobial coverage or excess duration of therapy. The primary outcome was total days of antibiotic therapy. Secondary outcomes included excess days of therapy and rates of 30-day readmission, Clostridioides difficile infection, and multidrug-resistant infection. Results There were no statistically significant differences in group demographics or clinical characteristics. The most common indication for antibiotics was hospital-acquired pneumonia, and the most common reason for ASP intervention was excess duration of therapy. The mean total number of antibiotic days per patient was reduced from 7.6 days in the pre-ADAP group to 6.6 days in the post-ADAP group (p < 0.05). The mean number of excess days of antibiotics was similarly reduced, from 2.3 days to 1.5 days, after implementation of the ADAP (p < 0.05). Conclusion Adoption of an ADAP—a more active approach to ASP interventions—was effective in reducing overall antibiotic usage and improving the efficiency of the ASP.
13
Sanghi, P., A. Oates, and A. K. Scott. "Antibiotic Policy and Clostridium Difficile." Age and Ageing 24, suppl 1 (January 1, 1995): P27—P28. http://dx.doi.org/10.1093/ageing/24.suppl_1.p27-c.
Full text
14
Budd, Emma, Emma Cramp, Mike Sharland, Kieran Hand, Philip Howard, Peter Wilson, Mark Wilcox, Berit Muller-Pebody, and Susan Hopkins. "Adaptation of the WHO Essential Medicines List for national antibiotic stewardship policy in England: being AWaRe." Journal of Antimicrobial Chemotherapy 74, no. 11 (July 30, 2019): 3384–89. http://dx.doi.org/10.1093/jac/dkz321.
Full textAbstract:
Abstract Objectives Appropriate use of and access to antimicrobials are key priorities of global strategies to combat antimicrobial resistance (AMR). The WHO recently classified key antibiotics into three categories (AWaRe) to improve access (Access), monitor important antibiotics (Watch) and preserve effectiveness of ‘last resort’ antibiotics (Reserve). This classification was assessed for antibiotic stewardship and quality improvement in English hospitals. Methods Using an expert elicitation exercise, antibiotics used in England but not included in the WHO AWaRe index were added to an appropriate category following a workshop consensus exercise with national experts. The methodology was tested using national antibiotic prescribing data and presented by primary and secondary care. Results In 2016, 46/108 antibiotics included within the WHO AWaRe index were routinely used in England and an additional 25 antibiotics also commonly used in England were not included in the WHO AWaRe index. WHO AWaRe-excluded and -included antibiotics were reviewed and reclassified according to the England-adapted AWaRE index with the justification by experts for each addition or alteration. Applying the England-adapted AWaRe index, Access antibiotics accounted for the majority (60.9%) of prescribing, followed by Watch (37.9%) and Reserve (0.8%); 0.4% of antibiotics remained unclassified. There was unexplained 2-fold variation in prescribing between hospitals within each AWaRe category, highlighting the potential for quality improvement. Conclusions We have adapted the WHO AWaRe index to create a specific index for England. The AWaRe index provides high-level understanding of antibiotic prescribing. Subsequent to this process the England AWaRe index is now embedded into national antibiotic stewardship policy and incentivized quality improvement schemes.
15
El-Baky, Rehab Mahmoud Abd, Eman Mohamed Senosy, Walid Omara, Doaa Safwat Mohamed, and Reham Ali Ibrahim. "The Impact of the Implementation of Culture-based Antibiotic Policy on the Incidence of Nosocomial Infections in Neonates Hospitalized in Neonatal Intensive Care Unit in a General Egyptian Hospital in Upper Egypt, 2016-2018." Journal of Pure and Applied Microbiology 14, no. 3 (September 5, 2020): 1879–92. http://dx.doi.org/10.22207/jpam.14.3.27.
Full textAbstract:
Nosocomial infections mainly are due to inefficient cleaning in association with the uncontrollable prescription of antimicrobials resulting in the emergence of multi-drug resistant pathogens in the hospital environment. Objectives:The study aims to evaluate the impact of the implementation of culture-guided antibiotic policy with strict infection control strategies on the occurrence of nosocomial infections and the resistance pattern ofthe isolated clinical and environmental pathogens. The study was done in 2 periods. Firstly, (August 2016 – April 2017), routine disinfection procedures and the applied antibiotic policy were evaluated. Secondly, according to the results a new antibiotic policy depending on the culture sensitivity results were implemented starting from June 2017 to February 2018 in association with strict infection control practices. As a result of this intervention, A change in the type of the isolated microorganisms was observed.Antibiotic resistance was decreased. Mortality rate was reduced from 14.1% to 9.5% of neonates with nosocomial infections, the number of the prescribed antibiotics didn’t exceed 4 antibiotics decreasing the overall cost for neonates’ therapy during their hospital stay. Each hospital should have its own antibiotic policy with the application of strict infection control strategies for the control of nosocomial infection.
16
Aseeri, Mohammed A. "The Impact of a Pediatric Antibiotic Standard Dosing Table on Dosing Errors." Journal of Pediatric Pharmacology and Therapeutics 18, no. 3 (September 1, 2013): 220–26. http://dx.doi.org/10.5863/1551-6776-18.3.220.
Full textAbstract:
OBJECTIVE The goal of this study was to compare the rate of dosing errors for antibiotic orders in pediatric patients before and after the implementation of an antibiotic standard dosing table with precalculated dosage for different weight ranges at a tertiary care hospital. METHODS A retrospective study of 300 antibiotic prescriptions for pediatric patients in three different settings (ambulatory care, inpatient, and emergency department) at a tertiary care hospital assessed the appropriateness of antibiotic dosing. The need for an antibiotic dosing standardization policy was identified after finding that more than 30% of patients experienced a dose variation of ±10% of the recommended daily dose. An antibiotic dosing standardization policy was implemented with an antibiotic standard dosing table for different weight ranges, and a hospital wide-education program was conducted to increase awareness of this new practice and its benefits. Three months after implementation, a random sampling of 300 antibiotic prescriptions collected from the same settings as the pre-intervention period was evaluated for compliance with the new policy and its effect on the number of antibiotic dosing errors. RESULTS Six hundred prescriptions were included in this study (300 in the pre-implementation phase and 300 in the post-implementation phase). Patient characteristics were similar in both groups in terms of sex, age, and weight. Physician compliance with the antibiotic dosing standardization policy after its implementation was 62%. The dosing standardization policy reduced the rate of dosing errors from 34.3% to 5.06% (p=0.0001), and weight documentation on the antibiotic prescription improved from 65.8% to 85.7% (p=0.0001). CONCLUSIONS Implementation of an antibiotic dosing standardization policy significantly reduced the incidence of dosing errors in antibiotics prescribed for pediatric patients in our hospital.
17
Hood, Kerenza, Jacqui Nuttall, David Gillespie, Victoria Shepherd, Fiona Wood, Donna Duncan, Helen Stanton, et al. "Probiotics for Antibiotic-Associated Diarrhoea (PAAD): a prospective observational study of antibiotic-associated diarrhoea (including Clostridium difficile-associated diarrhoea) in care homes." Health Technology Assessment 18, no. 63 (October 2014): 1–84. http://dx.doi.org/10.3310/hta18630.
Full textAbstract:
BackgroundAntibiotic prescribing rates in care homes are higher than in the general population. Antibiotics disrupt the normal gut flora, sometimes causing antibiotic-associated diarrhoea (AAD).Clostridium difficile(Hall and O’Toole 1935) Prévot 1938 is the most commonly identified cause of AAD. Little is known either about the frequency or type of antibiotics prescribed in care homes or about the incidence and aetiology of AAD in this setting.ObjectivesThe Probiotics for Antibiotic-Associated Diarrhoea (PAAD) study was designed as a two-stage study. PAAD stage 1 aimed to (1) prospectively describe antibiotic prescribing in care homes; (2) determine the incidence ofC. difficilecarriage and AAD (includingC. difficile-associated diarrhoea); and (3) to consider implementation challenges and establish the basis for a sample size estimation for a randomised controlled trial (RCT) of probiotic administration with antibiotics to prevent AAD in care homes. If justified by PAAD stage 1, the RCT would be implemented in PAAD stage 2. However, as a result of new evidence regarding the clinical effectiveness of probiotics on the incidence of AAD, a decision was taken not to proceed with PAAD stage 2.DesignPAAD stage 1 was a prospective observational cohort study in care homes in South Wales with up to 12 months’ follow-up for each resident.SettingRecruited care homes had management and owner’s agreement to participate and three or more staff willing to take responsibility for implementing the study.ParticipantsEleven care homes were recruited, but one withdrew before any residents were recruited. A total of 279 care home residents were recruited to the observational study and 19 withdrew, 16 (84%) because of moving to a non-participating care home.Main outcome measuresThe primary outcomes were the rate of antibiotic prescribing, incidence of AAD, defined as three or more loose stools (type 5–7 on the Bristol Stool Chart) in a 24-hour period, andC. difficilecarriage confirmed on stool culture.ResultsStool samples were obtained at study entry from 81% of participating residents. Over half of the samples contained antibiotic-resistant isolates, with Enterobacteriaceae resistant to ciprofloxacin in 47%. Residents were prescribed an average of 2.16 antibiotic prescriptions per year [95% confidence interval (CI) 1.90 to 2.46]. Antibiotics were less likely to be prescribed to residents from dual-registered homes. The incidence of AAD was 0.57 (95% CI 0.41 to 0.81) episodes per year among those residents who were prescribed antibiotics. AAD was more likely in residents who were prescribed co-amoxiclav than other antibiotics and in those residents who routinely used incontinence pads. AAD was less common in residents from residential homes.ConclusionsCare home residents, particularly in nursing homes, are frequently prescribed antibiotics and often experience AAD. Antibiotic resistance, including ciprofloxacin resistance, is common in Enterobacteriaceae isolated from the stool of care home residents. Co-amoxiclav is associated with greater risk of AAD than other commonly prescribed antibiotics.Trial registrationCurrent Controlled Trials ISRCTN 7954844.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 18, No. 63. See the NIHR Journals Library website for further project information.
18
S., Anulakshmi, and Annapurna Yadavalli. "A prospective study on antibiotic prescribing pattern among in-patients of medicine department of a tertiary care hospital." International Journal of Basic & Clinical Pharmacology 9, no. 6 (May 21, 2020): 902. http://dx.doi.org/10.18203/2319-2003.ijbcp20202179.
Full textAbstract:
Background: Irrational prescription is a major contributor to the antimicrobial resistance. Tertiary care centres in a state are the centres of excellence where policies are framed. So, they have an important role in promoting rational antibiotic prescription.Methods: The study was conducted on in-patients of medicine ward in government medical college, Calicut, for a period of 2 months (January to February 2018), The data was collected from IP case records of patients. The parameters checked includes appropriateness of the antibiotic as, to whether it is according to our hospital antibiotic policy, whether de-escalation and change to oral drug was done, whether it is prescribed by generic name, is it given as fixed drug combination (FDC), is it from national list of essential medicine.Results: Among the 135-prescription analyzed, total 225 antibiotics were used. Cephalosporins (32%) were the most commonly used. Of this only 40% was given by generic prescription. 27% was FDCs. 55% was from national list of essential medicines and 69% of them were ‘WATCH’ drug according to WHO Antibiotic Policy. Regarding appropriateness of prescriptions around 56% included right drug, 93% had right dose and frequency, and 70% had right duration and 100% were given through right route.Conclusions: Strict adherence to hospital antibiotic policy and plan for effective teaching programs regarding antibiotic resistance and importance of rational prescription of antibiotics can improve the quality of antibiotic prescription and minimize antibiotic resistance.
19
Shah, Amit, Bharat Gajjar, and Ravi Shankar. "Antibiotic Utilization for Surgical Prophylaxis in a Tertiary Care Teaching Rural Hospital." International Journal of User-Driven Healthcare 1, no. 4 (October 2011): 1–14. http://dx.doi.org/10.4018/ijudh.2011100101.
Full textAbstract:
Rational antibiotic prophylaxis reduces the incidence of surgical wound infection. Improper antibiotic prophylaxis leads to excessive surgical wound infection and increased drug resistance. There is an urgent need to establish and implement antibiotic policy but it cannot be done if baseline data is not available. In this study, the authors gathered baseline data about the pattern of surgical antibiotic prophylaxis in their institute. They found that most of the perioperative use of antibiotics was not as per standard guidelines in terms of choice of antibiotics and total duration of treatment. Interventions are warranted to promote the development, dissemination, and adoption of evidence-based guidelines for antibiotic surgical prophylaxis.
20
Nickas, Mark. "A PATENT PRIZE SYSTEM TO PROMOTE DEVELOPMENT OF NEW ANTIBIOTICS AND CONSERVATION OF EXISTING ONES." Pittsburgh Journal of Technology Law and Policy 12 (April 13, 2012): 255–87. http://dx.doi.org/10.5195/tlp.2012.98.
Full textAbstract:
Antibiotics are valuable drugs that fight bacterial infections, but our supply of antibiotics is at risk. Existing antibiotics gradually lose their effectiveness due to bacterial resistance, and few new antibiotics are being developed to replace them. A variety of models have been proposed to promote the conservation of existing antibiotics or incentivize private actors, i.e., drug companies, to develop new ones. Previous models, however, all encourage investment in antibiotic research and development via patent rights, which also create an incentive to oversell antibiotics. Because the inappropriate use of antibiotics accelerates the development of resistance, patent rights put the public health objectives of antibiotic development and conservation in tension with one another. This article proposes an antibiotic-specific patent prize system that uncouples the two policy objectives necessary to achieve a stable antibiotic supply. Although others have proposed patent prize systems to promote drug development generally, the system described here is tailored to address the unique features of antibiotic markets.
21
Dartnell, Jonathan, Kirsten Sterling, Aine Heaney, and Suzanne Blogg. "OP85 Persistence Leads To Ongoing Decreases In Primary Care Antibiotic Use." International Journal of Technology Assessment in Health Care 35, S1 (2019): 22. http://dx.doi.org/10.1017/s0266462319001405.
Full textAbstract:
IntroductionAustralia has had high rates of antibiotic use in primary care. Consumer and health professional knowledge and practices in the community vary. In 2012, NPS MedicineWise implemented a five-year national educational program for consumers, general practitioners (GPs) and pharmacies to reduce antibiotic use in Australia.MethodsFor consumers, a social marketing approach was used focusing on the winter months. Strategies leveraged collectivism, nudge theory, celebrity endorsement and co-creation and used multiple communication channels. For health professionals, interventions were most intense in 2012 with additional activities implemented each year including face-to-face educational visiting, audits, comparative prescribing feedback, case studies and point-of-care materials. Surveys were conducted periodically to evaluate changes in knowledge and awareness. Pharmaceutical Benefits Scheme (PBS) claims data were analyzed. Organization for Economic Co-operation and Development data was used to compare Australian antibiotic per capita consumption to other countries. Time series analyses were used to estimate the cumulative program effect comparing observed and expected monthly dispensing volumes of antibiotics commonly prescribed for upper respiratory tract infections (URTIs), had interventions not occurred.ResultsBetween 2012 and 2017, GP antibiotic PBS prescriptions reduced by 18.4 percent. Antibiotic defined daily doses per 1000 inhabitants reduced from 23.7 in 2012 to 18.4 in 2016, similar to Norway (18.6 in 2016) and the UK (18.7). Time series modelling estimated 24.8 percent fewer GP antibiotic URTI prescriptions by 2017 versus no program. Consumer survey results indicated increased awareness of antibiotic resistance (50 percent in 2011, 74 percent in 2017) and the minority expect/request antibiotics for URTIs (22 percent in 2017).ConclusionsA five-year national educational program with multiple and repeated interventions for health professionals and consumers has resulted in ongoing reductions in antibiotic use in primary care.
22
Jogdand, Sangita, Raju Shinde, and Naman Chandrakar. "Outcome of Evidence-based Allocation of Single-dose Antibiotic extended to Three-dose Antibiotic Prophylaxis in Surgical Site Infection." International Journal of Recent Surgical and Medical Sciences 03, no. 02 (December 2017): 079–84. http://dx.doi.org/10.5005/jp-journals-10053-0046.
Full textAbstract:
Abstract Aim: To study the outcome of evidence-based allocation of single-dose antibiotic extended to three-dose antibiotics prophylaxis in surgical site infection (SSI). Materials and methods: A total of 183 clean surgical procedures in all age groups and of both genders with encountered comorbidities were included in the study. Surgical procedures like inguinal hernia, primary vaginal hydrocele, congenital hernia and hydrocele, fibroadenoma, and other surface swellings were targeted procedures. These procedures were of <1 hour duration and American Society of Anesthesiologists (ASA) grades I and II in study population. Ceftriaxone with sulbactam 1.5 gm was prophylactic antibiotic given 1 hour prior to incision. Excess local signs for inflammation were observed strictly for extension of antibiotics to three doses or multiple doses. Results: Success of evidence-based policy of randomization to single or three doses was 76.5% in all patients, and converting to three doses was 85.7%. Favorable outcome was seen in the patients with comorbidities—76.19% in hypertension, 57.14% in diabetes, and 28.57% in obesity. Only 14.3% of overall patients required extended multiple dose antibiotic therapy, which clearly projects that evidence-based policy implementation was effective in reducing number of doses. Conclusion: Evidence-based flexible antibiotic dose is effective in commonly performed procedures even with comorbidities. Flexibility depending on local signs to modify dose policy gives piece of mind with excellent outcome. Clinical significance: Adopting flexible antibiotic dosing reduces cost of antibiotics therapy with positive mindset for accepting reduced numbers of doses without affecting the outcome of surgical procedure.
23
Beardsley, James, Mark Vestal, Norbert Rosario, Kalyn Meosky, James Johnson, Vera Luther, Christopher Ohl, and John Williamson. "Accuracy of and prescriber perceptions related to documenting antibiotic indications during order entry at an academic medical center." American Journal of Health-System Pharmacy 77, no. 4 (January 7, 2020): 282–87. http://dx.doi.org/10.1093/ajhp/zxz318.
Full textAbstract:
Abstract Purpose To assess the accuracy of antibiotic indication documentation provided during order entry and prescriber perceptions of the requirement to specify indications. Methods Patients who received 1 of 6 selected antibiotics from May 1 through June 30, 2017, were identified. Records of 30 randomly selected patients who received each study antibiotic were retrospectively reviewed. The primary endpoint was indication accuracy, defined as agreement of the indication entered during order entry with that documented in progress notes at the time of order entry. Secondary endpoints included correlation of entered indication and final diagnosis for empiric antibiotics. A brief survey was emailed to prescribers to assess the burden and perceptions of requiring an indication during order entry. Results Four thousand five hundred twenty-four patients received 1 or more doses of a study antibiotic. For the 180 patients selected for evaluation, 89.4% of indications were accurate. Indications for antibiotics ordered for prophylaxis were more likely to be inaccurate than those for empiric or definitive antibiotics (accuracy rates of 46%, 94%, and 92%, respectively, p < 0.05). For empiric antibiotics, 78.5% of indications documented at order entry matched the final diagnosis. Two hundred fifty-four of 863 prescribers (29%) responded to the survey request. Most respondents felt that documenting the indication took no more than 20 seconds, was a “minor nuisance” or “occasionally burdensome,” and had no impact on their consideration of antibiotic appropriateness. Conclusion With the exception of prophylaxis, the indications documented during order entry were sufficiently accurate to assist antimicrobial stewardship efforts. Although indication documentation was perceived as a minor burden, surveyed prescribers indicated it had only a minimal beneficial effect on antibiotic prescribing.
24
Outterson, Kevin, John H. Powers, Enrique Seoane-Vazquez, Rosa Rodriguez-Monguio, and Aaron S. Kesselheim. "Approval and Withdrawal of New Antibiotics and other Antiinfectives in the U.S., 1980–2009." Journal of Law, Medicine & Ethics 41, no. 3 (2013): 688–96. http://dx.doi.org/10.1111/jlme.12079.
Full textAbstract:
Antibiotic use triggers evolutionary and ecological responses from bacteria, leading to antibiotic resistance and harmful patient outcomes. Two complementary strategies support long-term antibiotic effectiveness: conservation of existing therapies and production of novel antibiotics. Conservation encompasses infection control, antibiotic stewardship, and other public health interventions to prevent infection, which reduce antibiotic demand. Production of new antibiotics allows physicians to replace existing drugs rendered less effective by resistance.In recent years, physicians and policymakers have raised concerns about the pipeline for new antibiotics, pointing to a decline in the number of antibiotics approved since the 1980s. This trend has been attributed to high research and development costs, low reimbursement for antibiotics, and regulatory standards for review and approval. Professional societies and researchers around the world have called for renewed emphasis on antimicrobial stewardship, while also supporting antibiotic research and development through grants, changes to intellectual property laws to extend market exclusivity periods, and modification of premarket testing regulations to reduce antibiotic development time and expenses.
25
Peña, Kelsey, Mandelin Cooper, Nickie Greer, Ty Elders, and Edward Septimus. "Process analysis of procalcitonin monitoring within community hospitals." American Journal of Health-System Pharmacy 77, no. 8 (April 1, 2020): 632–35. http://dx.doi.org/10.1093/ajhp/zxaa028.
Full textAbstract:
Abstract Purpose Monitoring of procalcitonin (PCT) levels may support appropriate antibiotic discontinuation. The purpose of this study was to determine the current state of PCT monitoring at community hospitals across the United States. Methods Data from adult patients who were admitted to community hospitals affiliated with a large healthcare system between August 1, 2016, and July 31, 2017, and who received antibiotics were evaluated for the number of PCT levels drawn and the timing between multiple levels. Data from eligible patients were evaluated for the discontinuation of antibiotics after meeting prespecified PCT thresholds for discontinuation of therapy, namely, a PCT measurement of <0.5 μg/L or a decrease of ≥80% from a previous peak value. Results PCT levels were evaluated for 103,913 patient data sets collected from 136 hospitals. Of these, 70% of the data sets showed a single PCT level drawn, and approximately 30% (30,887) of the data sets showed multiple levels drawn. The first PCT measurement was drawn within 36 hours of antibiotic initiation in 96% of the patients. Of those with multiple levels, 23% (7,089) had levels drawn 24 to 72 hours apart. A small proportion (20% [6,127]) of the patients with multiple levels were eligible for evaluation of appropriate antibiotic discontinuation. Of these, 1,973 (32.2%) patients had antibiotics discontinued within 36 hours of meeting the prespecified PCT thresholds; these patients had a mean duration of antibiotic therapy of 6.1 days with a median of 4.7. Conclusion Additional standardization of ongoing PCT monitoring and education regarding the appropriate discontinuation of antibiotics when thresholds are reached could aid in the use of this biomarker in support of antibiotic and laboratory stewardship.
26
Shapiro, Robert, Rose Laignel, Caitlin Kowcheck, Valerie White, and Mahreen Hashmi. "Modifying pre-operative antibiotic overuse in gynecologic surgery." International Journal of Health Care Quality Assurance 31, no. 5 (June 11, 2018): 400–405. http://dx.doi.org/10.1108/ijhcqa-04-2017-0066.
Full textAbstract:
Purpose Previous studies indicate adherence to pre-operative antibiotic prophylaxis guidelines has been inadequate. The purpose of this paper is to determine adherence rates to current perioperative antibiotic prophylaxis guidelines in gynecologic surgery at a tertiary care, academic institution. As a secondary outcome, improving guidelines after physician re-education were analyzed. Design/methodology/approach A retrospective chart review (2,463 patients) was completed. The authors determined if patients received perioperative antibiotic prophylaxis in accordance with current guidelines from the America College of Obstetricians and Gynecologists. Data were obtained before and after physician tutorials. Quality control was implemented by making guideline failures transparent. Statistical analysis used Fisher’s exact and agreement tests. Findings In total, 23 percent of patients received antibiotics not indicated across all procedures. This decreased to 9 percent after physician re-education and outcome transparency (p<0.0001). Laparoscopy was the procedure with the lowest guideline compliance prior to education. The compliance improved from 52 to 92 percent (p<0.0001) after re-education. Practical implications Gynecologic surgeons overuse antibiotics for surgical prophylaxis. Physician re-education and transparency were shown to enhance compliance. Originality/value Educational tutorials are an effective strategy for encouraging physicians to improve outcomes, which, in turn, allows the healthcare system a non-punitive way to monitor quality and mitigate cost.
27
Eilermann, Kerstin, Katrin Halstenberg, Ludwig Kuntz, Kyriakos Martakis, Bernhard Roth, and Daniel Wiesen. "The Effect of Expert Feedback on Antibiotic Prescribing in Pediatrics: Experimental Evidence." Medical Decision Making 39, no. 7 (August 17, 2019): 781–95. http://dx.doi.org/10.1177/0272989x19866699.
Full textAbstract:
Background. Inappropriate prescribing of antibiotics, which is common in pediatric care, is a key driver of antimicrobial resistance. To mitigate the development of resistance, antibiotic stewardship programs often suggest the inclusion of feedback targeted at individual providers. Empirically, however, it is not well understood how feedback affects individual physicians’ antibiotic prescribing decisions. Also, the question of how physicians’ characteristics, such as clinical experience, relate to antibiotic prescribing decisions and to responses to feedback is largely unexplored. Objective. To analyze the causal effect of descriptive expert feedback (and individual characteristics) on physicians’ antibiotic prescribing decisions in pediatrics. Design. We employed a randomized, controlled framed field experiment, in which German pediatricians ( n=73) decided on the length of first-line antibiotic treatment for routine pediatric cases. In the intervention group ( n=39), pediatricians received descriptive feedback in form of an expert benchmark, which allowed them to compare their own prescribing decisions with expert recommendations. The recommendations were elicited in a survey of pediatric department directors ( n=20), who stated the length of antibiotic therapies they would choose for the routine cases. Pediatricians’ characteristics were elicited in a comprehensive questionnaire. Results. Providing pediatricians with expert feedback significantly reduced the length of antibiotic therapies by 10% on average. Also, the deviation of pediatricians’ decisions from experts’ recommendations significantly decreased. Antibiotic therapy decisions were significantly related to pediatricians’ clinical experience, risk attitudes, and personality traits. The effect of feedback was significantly associated with physicians’ experience. Conclusion. Our results indicate that descriptive expert feedback can be an effective means to guide pediatricians, especially those who are inexperienced, toward more appropriate antibiotic prescribing. Therefore, it seems to be suitable for inclusion in antibiotic stewardship programs.
28
Harbarth, Stephan. "Antibiotic policy and penicillin-G shortage." Lancet 355, no. 9215 (May 2000): 1650. http://dx.doi.org/10.1016/s0140-6736(05)72558-7.
Full text
29
Karamchandani, Kunal, Kyle Barden, and Jansie Prozesky. "Adherence to surgical antimicrobial prophylaxis: “checking-the-box” is not enough." International Journal of Health Care Quality Assurance 32, no. 2 (March 11, 2019): 470–73. http://dx.doi.org/10.1108/ijhcqa-05-2018-0104.
Full textAbstract:
PurposeThe purpose of this paper is to review surgical antimicrobial prophylaxis administration practices in a small cohort and assess compliance with national guidelines.Design/methodology/approachPatients that developed surgical site infections (SSI) in a tertiary care academic medical center over a two-year period were identified. Their electronic medical records were reviewed for compliance with national guidelines with respect to surgical antibiotic prophylaxis.FindingsOver a two-year period, 283 SSI patients were identified. An appropriate antibiotic was chosen in 80 percent, an appropriate dose was administered in 45 percent and timing complied in 89 percent. The antibiotics were appropriately re-dosed in only 9.2 percent in whom the requirement was met. The prescribing guidelines were adhered to in entirety in only 54 patients (23.8 percent).Practical implicationsTimely and appropriate antibiotic administration prior to surgery is essential to prevent SSI. Proper diligence is required to accomplish this task effectively.Originality/valueBased on the findings, it appears that merely, “checking a box” for antibiotic administration during surgery is not enough, and a multidisciplinary approach should be followed to ensure “appropriate” antibiotic administration.
30
Bloomer, Ellen, and Martin McKee. "Policy options for reducing antibiotics and antibiotic-resistant genes in the environment." Journal of Public Health Policy 39, no. 4 (October 8, 2018): 389–406. http://dx.doi.org/10.1057/s41271-018-0144-x.
Full text
31
Gould, I. M., and B. Jappy. "Trends in hospital antibiotic prescribing after introduction of an antibiotic policy." Journal of Antimicrobial Chemotherapy 38, no. 5 (November 1, 1996): 895–904. http://dx.doi.org/10.1093/jac/38.5.895.
Full text
32
Vlahovic-Palcevski, V., M. Morovic, and G. Palcevski. "Antibiotic utilization at the university hospital after introducing an antibiotic policy." European Journal of Clinical Pharmacology 56, no. 1 (April 26, 2000): 97–101. http://dx.doi.org/10.1007/s002280050727.
Full text
33
Roope, Laurence S. J., Richard D. Smith, Koen B. Pouwels, James Buchanan, Lucy Abel, Peter Eibich, Christopher C. Butler, et al. "The challenge of antimicrobial resistance: What economics can contribute." Science 364, no. 6435 (April 4, 2019): eaau4679. http://dx.doi.org/10.1126/science.aau4679.
Full textAbstract:
As antibiotic consumption grows, bacteria are becoming increasingly resistant to treatment. Antibiotic resistance undermines much of modern health care, which relies on access to effective antibiotics to prevent and treat infections associated with routine medical procedures. The resulting challenges have much in common with those posed by climate change, which economists have responded to with research that has informed and shaped public policy. Drawing on economic concepts such as externalities and the principal–agent relationship, we suggest how economics can help to solve the challenges arising from increasing resistance to antibiotics. We discuss solutions to the key economic issues, from incentivizing the development of effective new antibiotics to improving antibiotic stewardship through financial mechanisms and regulation.
34
D'Angeli, Marisa Anne, Joe B. Baker, Douglas R. Call, Margaret A. Davis, Kelly J. Kauber, Uma Malhotra, Gregory T. Matsuura, et al. "Antimicrobial stewardship through a one health lens." International Journal of Health Governance 21, no. 3 (September 5, 2016): 114–30. http://dx.doi.org/10.1108/ijhg-02-2016-0009.
Full textAbstract:
Purpose – Antibiotic resistance (AR) is a global health crisis that is attracting focussed attention from healthcare, public health, governmental agencies, the public, and food producers. The purpose of this paper is to describe the work in Washington State to combat resistance and promote antimicrobial stewardship from a one health perspective. Design/methodology/approach – In 2014, the Washington State Department of Health convened a One Health Steering Committee and two workgroups to focus on AR, the One Health Antimicrobial Stewardship work group and the One Health Antimicrobial Resistance Surveillance work group. The group organized educational sessions to establish a basic understanding of epidemiological factors that contribute to resistance, including antibiotic use, transmission of resistant bacteria, and environmental contamination with resistant bacteria and antibiotic residues. Findings – The authors describe the varied uses of antibiotics; efforts to promote stewardship in human, and animal health, including examples from the USA and Europe; economic factors that promote use of antibiotics in animal agriculture; and efforts, products and next steps of the workgroups. Originality/value – In Washington, human, animal and environmental health experts are working collaboratively to address resistance from a one health perspective. The authors are establishing a multi-species resistance database that will allow tracking resistance trends in the region. Gaps include measurement of antibiotic use in humans and animals; integrated resistance surveillance information; and funding for AR and animal health research.
35
Kanu, Joseph Sam, Mohammed Khogali, Katrina Hann, Wenjing Tao, Shuwary Barlatt, James Komeh, Joy Johnson, et al. "National Antibiotic Consumption for Human Use in Sierra Leone (2017–2019): A Cross-Sectional Study." Tropical Medicine and Infectious Disease 6, no. 2 (May 13, 2021): 77. http://dx.doi.org/10.3390/tropicalmed6020077.
Full textAbstract:
Monitoring antibiotic consumption is crucial to tackling antimicrobial resistance. However, currently there is no system in Sierra Leone for recording and reporting on antibiotic consumption. We therefore conducted a cross-sectional study to assess national antibiotic consumption expressed as defined daily dose (DDD) per 1000 inhabitants per day using all registered and imported antibiotics (categorized under the subgroup J01 under the anatomical and therapeutic classification (ATC) system) as a proxy. Between 2017–2019, total cumulative consumption of antibiotics was 19 DDD per 1000 inhabitants per day. The vast majority consisted of oral antibiotics (98.4%), while parenteral antibiotics made up 1.6%. According to therapeutic/pharmacological subgroups (ATC level 3), beta-lactam/penicillins, quinolones, and other antibacterials (mainly oral metronidazole) comprised 65% of total consumption. According to WHO Access, Watch, and Reserve (AWaRe), 65% of antibiotics consumed were Access, 31% were Watch, and no Reserve antibiotics were reported. The top ten oral antibiotics represented 97% of total oral antibiotics consumed, with metronidazole (35%) and ciprofloxacin (15%) together constituting half of the total. Of parenteral antibiotics consumed, procaine penicillin (32%) and ceftriaxone (19%) together comprised half of the total. Policy recommendations at global and national levels have been made to improve monitoring of antibiotic consumption and antibiotic stewardship.
36
Wu, Jianyun, Daniel Taylor, Jonathan Dartnell, Aine Heaney, Lynn Weekes, Suzanne Blogg, Kirsten Sterling, and Anthony Carr. "PP16 Turning The Tide On Antibiotic Use With Consumers And Health Professionals." International Journal of Technology Assessment in Health Care 34, S1 (2018): 71. http://dx.doi.org/10.1017/s0266462318001885.
Full textAbstract:
Introduction:Many countries have a national antimicrobial resistance strategy. In Australia, primary care is especially important because this setting encompasses a high proportion of antibiotic use. While antibiotic use decreased during the 1990s, it began to increase again in the mid-2000s. In response to this, in 2009 NPS MedicineWise implemented a series of nationwide educational interventions for consumers, family physicians (general practitioners), and community pharmacies that aimed to reduce excessive antibiotic use.Methods:For consumers a social marketing approach was used, including strategies that leveraged collectivism, nudge theory, celebrity endorsement, and co-creation. Channels included social, print, radio, and other media as well as practice waiting rooms and pharmacies. For health professionals, interventions included face-to-face education, audits, comparative prescribing feedback, case studies, and point-of-care materials. Surveys of consumers and family physicians were conducted periodically to evaluate changes in knowledge and behavior. National Pharmaceutical Benefits Scheme claims data were analyzed using a Bayesian structural time-series model to estimate the cumulative effect of interventions by comparing the observed and expected monthly dispensing volumes if the interventions had not occurred.Results:The consumer survey results indicated that more people were aware of antibiotic resistance (seventy-four percent in 2017 versus seventy percent in 2014), with the minority requesting or expecting antibiotics for upper respiratory tract infections (URTIs) (twenty-two percent in 2017). People underestimated the usual duration of symptoms for URTIs and were more inclined to expect antibiotics beyond that timeframe. Compared with non-participants, family physicians who participated in the program reported more frequent discussions about hand hygiene (ninety percent versus eighty-two percent) and proper use of antibiotics with patients (ninety-five percent versus eighty-eight percent). Between 2009 and 2015 there was an estimated fourteen percent reduction in prescriptions dispensed to concessional patients for antibiotics commonly prescribed for URTIs.Conclusions:Family physicians and consumers have responded positively to national programs. Sustaining and building on these improvements will require continued education and further innovation.
37
Sharma, Shakti, Nikita Kumari, Rinku Sengupta, Yashika Malhotra, and Saru Bhartia. "Rationalising antibiotic use after low-risk vaginal deliveries in a hospital setting in India." BMJ Open Quality 10, Suppl 1 (July 2021): e001413. http://dx.doi.org/10.1136/bmjoq-2021-001413.
Full textAbstract:
BackgroundIn 2017, a postoperative multidrug resistant case of urinary tract infection made obstetricians at Sitaram Bhartia Institute of Science and Research introspect the antibiotic usage in labouring mothers. Random case file reviews indicated overuse and variability of practice among care providers. This prompted us to explore ways to rationalise antibiotic use.MethodsA multidisciplinary team of obstetricians, paediatricians and quality officers was formed to run this improvement initiative at a private hospital facility in India. Review of literature advocated formulating a departmental antibiotic policy. Creating this policy and implementing it using improvement methodology helped us rationalise antibiotic usage.InterventionsWe aimed to reduce the use of antibiotics from 42% to less than 10% in uncomplicated vaginal deliveries. We tested a series of sequential interventions using the improvement methodology of Plan–Do–Study–Act (PDSA) cycles, an approach recommended by the Institute for Healthcare Improvement. Learning from the PDSA cycle of the previous intervention helped decide the subsequent change ideas. The interventions included creation of a departmental antibiotic policy, staff engagement, and modification in documentation, concept of dual responsibility and team huddles as feedback opportunities. Information was analysed to understand the progress and improvement with change ideas.ResultsBackground analysis revealed that antibiotic usage ranged from 24% to 69% and average rate of antibiotic prophylaxis was high (42.28%) in low-risk uncomplicated vaginal deliveries. The sequential changes resulted in reduction in antibiotic usage to 10% in the target population by 4 months. Sustained improvement was noted in the following months.ConclusionWe succeeded in implementing a departmental antibiotic policy aligning it with existing international guidelines and our local challenges. Antibiotic stewardship was one of the first major steps in our journey to avoid multidrug-resistant infections. Sustaining outcomes will involve continuous feedback to ensure engagement of all stakeholders in a hospital setting.
38
Eriksen, Jaran, Ingeborg Björkman, Marta Röing, Sabiha Y. Essack, and Cecilia Stålsby Lundborg. "Exploring the One Health Perspective in Sweden’s Policies for Containing Antibiotic Resistance." Antibiotics 10, no. 5 (May 3, 2021): 526. http://dx.doi.org/10.3390/antibiotics10050526.
Full textAbstract:
Antibiotic resistance is considered to be a major threat to global health. The main driver of antibiotic resistance is antibiotic use. Antibiotics are used in humans, animals, and food production and are released into the environment. Therefore, it is imperative to include all relevant sectors in the work to contain antibiotic resistance, i.e., a One Health approach. In this study, we aimed to describe and analyse Sweden’s policies related to containing antibiotic resistance, from a One Health perspective. Twenty-three key policy documents related to containment of antibiotic resistance in Sweden were selected and analysed according to the policy triangle framework. Sweden started early to introduce policies for containing antibiotic resistance from an international perspective. Systematic measures against antibiotic resistance were implemented in the 1980s, strengthened by the creation of Strama in 1995. The policies involve agencies and organisations from human and veterinary medicine, the environment, and food production. All actors have clear responsibilities in the work to contain antibiotic resistance with a focus on international collaboration, research, and innovation. Sweden aims to be a model country in the work to contain antibiotic resistance and has a strategy for achieving this through international cooperation through various fora, such as the EU, the UN system, and OECD.
39
Yin, Jia, Oliver James Dyar, Peng Yang, Ding Yang, Gaetano Marrone, Mingli Sun, Chengyun Sun, Qiang Sun, and Cecilia Stålsby Lundborg. "Pattern of antibiotic prescribing and factors associated with it in eight village clinics in rural Shandong Province, China: a descriptive study." Transactions of The Royal Society of Tropical Medicine and Hygiene 113, no. 11 (July 11, 2019): 714–21. http://dx.doi.org/10.1093/trstmh/trz058.
Full textAbstract:
Abstract Background This study describes the patterns of antibiotic prescribing in eight village clinics in rural China and evaluates factors associated with antibiotic prescribing using quantitative and qualitative methods. Methods From January 2015 to July 2017, 60 prescriptions were collected monthly from selected village clinics in Shandong, China. Village clinic doctors completed a questionnaire regarding their knowledge of antibiotic prescribing. Semi-structured interviews were conducted with 15 village doctors and 1 deputy director from the township hospital. Results Of the 14 526 prescriptions collected, 5851 (40.3%) contained at least one antibiotic, among which 18.4% had two or more antibiotics and 24.3% had parenteral antibiotics. The antibiotic prescribing rate (β=−0.007 [95% confidence interval −0.009 to −0.004]) showed a declining trend (1.7% per month). Higher antibiotic prescribing rates were observed for patients <45 y of age and those diagnosed with upper respiratory tract infections and among village doctors who had less working experience and a lower level of knowledge on antibiotic prescribing. Qualitative analyses suggested that antibiotic prescribing was influenced by the patients’ symptoms, patients’ requests, policies restraining the overuse of antibiotics, subsidies for referral and routine village doctor training. Conclusions Antibiotic prescribing has declined in the included village clinics, which may be due to the policy of reducing antibiotic overuse in primary health care centres in China.
40
Hassan, Md Zakiul, Mohammad Riashad Monjur, Md Abdullah Al Jubayer Biswas, Fahmida Chowdhury, Mohammad Abdullah Heel Kafi, Jeffrey Braithwaite, Adam Jaffe, and Nusrat Homaira. "Antibiotic use for acute respiratory infections among under-5 children in Bangladesh: a population-based survey." BMJ Global Health 6, no. 4 (April 2021): e004010. http://dx.doi.org/10.1136/bmjgh-2020-004010.
Full textAbstract:
IntroductionDespite acute respiratory infections (ARIs) being the single largest reason for antibiotic use in under-5 children in Bangladesh, the prevalence of antibiotic use in the community for an ARI episode and factors associated with antibiotic use in this age group are unknown.MethodsWe analysed nationally representative, population-based, household survey data from the Bangladesh Demographic and Health Survey 2014 to determine the prevalence of antibiotic use in the community for ARI in under-5 children. Using a causal graph and multivariable logistical regression, we then identified and determined the sociodemographic and antibiotic source factors significantly associated with the use of antibiotics for an episode of ARI.ResultsWe analysed data for 2 144 children aged <5 years with symptoms of ARI from 17 300 households. In our sample, 829 children (39%) received antibiotics for their ARI episode (95% CI 35.4% to 42.0%). Under-5 children from rural households were 60% (adjusted OR (aOR): 1.6; 95% CI 1.2 to 2.1) more likely to receive antibiotics compared with those from urban households, largely driven by prescriptions from unqualified or traditional practitioners. Private health facilities were 50% (aOR: 0.5; 95% CI 0.3 to 0.7) less likely to be sources of antibiotics compared with public health facilities and non-governmental organisations. Age of children, sex of children or household wealth had no impact on use of antibiotics.ConclusionIn this first nationally representative analysis of antibiotic use in under-5 children in Bangladesh, we found almost 40% of children received antibiotics for an ARI episode. The significant prevalence of antibiotic exposure in under-5 children supports the need for coordinated policy interventions and implementation of clinical practice guidelines at point of care to minimise the adverse effects attributed to antibiotic overuse.
41
John, Shinu Mary, Bijoy Kumar Panda, Deepak Govind Bhosle, and Nikki Soman. "Evaluation of cephalosporins utilization and compliance with reference to the hospital antibiotic policy of an Indian tertiary care hospital." International Journal of Basic & Clinical Pharmacology 8, no. 5 (April 23, 2019): 1044. http://dx.doi.org/10.18203/2319-2003.ijbcp20191599.
Full textAbstract:
Background: Emergence of bacterial resistance in hospital settings due to the liberal use of antibiotics which led to an altered impact on its therapeutic efficacy and outcome, thereby increasing the treatment costs in patients. In this regard the study aims to evaluate the cephalosporins utilization and compliance to the hospital antibiotic policy in general medicine ward.Methods: A prospective observational study was carried out over an eleven-month period in patients prescribed with cephalosporins. Clinical data of inpatients were collected and evaluated by using World Health Organization (WHO) core prescribing indicators and defined daily dose per 100 bed-days. The comparison between the cephalosporins prescribed in the chart records to the recommendations mentioned in the institutional antibiotic policy v.2.0, help to determine the deviations in their usage pattern.Results: A total of 370 patients were enrolled in the study, of which 54.6% were females. Cephalosporins were empirically prescribed in 240 (64.9%) cases. The average number of total antibiotics and cephalosporins per encounter was 1.6 and 1 respectively. Among the total antibiotics, 63.7% were cephalosporins. Third generation cephalosporins (98.4%) were commonly prescribed, with ceftriaxone (93%) in parenteral form for respiratory tract infections (31.9%). Total parenteral antibiotics prescribed were found to be 68.8% of which 88.6% were cephalosporins. Utilization pattern of cephalosporins amounted to be 4.95 DDD/100 bed-days. Overall compliance was achieved in 191 (51.6%) prescriptions.Conclusions: The rate of prescribing of cephalosporins was marginally high. There was a low rate of compliance towards policy which reflects the urgent need for repetitive intervention to comply antibiotic policy.
42
Gulliford, Martin C., Dorota Juszczyk, A. Toby Prevost, Jamie Soames, Lisa McDermott, Kirin Sultana, Mark Wright, et al. "Electronically delivered interventions to reduce antibiotic prescribing for respiratory infections in primary care: cluster RCT using electronic health records and cohort study." Health Technology Assessment 23, no. 11 (March 2019): 1–70. http://dx.doi.org/10.3310/hta23110.
Full textAbstract:
BackgroundUnnecessary prescribing of antibiotics in primary care is contributing to the emergence of antimicrobial drug resistance.ObjectivesTo develop and evaluate a multicomponent intervention for antimicrobial stewardship in primary care, and to evaluate the safety of reducing antibiotic prescribing for self-limiting respiratory infections (RTIs).InterventionsA multicomponent intervention, developed as part of this study, including a webinar, monthly reports of general practice-specific data for antibiotic prescribing and decision support tools to inform appropriate antibiotic prescribing.DesignA parallel-group, cluster randomised controlled trial.SettingThe trial was conducted in 79 general practices in the UK Clinical Practice Research Datalink (CPRD).ParticipantsAll registered patients were included.Main outcome measuresThe primary outcome was the rate of antibiotic prescriptions for self-limiting RTIs over the 12-month intervention period.Cohort studyA separate population-based cohort study was conducted in 610 CPRD general practices that were not exposed to the trial interventions. Data were analysed to evaluate safety outcomes for registered patients with 45.5 million person-years of follow-up from 2005 to 2014.ResultsThere were 41 intervention trial arm practices (323,155 patient-years) and 38 control trial arm practices (259,520 patient-years). There were 98.7 antibiotic prescriptions for RTIs per 1000 patient-years in the intervention trial arm (31,907 antibiotic prescriptions) and 107.6 per 1000 patient-years in the control arm (27,923 antibiotic prescriptions) [adjusted antibiotic-prescribing rate ratio (RR) 0.88, 95% confidence interval (CI) 0.78 to 0.99;p = 0.040]. There was no evidence of effect in children aged < 15 years (RR 0.96, 95% CI 0.82 to 1.12) or adults aged ≥ 85 years (RR 0.97, 95% CI 0.79 to 1.18). Antibiotic prescribing was reduced in adults aged between 15 and 84 years (RR 0.84, 95% CI 0.75 to 0.95), that is, one antibiotic prescription was avoided for every 62 patients (95% CI 40 to 200 patients) aged 15–84 years per year. Analysis of trial data for 12 safety outcomes, including pneumonia and peritonsillar abscess, showed no evidence that these outcomes might be increased as a result of the intervention. The analysis of data from non-trial practices showed that if a general practice with an average list size of 7000 patients reduces the proportion of RTI consultations with antibiotics prescribed by 10%, then 1.1 (95% CI 0.6 to 1.5) more cases of pneumonia per year and 0.9 (95% CI 0.5 to 1.3) more cases of peritonsillar abscesses per decade may be observed. There was no evidence that mastoiditis, empyema, meningitis, intracranial abscess or Lemierre syndrome were more frequent at low-prescribing practices.LimitationsThe research was based on electronic health records that may not always provide complete data. The number of practices included in the trial was smaller than initially intended.ConclusionsThis study found evidence that, overall, general practice antibiotic prescribing for RTIs was reduced by this electronically delivered intervention. Antibiotic prescribing rates were reduced for adults aged 15–84 years, but not for children or the senior elderly.Future workStrategies for antimicrobial stewardship should employ stratified interventions that are tailored to specific age groups. Further research into the safety of reduced antibiotic prescribing is also needed.Trial registrationCurrent Controlled Trials ISRCTN95232781.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 23, No. 11. See the NIHR Journals Library website for further project information.
43
Manoj Kumar, Anu Sharma, Yasmeen M, and Parwez. "A review on Antibiotic Policy and Antimicrobial Stewardship Program (AMSP) – Need of the hour." International Journal of Research in Pharmaceutical Sciences 12, no. 2 (April 7, 2021): 1233–37. http://dx.doi.org/10.26452/ijrps.v12i2.4665.
Full textAbstract:
Emerging trends of antimicrobial resistance and development of multidrug resistance and pan resistant strains have become a significant public health problem worldwide. The rate at which newer drugs are developing has slowed down and clinicians are left with only limited therapeutic options for treatment of the patient. We are heading towards the pre antibiotic discovery phase where mortality was high due to unavailability of appropriate drugs; however, in current situation due to misuse or over use of antibiotics, microbes have developed newer methods of resistance, thus rendering these antimicrobials ineffective in their action which has resulted in increased morbidity and mortality among patient and increase in the health care expenditure. Antimicrobial resistance continues to be a major public health problem of international concern. As there is alarming situation globally due to development of multi and pan resistant bacteria which are also known as superbugs, these superbugs have resulted in havoc as these infections are not treatable and is of great concern to the treating physician. Judicious use of antibiotics and implementation of antibiotic stewardship program are the only ways to combat the current situation. The present review aims to provide information on framing of antibiotic policy and implementation of antimicrobial stewardship program.
44
Braxton, Carla C., Patricia A. Gerstenberger, and Glendon G. Cox. "Improving Antibiotic Stewardship." Journal of Ambulatory Care Management 33, no. 2 (April 2010): 131–40. http://dx.doi.org/10.1097/jac.0b013e3181d91680.
Full text
45
Adeapena, Wisdom, Samuel Afari-Asiedu, Robinah Najjemba, Johan van Griensven, Alexandre Delamou, Kwame Ohene Buabeng, and Kwaku Poku Asante. "Antibiotic Use in a Municipal Veterinary Clinic in Ghana." Tropical Medicine and Infectious Disease 6, no. 3 (July 20, 2021): 138. http://dx.doi.org/10.3390/tropicalmed6030138.
Full textAbstract:
Antimicrobial resistance (AMR) is a threat to public health, impacting both human and animal health as well as the economy. This study sought to describe antibiotic prescription practices and use in the Kintampo North Municipal Veterinary Clinic in Ghana using routinely collected data. Of the 513 animals presented for care between 2013 and 2019, the most common animals were dogs (71.9%), goats (13.1%), and sheep (11.1%). Antibiotics were prescribed for 273/513 (53.2%) of the animals. Tetracycline was the most commonly prescribed class of antibiotics, (99.6%). Of the 273 animals that received antibiotics, the route of administration was not documented in 68.9%, and antibiotic doses were missing in the treatment records in 37.7%. Details of the antibiotic regimen and the medical conditions diagnosed were often not recorded (52.8%). This study recommends appropriate documentation to enable continuous audit of antibiotic prescription practice and to improve quality of use. There is also the need for a national survey on antibiotic prescribtion and use in animal health to support policy implementation and decision making in One-Health in Ghana.
46
Khan, Mishal S., Anna Durrance-Bagale, Ana Mateus, Zia Sultana, Rumina Hasan, and Johanna Hanefeld. "What are the barriers to implementing national antimicrobial resistance action plans? A novel mixed-methods policy analysis in Pakistan." Health Policy and Planning 35, no. 8 (August 3, 2020): 973–82. http://dx.doi.org/10.1093/heapol/czaa065.
Full textAbstract:
Abstract Despite political commitment to address antimicrobial resistance (AMR), countries are facing challenges to implementing policies to reduce inappropriate use of antibiotics. Critical factors to the success of policy implementation in low- and middle-income countries (LMIC), such as capacity for enforcement, contestation by influential stakeholders and financial interests, have been insufficiently considered. Using Pakistan as a case study representing a populous country with extremely high antibiotic usage, we identified 195 actors who affect policies on antibiotic use in humans and animals through a snowballing process and interviewed 48 of these who were nominated as most influential. We used a novel card game-based methodology to investigate policy actors’ support for implementation of different regulatory approaches addressing actions of frontline healthcare providers and antibiotic producers across the One Health spectrum. We found that there was only widespread support for implementing hard regulations (prohibiting certain actions) against antibiotic suppliers with little power—such as unqualified/informal healthcare providers and animal feed producers—but not to target more powerful groups such as doctors, farmers and pharmaceutical companies. Policy actors had limited knowledge to develop implementation plans to address inappropriate use of antibiotics in animals, even though this was recognized as a critical driver of AMR. Our results indicate that local political and economic dynamics may be more salient to policy actors influencing implementation of AMR national action plans than solutions presented in global guidelines that rely on implementation of hard regulations. This highlights a disconnect between AMR action plans and the local contexts where implementation takes place. Thus if the global strategies to tackle AMR are to become implementable policies in LMIC, they will need greater appreciation of the power dynamics and systemic constraints that relate to many of the strategies proposed.
47
Kolosova, N. G., and A. B. Kolosova. "Topical issues of inhaled antibacterial therapy of respiratory diseases in children." Medical Council, no. 17 (October 22, 2018): 128–31. http://dx.doi.org/10.21518/2079-701x-2018-17-128-131.
Full textAbstract:
Despite the fact that acute respiratory infections have viral etiology, the frequency of antibiotic prescriptions accounts for more than 70% in outpatient practice. However, the preventive administration of systemic antibiotics does not reduce the duration of the disease and the incidence of bacterial complications. In addition, the irrational use of antibiotic therapy can lead to the development of antibiotic resistance of infectious disease pathogens. The global problem of antibiotic resistance is seen as a serious threat to public health, and therefore the systemic antibiotic restriction policy is crucial, which helps to reduce the formation of antibiotic-resistant strains of infectious agents. The possibility of using local antibacterial drugs enables optimization of antibiotic therapy and reduces the risk of the development of antibiotic resistance. The article discusses the issues of use of thiamphenicol glycinate acetylcysteinate in various diseases in children.
48
Kaur, Amritpal, Rajan Bhagat, Navjot Kaur, Nusrat Shafiq, Vikas Gautam, Samir Malhotra, Vikas Suri, and Ashish Bhalla. "A study of antibiotic prescription pattern in patients referred to tertiary care center in Northern India." Therapeutic Advances in Infectious Disease 5, no. 4 (May 10, 2018): 63–68. http://dx.doi.org/10.1177/2049936118773216.
Full textAbstract:
Background: Tremendous infectious disease burden and rapid emergence of multidrug resistant pathogens continues to burden our healthcare system. Antibiotic stewardship program often implements antibiotic policies that help in preventing unnecessary use of antibiotics and in optimizing management. To develop such a policy for management of infections in the emergency unit, it is important to analyze the information regarding antibiotic prescription patterns in patients presenting to the emergency room referred from various healthcare settings. This study was conducted with the aforementioned background. Methods: We conducted a prospective observational study in triage area of emergency unit of a tertiary care hospital. All the referred patients were screened for antibiotic prescription. Data extraction form was used to capture information on patient demographics, diagnosis and antibiotics prescribed. Antibiotic prescription details with regard to dosage, duration and frequency of antimicrobial administration were also recorded. Data were summarized using descriptive statistics as appropriate. Results: Out of 517 screened patients, 300 were prescribed antimicrobials. Out of 29 antibiotics prescribed, 12 were prescribed in more than 90% of patients. Broad spectrum antibiotics accounted for 67.3% of prescriptions. In 129 out of 300 patients, no evidence of infectious etiology was found. Conclusion: Our study highlights some common but serious lapses in antibiotic prescription patterns in patients referred from various healthcare settings. This emphasizes the need to provide training for rational use of antibiotics across healthcare settings.
49
Simoens, Steven. "Factors Affecting the Cost Effectiveness of Antibiotics." Chemotherapy Research and Practice 2011 (February 6, 2011): 1–6. http://dx.doi.org/10.1155/2011/249867.
Full textAbstract:
In an era of spiraling health care costs and limited resources, policy makers and health care payers are concerned about the cost effectiveness of antibiotics. The aim of this study is to draw on published economic evaluations with a view to identify and illustrate the factors affecting the cost effectiveness of antibiotic treatment of bacterial infections. The findings indicate that the cost effectiveness of antibiotics is influenced by factors relating to the characteristics and the use of antibiotics (i.e., diagnosis, comparative costs and comparative effectiveness, resistance, patient compliance with treatment, and treatment failure) and by external factors (i.e., funding source, clinical pharmacy interventions, and guideline implementation interventions). Physicians need to take into account these factors when prescribing an antibiotic and assess whether a specific antibiotic treatment adds sufficient value to justify its costs.
50
Lim, Jane Mingjie, Shweta Rajkumar Singh, Minh Cam Duong, Helena Legido-Quigley, Li Yang Hsu, and Clarence C. Tam. "Impact of national interventions to promote responsible antibiotic use: a systematic review." Journal of Antimicrobial Chemotherapy 75, no. 1 (September 6, 2019): 14–29. http://dx.doi.org/10.1093/jac/dkz348.
Full textAbstract:
Abstract Background Global recognition of antimicrobial resistance (AMR) as an urgent public health problem has galvanized national and international efforts. Chief among these are interventions to curb the overuse and misuse of antibiotics. However, the impact of these initiatives is not fully understood, making it difficult to assess the expected effectiveness and sustainability of further policy interventions. We conducted a systematic review to summarize existing evidence for the impact of nationally enforced interventions to reduce inappropriate antibiotic use in humans. Methods We searched seven databases and examined reference lists of retrieved articles. To be included, articles had to evaluate the impact of national responsible use initiatives. We excluded studies that only described policy implementations. Results We identified 34 articles detailing interventions in 21 high- and upper-middle-income countries. Interventions addressing inappropriate antibiotic access included antibiotic committees, clinical guidelines and prescribing restrictions. There was consistent evidence that these were effective at reducing antibiotic consumption and prescription. Interventions targeting inappropriate antibiotic demand consisted of education campaigns for healthcare professionals and the general public. Evidence for this was mixed, with several studies showing no impact on overall antibiotic consumption. Conclusions National-level interventions to reduce inappropriate access to antibiotics can be effective. However, evidence is limited to high- and upper-middle-income countries, and more evidence is needed on the long-term sustained impact of interventions. There should also be a simultaneous push towards standardized outcome measures to enable comparisons of interventions in different settings.