Academic literature on the topic 'Antimicrobial stewardship; Antimicrobials; hospital pharmacists'

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Journal articles on the topic "Antimicrobial stewardship; Antimicrobials; hospital pharmacists"

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Hamada, Yukihiro, Fumiya Ebihara, and Ken Kikuchi. "A Strategy for Hospital Pharmacists to Control Antimicrobial Resistance (AMR) in Japan." Antibiotics 10, no. 11 (October 21, 2021): 1284. http://dx.doi.org/10.3390/antibiotics10111284.

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In Japan, there is concern regarding the relation between the inappropriate use of antibiotics and antibiotic resistance (AMR). Increased bacterial resistance is due in part to the inappropriate use of antimicrobial agents. The support of the pharmacist becomes important, and there is growing interest in antimicrobial stewardship to promote the appropriate and safe use of antimicrobials needed for the optimal selection of drugs, doses, durations of therapy, therapeutic drug monitoring (TDM), and implementations of cost containment strategies in Japan. Pharmacists should strive to disseminate the concept of “choosing wisely” in relation to all medicines, implement further interventions, and put them into practice. In this article, we present data for antimicrobial stewardship and Japan’s AMR action plan, focusing on how pharmacists should be involved in enabling physicians to choose antimicrobials wisely.
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Shealy, Stephanie, Joseph Kohn, Emily Yongue, Casey Troficanto, Brandon Bookstaver, Julie A. Justo, Michelle Crenshaw, Hana Winders, Sangita Dash, and Majdi Al-Hasan. "Motivational Application of Standardized Antimicrobial Administration Ratios Within a Healthcare System." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s321. http://dx.doi.org/10.1017/ice.2020.918.

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Background: Hospitals in the United States have been encouraged to report antimicrobial use (AU) to the CDC NHSN since 2011. Through the NHSN Antimicrobial Use Option module, health systems may compare standardized antimicrobial administration ratios (SAARs) across specific facilities, patient care locations, time periods, and antimicrobial categories. To date, participation in the NHSN Antimicrobial Use Option remains voluntary and the value of reporting antimicrobial use and receiving monthly SAARs to multihospital healthcare systems has not been clearly demonstrated. In this cohort study. we examined potential applications of SAAR within a healthcare system comprising multiple local hospitals. Methods: Three hospitals within Prisma Health-Midlands (hospitals A, B, and C) became participants in the NHSN Antimicrobial Use Option in July 2017. SAAR reports were presented initially in October 2017 and regularly (every 3–4 months) thereafter during interprofessional antimicrobial stewardship system-wide meetings until end of study in June 2019. Through interfacility comparisons and by analyzing SAAR categories in specific patient-care locations, primary healthcare providers and pharmacists were advised to incorporate results into focused antimicrobial stewardship initiatives within their facility. Specific alerts were designed to promote early de-escalation of antipseudomonal β-lactams and vancomycin. The Student t test was used to compare mean SAAR in the preintervention period (July through October 2017) to the postintervention period (November 2017 through June 2019) for all antimicrobials and specific categories and locations within each hospital. Results: During the preintervention period, mean SAAR for all antimicrobials in hospitals A, B, and C were 0.69, 1.09, and 0.60, respectively. Notably, mean SAARs at hospitals A, B, and C in intensive care units (ICU) during the preintervention period were 0.67, 1.36, and 0.83 for broad-spectrum agents used for hospital-onset infections and 0.59, 1.27, and 0.68, respectively, for agents used for resistant gram-positive infections. After antimicrobial stewardship interventions, mean SAARs for all antimicrobials in hospital B decreased from 1.09 to 0.83 in the postintervention period (P < .001). Mean SAARs decreased from 1.36 to 0.81 for broad-spectrum agents used for hospital-onset infections and from 1.27 to 0.72 for agents used for resistant gram-positive infections in ICU at hospital B (P = .03 and P = .01, respectively). No significant changes were noted in hospitals A and C. Conclusions: Reporting AU to the CDC NHSN and the assessment of SAARs across hospitals in a healthcare system had motivational effects on antimicrobial stewardship practices. Enhancement and customization of antimicrobial stewardship interventions was associated with significant and sustained reductions in SAARs for all antimicrobials and specific antimicrobial categories at those locations.Funding: NoneDisclosures: None
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Lai, Wan Mae, Farida Hanim Islahudin, Rahela Ambaras Khan, and Wei Wen Chong. "Pharmacists’ Perspectives of Their Roles in Antimicrobial Stewardship: A Qualitative Study among Hospital Pharmacists in Malaysia." Antibiotics 11, no. 2 (February 9, 2022): 219. http://dx.doi.org/10.3390/antibiotics11020219.

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Antimicrobial resistance has negatively impacted patient outcomes and increased healthcare costs. Antimicrobial stewardship (AMS) includes all activities and policies to promote the judicious use of antimicrobials. Pharmacists are key players in AMS models worldwide. However, there is a research gap in the role of pharmacists as antimicrobial stewards in Malaysia. This study aimed to explore hospital pharmacists’ perspectives on their roles in, and barriers and facilitators to the implementation of AMS strategies. Individual, semi-structured interviews were conducted with 16 hospital pharmacists involved in AMS activities from 13 public hospitals in Kuala Lumpur and Selangor. Audio-taped interviews were transcribed verbatim and imported into NVivo software version 10.0 (QSR). A thematic analysis method was used to identify themes from the qualitative data until theme saturation was reached. Respondents perceived pharmacists as having important roles in the implementation of AMS strategies, in view of the multiple tasks they were entrusted with. They described their functions as antimicrobial advisors, antimicrobial guardians and liaison personnel. The lack of resources in terms of training, manpower and facilities, as well as attitudinal challenges, were some barriers identified by the respondents. Administrative support, commitment and perseverance were found to be facilitators to the role of pharmacists in AMS. In conclusion, pharmacists in public hospitals play important roles in AMS teams. This study has provided insights into the support that AMS pharmacists in public hospitals require to overcome the barriers they face and to enhance their roles in the implementation of AMS strategies.
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Bulger, Peter, Alyssa Y. Castillo, John B. Lynch, John B. Lynch, Paul Pottinger, Jeannie D. Chan, Rupali Jain, Mandana Naderi, Zahra Kassamali, and Chloe Bryson-Cahn. "133. A Review of Antimicrobial Formularies at Rural Hospitals: Stewardship Opportunities Abound." Open Forum Infectious Diseases 8, Supplement_1 (November 1, 2021): S179. http://dx.doi.org/10.1093/ofid/ofab466.335.

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Abstract Background Management of a hospital’s antimicrobial formulary is an important aspect of antimicrobial stewardship and cost containment strategies. Ensuring that essential medications for clinical care are available and excluding therapeutic duplicates and unnecessary antimicrobials is time and resource intensive. Comparisons of antimicrobial formularies across multiple rural hospitals have not been evaluated in the literature. We hypothesized that a comprehensive formulary evaluation would reveal important opportunities for antimicrobial stewardship efforts and could help smaller hospitals optimize available medications. Methods The University of Washington Tele-Antimicrobial Stewardship Program (UW-TASP) is comprised of 68 hospitals of varying sizes, most of which are rural and critical access, in Washington, Oregon, Arizona, Idaho, and Utah. We surveyed UW-TASP participating hospitals and other networked rural hospitals in multiple Western states using REDCap, a HIPAA-compliant, electronic data management program. Respondents reported which antimicrobials are on their hospital formulary as well as basic information about hospital size and inpatient units. Data were reviewed by a panel of infectious diseases trained physicians and pharmacists at UW-TASP. Results Surveys from 49 hospitals were received; two were excluded from the data analysis (Table 1) – one submission was incomplete, and one was a large inpatient psychiatric hospital. Select antimicrobials and proportion of hospitals carrying these agents is shown in Table 2. Several antimicrobials are on the formulary at all hospitals, regardless of size. In some critical access hospitals (&lt; 25 beds), empiric first-line bacterial meningitis and viral encephalitis coverage (Table 3) was lacking. Six hospitals (12.7%) lacked ampicillin for Listeria coverage and only one had a suitable alternative agent (meropenem). Seven hospitals (14.9%) lacked intravenous acyclovir, although three had oral valacyclovir. Formulary inclusion of agents for multi-drug resistant organisms was rare. Conclusion In critical access hospitals in the Western USA, lack of essential empiric antimicrobials may be more of a concern than inclusion of agents with unnecessarily broad spectra. Disclosures Chloe Bryson-Cahn, MD, Alaska Airlines (Other Financial or Material Support, Co-Medical Director, position is through the University of Washington)
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Rubin, Ellen C., Alison L. Blackman, Eleanor K. Broadbent, David Wang, Ilda Plasari, Pawlose Ketema, Karrine Brade, and Tamar F. Barlam. "103. Expansion of an Antimicrobial Stewardship Program Through Implementation of a Discharge Verification Queue." Open Forum Infectious Diseases 8, Supplement_1 (November 1, 2021): S166. http://dx.doi.org/10.1093/ofid/ofab466.305.

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Abstract Background Antimicrobial stewardship programs (ASPs) have traditionally focused interventions on inpatient care to improve antibiotic prescribing. Support of effective interventions for ASPs targeting antibiotic prescriptions at hospital discharge is emerging. Our objective was to expand stewardship services into the outpatient setting through implementation of a process by the antimicrobial stewardship team (AST) to verify antimicrobials prescribed at discharge. Methods This quality improvement initiative incorporated a discharge order verification queue managed by AST pharmacists to review electronically prescribed antimicrobials Monday through Friday, from 8:00 am to 4:00 pm. The queue was piloted Sep 2020 and expanded hospital-wide Feb 2021. Patients &lt; 18 years old and those with observation or emergency department status were excluded. The AST pharmacist reviewed discharge prescriptions for appropriateness, intervened directly with prescribers, and either rejected or verified prescriptions prior to transmission to outpatient pharmacies. Complicated cases were reviewed with the AST physician to evaluate intervention appropriateness. Interventions were categorized as either dose adjustment, duration, escalation or de-escalation, discontinuation, or safety monitoring. Results A total of 602 prescriptions were reviewed between Sep 2020 and Apr 2021. An AST pharmacist intervened on 28% (171/602) of prescriptions. The most common intervention types were duration (41%, 70/171), discontinuation (18%, 31/171), and dose adjustment (17%, 30/171). The most common indications in which the duration was shortened was community acquired pneumonia (26%, 18/70), skin and soft tissue infection (21%, 15/70), and urinary tract infection (17%, 12/70). The most common antibiotics recommended for discontinuation were cephalexin (32%, 10/31) and trimethoprim-sulfamethoxazole (10%, 3/31). The overall intervention acceptance rate was 78%. Conclusion An AST pharmacist review of antimicrobial prescriptions at discharge improved appropriate prescribing. The discharge queue serves as an effective stewardship strategy for inpatient ASPs to expand into the outpatient setting. Disclosures All Authors: No reported disclosures
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MacDougall, Conan, and Ron E. Polk. "Antimicrobial Stewardship Programs in Health Care Systems." Clinical Microbiology Reviews 18, no. 4 (October 2005): 638–56. http://dx.doi.org/10.1128/cmr.18.4.638-656.2005.

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SUMMARY Antimicrobial stewardship programs in hospitals seek to optimize antimicrobial prescribing in order to improve individual patient care as well as reduce hospital costs and slow the spread of antimicrobial resistance. With antimicrobial resistance on the rise worldwide and few new agents in development, antimicrobial stewardship programs are more important than ever in ensuring the continued efficacy of available antimicrobials. The design of antimicrobial management programs should be based on the best current understanding of the relationship between antimicrobial use and resistance. Such programs should be administered by multidisciplinary teams composed of infectious diseases physicians, clinical pharmacists, clinical microbiologists, and infection control practitioners and should be actively supported by hospital administrators. Strategies for changing antimicrobial prescribing behavior include education of prescribers regarding proper antimicrobial usage, creation of an antimicrobial formulary with restricted prescribing of targeted agents, and review of antimicrobial prescribing with feedback to prescribers. Clinical computer systems can aid in the implementation of each of these strategies, especially as expert systems able to provide patient-specific data and suggestions at the point of care. Antibiotic rotation strategies control the prescribing process by scheduled changes of antimicrobial classes used for empirical therapy. When instituting an antimicrobial stewardship program, a hospital should tailor its choice of strategies to its needs and available resources.
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Bishop, Bryan M. "Antimicrobial Stewardship in the Emergency Department." Journal of Pharmacy Practice 29, no. 6 (July 8, 2016): 556–63. http://dx.doi.org/10.1177/0897190015585762.

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Antimicrobial resistance is a national public health concern. Misuse of antimicrobials for conditions such as upper respiratory infection, urinary tract infections, and cellulitis has led to increased resistance to antimicrobials commonly utilized to treat those infections, such as sulfamethoxazole/trimethoprim and flouroquinolones. The emergency department (ED) is a site where these infections are commonly encountered both in ambulatory patients and in patients requiring admission to a hospital. The ED is uniquely positioned to affect the antimicrobial use and resistance patterns in both ambulatory settings and inpatient settings. However, implementing antimicrobial stewardship programs in the ED is fraught with challenges including diagnostic uncertainty, distractions secondary to patient or clinician turnover, and concerns with patient satisfaction to name just a few. However, this review article highlights successful interventions that have stemmed inappropriate antimicrobial use in the ED setting and warrant further study. This article also proposes other, yet to be validated proposals. Finally, this article serves as a call to action for pharmacists working in antimicrobial stewardship programs and in emergency medicine settings. There needs to be further research on the implementation of these and other interventions to reduce inappropriate antimicrobial use to prevent patient harm and curb the development of antimicrobial resistance.
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Tauman, Allison V., Ari Robicsek, Joyce Roberson, and John M. Boyce. "Health Care-Associated Infection Prevention and Control: Pharmacists' Role in Meeting National Patient Safety Goal 7." Hospital Pharmacy 44, no. 5 (May 2009): 401–11. http://dx.doi.org/10.1310/hpj4405-401.

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Health care-associated infections and antimicrobial resistance are continually increasing, with fewer drugs available for effective treatment. Potential benefits of infection control and antimicrobial stewardship programs include improvements in antibiotic use and conversion from intravenous (IV) to oral antibiotics and reductions in resistance and infection rates and length of hospital stay. NorthShore University HealthSystem in Evanston, Illinois, was the first large hospital system in North America that adopted universal inpatient surveillance for methicillin-resistant Staphylococcus aureus (MRSA). Results showed that nasal MRSA was a powerful predictor of MRSA disease and antibiotic resistance in other organisms. MRSA infections occurring up to 30 days posthospitalization decreased by approximately 70%. At the Hospital of Saint Raphael, a community teaching hospital in New Haven, Connecticut, an antimicrobial stewardship pilot program focused on automatic conversation from IV to oral antimicrobials and appropriate antimicrobial use. The percentage of patients receiving oral fluconazole increased from 63% to 77%; the percentage of those receiving oral linezolid increased from 54% to 71%. Total antibiotic use decreased by 6%. Based on the 60-day trial, potential cost savings were estimated as $874,000 annually, less the cost of a pharmacist's salary and benefits. Infection control and antimicrobial stewardship programs offer pharmacists new opportunities for helping improve patient safety and quality of care. Pharmacy-medical staff partnership, combined with support from microbiology, infection control, information technology, and hospital administration, is key to a successful program.
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Beaulieu, Ronald, Milner Staub, Thomas Talbot, Matthew Greene, Gowri Satyanarayana, Patty Wright, Whitney Nesbitt, Amy Myers, and George Nelson. "Implementation of a Resource-Efficient Indirect Handshake Stewardship Model at an Academic Medical Center." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s272. http://dx.doi.org/10.1017/ice.2020.841.

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Background: Handshake antibiotic stewardship is an effective but resource-intensive strategy for reducing antimicrobial utilization. At larger hospitals, widespread implementation of direct handshake rounds may be constrained by available resources. To optimize resource utilization and mirror handshake antimicrobial stewardship, we designed an indirect feedback model utilizing existing team pharmacy infrastructure. Methods: The antibiotic stewardship program (ASP) utilized the plan-do-study-act (PDSA) improvement methodology to implement an antibiotic stewardship intervention centered on antimicrobial utilization feedback and patient-level recommendations to optimize antimicrobial utilization. The intervention included team-based antimicrobial utilization dashboard development, biweekly antimicrobial utilization data feedback of total antimicrobial utilization and select drug-specific antimicrobial utilization, and twice weekly individualized review by ASP staff of all patients admitted to the 5 hospitalist teams on antimicrobials with recommendations (discontinuation, optimization, etc) relayed electronically to team-based pharmacists. Pharmacists were to communicate recommendations as an indirect surrogate for handshake antibiotic stewardship. As reviewer duties expanded to include a rotation of multiple reviewers, a standard operating procedure was created. A closed-loop communication model was developed to ensure pharmacist feedback receipt and to allow intervention acceptance tracking. During implementation optimization, a team pharmacist-champion was identified and addressed communication lapses. An outcome measure of days of therapy per 1,000 patient days present (DOT/1,000 PD) and balance measure of in-hospital mortality were chosen. Implementation began April 5, 2019, and data were collected through October 31, 2019. Preintervention comparison data spanned December 2017 to April 2019. Results: Overall, 1,119 cases were reviewed by the ASP, of whom 255 (22.8%) received feedback. In total, 236 of 362 recommendations (65.2%) were implemented (Fig. 1). Antimicrobial discontinuation was the most frequent (147 of 362, 40.6%), and most consistently implemented (111 of 147, 75.3%), recommendation. The DOT/1,000 PD before the intervention compared to the same metric after intervention remained unchanged (741.1 vs 725.4; P = .60) as did crude in-hospital mortality (1.8% vs 1.7%; P = .76). Several contributing factors were identified: communication lapses (eg, emails not received by 2 pharmacists), intervention timing (mismatch of recommendation and rounding window), and individual culture (some pharmacists with reduced buy-in selectively relayed recommendations). Conclusion: Although resource efficient, this model of indirect handshake did not significantly impact total antimicrobial utilization. Through serial PDSA cycles, implementation barriers were identified that can be addressed to improve the feedback process. Communication, expectation management, and interpersonal relationship development emerged as critical issues contributing to poor recommendation adherence. Future PDSA cycles will focus on streamlining processes to improve communication among stakeholders.Funding: NoneDisclosures: None
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Yeoh, Kim, Catherine George, and Kirsty Buising. "Improving Patient Knowledge and Understanding of Their Antimicrobial Therapy: An Antimicrobial Stewardship Intervention." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s289. http://dx.doi.org/10.1017/ice.2020.863.

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Background: The Australian Antimicrobial Stewardship Clinical Care Standard states that patients should receive information about their antimicrobial therapy, including their indication, how and when to take them, their duration, and potential side effects. The level of information provided to hospital inpatients about their prescribed antimicrobial therapy is not well understood. Our objective was to evaluate whether adult inpatients received specific information about their antimicrobials in accordance with antimicrobial stewardship clinical care standards, to identify any gaps that needed to be addressed. Methods: Patients receiving 1 or more antimicrobials for >72 hours who were admitted on an acute or subacute ward were recruited. A survey tool was designed and conducted to establish the current status of information provision to patients. The information gathered was used to develop and deliver activities and resources to facilitate better communication about antimicrobial therapy. Results: In total, 54 patients were surveyed. Most patients (83%) were informed that they were taking antimicrobials, and of these, 96% said they knew the indication, 18% were informed of potential side effects, and 36% knew the duration. Only 22% were informed of the review plan, and only 27% knew whether antimicrobials would be continued on discharge. Written information was given to 11% of patients. Over half of these patients (56%) either wanted more information or had concerns about their antimicrobials. Patients reported difficulty in obtaining information with some receiving information via “word-of-mouth from other patients.” Moreover, 58% of patients received antimicrobial information from doctors, 13% from nurses, and 12% from pharmacists. However, most patients stated that they expected information from all 3 professional groups. In response to these survey findings, a focus group of antimicrobial stewardship experts was convened to discuss methods of improving delivery of information to patients regarding their antimicrobial therapy. We undertook nursing education to empower nurses to discuss information about antimicrobials with their patients, and we developed consumer information sheets. Conclusions: More needs to be done to inform patients about the antimicrobials used in their treatments to empower them to participate in their treatment. This factor will be the focus of future antimicrobial stewardship interventions.Funding: NoneDisclosures: None
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Books on the topic "Antimicrobial stewardship; Antimicrobials; hospital pharmacists"

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Patel, Sanjay, and Julia Bielicki. Antimicrobial stewardship in paediatrics. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198758792.003.0014.

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The general principles of antimicrobial stewardship can be applied to the paediatric population, but children have unique challenges that must be addressed when considering a paediatric antimicrobial stewardship programme, including the aetiology of paediatric infections, the non-specific nature of these infections, the difficulty in obtaining microbiology specimens, and paucity of data on antimicrobial dose and duration. Different antimicrobial stewardship strategies tailored to neonates and children are required in primary care and secondary/tertiary care settings. While children with complex infections are generally managed in hospital settings where prescribing can be closely monitored by antimicrobial stewardship teams, the majority of paediatric antimicrobial prescribing occurs in primary care. Promoting and monitoring the judicious use of antimicrobials in this setting is especially challenging.
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Wiffen, Philip, Marc Mitchell, Melanie Snelling, and Nicola Stoner. Therapy-related issues: infections. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198735823.003.0019.

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This chapter outlines information relevant to pharmacists and other healthcare professionals related to microbiology and infectious diseases. Basic microbiology is covered including modes of action of antibacterials and the selection and use of antimicrobials. Key aspects of antimicrobial stewardship (including resistance, antimicrobial prophylaxis, and writing guidelines) and of infection control are covered. The chapter includes an extensive review of the treatment of human immunodeficiency virus and a discussion of key principles in the treatment of tuberculosis.
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Book chapters on the topic "Antimicrobial stewardship; Antimicrobials; hospital pharmacists"

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Meddings, Jennifer, Vineet Chopra, and Sanjay Saint. "Taking on Clostridioides difficile." In Preventing Hospital Infections, 141–57. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780197509159.003.0010.

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The adaptive approach used in the previous chapters to prevent catheter-associated urinary tract infection (CAUTI) is applied to an initiative to prevent Clostridioides difficile (formerly Clostridium difficile) infection. These two initiatives differ regarding their scope, the members of their teams, and the elements of their bundles. For preventing C. difficile, for example, the most important bundle item is antimicrobial stewardship since the use of broad-spectrum antibiotics vastly increases a person’s risk of becoming infected. Infectious diseases physicians or clinical pharmacists are to examine the circumstances of antimicrobial prescriptions they have filled to see whether they meet infection prevention standards; if not, the prescribing physician will receive prompt feedback. Differences aside, the basic elements of the CAUTI framework apply, from the C-suite’s decision to go ahead with the initiative to the tactics used to sell the C. difficile bundle to the hospital staff.
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Ameen, Sarfaraz, and Caoimhe NicFhogartaigh. "Antimicrobial Stewardship." In Tutorial Topics in Infection for the Combined Infection Training Programme. Oxford University Press, 2019. http://dx.doi.org/10.1093/oso/9780198801740.003.0028.

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Antimicrobial stewardship (AMS) is a healthcare- system- wide approach to promoting and monitoring the judicious use of antimicrobials (including antibiotics) to preserve their future effectiveness and optimize outcomes for patients. Put simply, it is using the right antibiotic, at the right dose, via the right route, at the right time, for the right duration (Centres for Disease Control, 2010). Antimicrobial resistance (AMR) is a serious and growing global public health concern. Antibiotics are a unique class of drug as their use in individual patients may have an impact on others through the spread of resistant organisms. Antibiotics are essential for saving lives in conditions such as sepsis, and without effective antibiotics even minor operations could be life-threatening due to the risk of resistant infections. Across Europe approximately 25,000 people die each year as a result of hospital infections caused by resistant bacteria, and others have more prolonged and complicated illness. By 2050, AMR is predicted to be one of the major causes of death worldwide. Protecting the use of currently available antibiotics is crucial as discovery of new antimicrobials has stalled. Studies consistently demonstrate that 30–50% of antimicrobial prescriptions are unnecessary or inappropriate. Figure 18.1 shows some of the reasons behind this. As well as driving increasing resistance, unnecessary prescribing leads to unwanted adverse effects, including avoidable drug reactions and interactions, Clostridium difficile-associated diarrhoea, and healthcare-associated infections with resistant micro-organisms, all of which are associated with adverse clinical outcomes, including increased length of hospital stay and mortality, with increased cost to healthcare systems. Prudent use of antibiotics improves patient care and clinical outcomes, reduces the spread of antimicrobial resistance, and saves money. There are a number of global and national guidelines outlining what a robust AMS programme should consist of (see Further reading and useful resources), including: ● Infectious Diseases Society of America (IDSA): Guidelines for Developing an Institutional Programme to Enhance Antimicrobial Stewardship. ● National Institute for Health and Care Excellence (NICE): Antimicrobial Stewardship: Systems and Processes for Effective Antimicrobial Medicine Use [NG15]. ● Department of Health (DoH): Start Smart Then Focus, updated 2015. ● DoH: UK 5- Year Antimicrobial Resistance Strategy 2013 to 2018.
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Anekoson Joshua, Istifanus, Mathew Bobai, and Clement Sokfa Woje. "Managing Antimicrobial Resistance beyond the Hospital Antimicrobial Stewardship: The Role of One Health." In The Global Antimicrobial Resistance Epidemic – Innovative Approaches and Cutting-Edge Solutions [Working Title]. IntechOpen, 2022. http://dx.doi.org/10.5772/intechopen.104170.

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Infections caused by micro-organisms affect the health of people and animals, causing morbidity and mortality, with Asia and Africa as the epicenters. Some of the infectious diseases are emerging and re-emerging in nature. Examples include viral hepatitis, Lassa fever, Ebola, yellow fever, tuberculosis, covid-19, measles, and malaria, among others. Antimicrobials have been playing an important role in the treatment of infections by these microbes. However, there has been a development of resistance to these antimicrobials as a result of many drivers. This write-up used secondary data to explore the management of antimicrobial resistance (AMR) beyond the hospital antimicrobial resistance steward using the one health concept. The findings showed AMR to be a transboundary, multifaceted ecosystem problem affecting both the developed and developing countries. It is also one of the top ten global public health threats facing mankind. Globally, AMR will cost over US$100 trillion in output loss by 2050, about 700,000 deaths a year, and 4,150,000 deaths in Africa by 2050. About 2.4 million people could die in high-income countries between 2015 and 2050 without a sustained effort to contain AMR. The drivers of AMR are beyond the hospital and hospital AMR stewardship. Therefore, the need for one health concept to manage it.
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Conference papers on the topic "Antimicrobial stewardship; Antimicrobials; hospital pharmacists"

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Moreno Diaz, R., MA Amor Garcia, and A. González Fuentes. "2SPD-031 The economic impact of antimicrobial shortages in antimicrobial stewardship programmes." In 26th EAHP Congress, Hospital pharmacists – changing roles in a changing world, 23–25 March 2022. British Medical Journal Publishing Group, 2022. http://dx.doi.org/10.1136/ejhpharm-2022-eahp.24.

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Fructuoso, L., P. Torrano Belmonte, J. Ibañez Caturla, P. Pacheco Lopez, MA Carvajal-Sanchez, S. Clavijos Bautista, C. Fernández Zamora, M. Hernandez Sanchez, and JA Gutierrez Sanchez. "4CPS-067 Pharmacist interventions in sequential antimicrobial therapy inside an antimicrobial stewardship programme (ASP)." In 26th EAHP Congress, Hospital pharmacists – changing roles in a changing world, 23–25 March 2022. British Medical Journal Publishing Group, 2022. http://dx.doi.org/10.1136/ejhpharm-2022-eahp.105.

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Aguado Paredes, A., M. Romero Gonzalez, J. Cordero Ramos, and M. Beltran Garcia. "4CPS-140 Antimicrobial stewardship programme in oncology patients through a multidisciplinary team." In 26th EAHP Congress, Hospital pharmacists – changing roles in a changing world, 23–25 March 2022. British Medical Journal Publishing Group, 2022. http://dx.doi.org/10.1136/ejhpharm-2022-eahp.398.

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Sopena, L., B. Bonaga, A. Gonzalo, B. Obon, R. Gracia, R. Fresquet, A. Merchan, I. Varela, A. Mª Angeles, and M. Arenere. "4CPS-156 Antimicrobial stewardship programme in a general surgery service: role of the pharmacist." In 26th EAHP Congress, Hospital pharmacists – changing roles in a changing world, 23–25 March 2022. British Medical Journal Publishing Group, 2022. http://dx.doi.org/10.1136/ejhpharm-2022-eahp.170.

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Jaume Gaya, M., R. Pérez Senoff, MS Sanz Parras, JM Saurina Gomila, A. Rey Ferrin, Á. García Álvarez, J. Martinez Sotelo, et al. "4CPS-047 Assessing the impact of antimicrobial stewardship programmes in hospitals: the role of pharmacists." In 25th EAHP Congress, 25th–27th March 2020, Gothenburg, Sweden. British Medical Journal Publishing Group, 2020. http://dx.doi.org/10.1136/ejhpharm-2020-eahpconf.148.

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