The International Collaborative Conference in Clinical Microbiology & Infectious Diseases
|
|
- Brandon Goodman
- 6 years ago
- Views:
Transcription
1 The International Collaborative Conference in Clinical Microbiology & Infectious Diseases PLUS: Antimicrobial stewardship in hospitals: Improving outcomes through better education and implementation of effective interventions February 2015 Gulf Hotel, Kingdom of Bahrain How to Optimize Antibiotic Stewardship in ICU Tariq Al-Musawi, MD, MS, ABIM Consultant Infectious Disease & Critical Care Medicine Deputy Chief, Critical Care Services Co-Chair, Infection Control Committee Saad Specialist Hospital, Al-Khobar, Saudi Arabia
2 ESKAPE Pathogens E S K A P E Enterococcus faecium (VRE) Staphylococcus aureus (MRSA) Klebsiella & Escherichia coli (ESBL+) Acinetobacter baumannii Pseudomonas aeruginosa Enterobacter species
3 Alvarez 1996 Rello 1997 Luna 1997 Kollef 1998 Kollef 1999 Ibrahim 2000 Mortality (%) Mortality Associated With Initial Inadequate Antibiotic Therapy among ICU Patients with Serious Infections Alvarez. Int Care Med. 1996;22:387. Ibrahim. Chest. 2000;118:146. Kollef. Chest. 1999; 115:462. Kollef MH. Chest. 1998;113:412. Luna. Chest. 1997;111:676. Rello. AJRCCM. 1997;156:196. Appropriate Inappropriate
4 Interventions Vs Outcomes
5 Policies & Interventions Policies that support optimal antibiotic use: Document dose, duration, and indication Develop and implement facility specific treatment recommendations
6 Policies & Interventions Interventions: Broad interventions: antibiotic Time outs, prior authorization, etc. Pharmacy-driven interventions: automatic change from IV to oral, dose adjustment and optimization, etc. Infection and syndrome specific intervention
7 Antibiotic Stewardship Interventions in ICU Antibiotic restriction or pre-approval Formal infectious diseases physician consultation Implementation of guidelines or protocols for de-escalation Formal reassessment of antibiotics on a pre-specified day of therapy Guidelines for antibiotic prophylaxis or treatment in ICU Implementation of computer-assisted decision support
8 Antibiotic Stewardship Interventions in ICU Antibiotic restriction or pre-approval Formal infectious diseases physician consultation Implementation of guidelines or protocols for de-escalation Formal reassessment of antibiotics on a pre-specified day of therapy Guidelines for antibiotic prophylaxis or treatment in ICU Implementation of computer-assisted decision support
9 Implementation of computer-assisted decision support Antibiotic Stewardship Interventions in ICU Antibiotic restriction or pre-approval Formal infectious diseases physician consultation Implementation of guidelines or protocols for deescalation Formal reassessment of antibiotics on a pre-specified day of therapy Guidelines for antibiotic prophylaxis or treatment in ICU
10 Antibiotic Stewardship Interventions in ICU Antibiotic restriction or pre-approval Formal infectious diseases physician consultation Implementation of guidelines or protocols for de-escalation Formal reassessment of antibiotics on a pre-specified day of therapy Guidelines for antibiotic prophylaxis or treatment in ICU Implementation of computer-assisted decision support
11 Antibiotic Stewardship Interventions in ICU Antibiotic restriction or pre-approval Formal infectious diseases physician consultation Implementation of guidelines or protocols for de-escalation Formal reassessment of antibiotics on a pre-specified day of therapy Guidelines for antibiotic prophylaxis or treatment in ICU Implementation of computer-assisted decision support
12 Implementation of computer-assisted decision support Antibiotic Stewardship Interventions in ICU Antibiotic restriction or pre-approval Formal infectious diseases physician consultation Implementation of guidelines or protocols for de-escalation Formal reassessment of antibiotics on a pre-specified day of therapy Guidelines for antibiotic prophylaxis or treatment in ICU
13 Outcome of Antibiotic Stewardship in ICUs Amount of targeted or overall antibiotic use Study Marra Sintchenko Meyer Geissler Unit of Measurement DDD/1000 ptdays DDD/1000 ptdays DDD/1000 ptdays DOT/1000 ptdays Antibiotic use in non-intervention period or group Antibiotic use in intervention period or group Difference % % % 0.05 P value % <0.01 Du g/day % 0.25 Brahmi No. of prescriptions 1.8/pt 1.5/pt -17% 0.02 Mullett Does/pt % NS Am J Infect Control 2009; 37: J Am Med Inform Assoc 2005; 12: Infection 2010; 38: Intensive Care Med 2003; 29: Crit Care Med 2003; 31: Med Mal Infect 2006; 36: Pediatrics 2001; 108: E75
14 Outcome of Antibiotic Stewardship in ICUs Amount of targeted or overall antibiotic use Most studies of restriction reported significant reduction in use of targeted Abx All showed a compensatory increase by ~ % in the use of other agents with a similar spectrum of use
15
16 Outcome of Antibiotic Stewardship in ICUs Amount of targeted or overall antibiotic use Studies of fluoroquinolone restriction resulted in the increased use of: Cefepime Int J Antimicrob Agents 2007; 30: aminoglycosides/macrolides J Hosp Infect 2005; 59: 83 9 Other studies led to increased use of piperacillin/tazobactam when restricting: ceftazidime cefepime J Infect Chemother 2006; 12: Braz J Infect Dis 2007; 11:
17 Outcome of Antibiotic Stewardship in ICUs Appropriateness of antibiotics Use of antibiotic management support programs resulted in: fewer susceptibility mismatch alerts (12 Vs 103 cases/ year, P<0.01) excessive drug-dosage alerts (87 Vs 202 cases/ year, P<0.01) mean days of excessive anti-infective doses (2.7 Vs 5.9 days/ patient, P<0.002) N Engl J Med 1998; 338: 232 8
18 Outcome of Antibiotic Stewardship in ICUs Duration of therapy Introduction of formal feedback on day 14 resulted in doctors discontinuing antibiotic therapy in 90% as compared with 48% of patients without such feedback (P<0.001) Intensive Care Med 2003; 29: A formal daily guideline for reassessment of VAP treatment led to a shorter duration of treatment (6.0 ± 4.9 days vs 8.0 ± 5.6 days, P=0.001) Chest 2004; 125:
19 Outcome of Antibiotic Stewardship in ICUs Duration of therapy Re-evaluation guideline at day 3 for patients with pulmonary infiltrates led to: far fewer patients being treated beyond this time point (28% vs 93%, P=0.0001) much shorter mean duration of antibiotic treatment (3 vs 9.8 days, P=0.0001) Am J Respir Crit Care Med 2000; 162: Broad day 3 reassessment protocol for all antibiotic recipients reduced average treatment durations in the ICU from 14.1 ± 2.9 days to 11.9 ± 1.2 days (P<0.001) Med Mal Infect 2006; 36: 460 5
20 Outcome of Antibiotic Stewardship in ICUs Rates of antibiotic resistance Cirpofloxacin restriction: Reduction in cipro-resistant P. aeruginosa Also reduction in cipro-resistant A. baumannii and K. pneumonia Int J Antimicrob Agents 2007; 30: In another study by Aubert et al, no reduction of cipro-resistant Enterobacteriaceae J Hosp Infect 2005; 59: 83 9
21 Outcome of Antibiotic Stewardship in ICUs Rates of antibiotic resistance Ceftazidime-restriction led to reduced ceftazidime-resistant: A. baumannii & ESBL-producing K. pneumoniae J Infect Chemother 2006; 12: P. aeruginosa E. coli & K. pneumoniae Pharm World Sci 2008; 30: Int J Antimicrob Agents 2007; 30: Crit Care Med 2003; 31:
22 Outcome of Antibiotic Stewardship in ICUs Rates of antibiotic resistance A day 3 reassessment protocol performed over 2 years was associated with reductions in: ESBL Klebsiella (68% to 44%, P<0.001) and carbapenem-resistant Pseudomonas (61% to 41%, P<0.05) Med Mal Infect 2006; 36: A day 3, day 7 and day 10 antibiotic reassessment intervention performed over 3 years demonstrated reduction in: Antimicrobial-resistant bacteria of nosocomial infections (37% to 15%, P< ) MRSA (61% to 13%, P<0.001) and ceftriaxone-resistant Enterobacteriaceae (37% to 13%, P<0.0001) No impact on ceftazidime-resistant P. aeruginosa or ESBL-producing Enterobacteriaceae. Intensive Care Med 2003; 29: 49 54
23 Outcome of Antibiotic Stewardship in ICUs Rates of antibiotic resistance Unanticipated beneficial effects included an observed reduction in: MRSA with ciprofloxacin restriction J Hosp Infect 2005; 59: 83 9 piperacillin/tazobactam- and imipenem-resistant P. aeruginosa with ceftazidime restriction J Infect Chemother 2006; 12: Unanticipated negative effects included an increase in: penicillinase-producing K. pneumoniae with ceftazidime restriction, favouring the use of piperacillin/tazobactam J Infect Chemother 2006; 12: 190 4
24 Outcome of Antibiotic Stewardship in ICUs Other clinical outcomes Nosocomial infection rates Length of stay Mortality Braz J Infect Dis 2003; 7: Crit Care Med 2003; 31: N Engl J Med 1998; 338: Intensive Care Med 2003; 29: Am J Infect Control 2009; 37: Chest 2004; 125: Med Mal Infect 2006; 36: 460 5
25 Our Model
26 Antibiotic Stewardship Practice in ICU
27 Tips Know the local data Define a target (s) Pick a strategy (-ies) Chose the team Audit outcomes Redesign
28 Thank You..!
29
Appropriate antimicrobial therapy in HAP: What does this mean?
Appropriate antimicrobial therapy in HAP: What does this mean? Jaehee Lee, M.D. Kyungpook National University Hospital, Korea KNUH since 1907 Presentation outline Empiric antimicrobial choice: right spectrum,
More informationMAGNITUDE OF ANTIMICROBIAL USE. Antimicrobial Stewardship in Acute and Long Term Healthcare Facilities: Design, Implementation and Challenges
Antimicrobial Stewardship in Acute and Long Term Healthcare Facilities: Design, Implementation and Challenges John A. Jernigan, MD, MS Division of Healthcare Quality Promotion Centers for Disease Control
More informationCollecting and Interpreting Stewardship Data: Breakout Session
Collecting and Interpreting Stewardship Data: Breakout Session Michael S. Calderwood, MD, MPH Regional Hospital Epidemiologist, Dartmouth-Hitchcock Medical Center March 20, 2019 None Disclosures Outline
More informationJump Starting Antimicrobial Stewardship
Jump Starting Antimicrobial Stewardship Amanda C. Hansen, PharmD Pharmacy Operations Manager Carilion Roanoke Memorial Hospital Roanoke, Virginia March 16, 2011 Objectives Discuss guidelines for developing
More informationAntibiotic Stewardship in the Hospital Setting
Antibiotic Stewardship in the Hospital Setting G. Evans, MD FRCPC Medical Director, Infection Prevention & Control Kingston General Hospital & Hotel Dieu Hospital EOPIC September 26, 2012 Stewardship stew-ard-ship
More informationBest Practices: Goals of Antimicrobial Stewardship
Best Practices: Goals of Antimicrobial Stewardship Gail Scully, M.D, M.P.H. and Elizabeth Radigan, PharmD, BCPS UMass Memorial Medical Center Division of Infectious Disease Department of Medicine September
More informationSustaining an Antimicrobial Stewardship
Sustaining an Antimicrobial Stewardship Much needless expense, untoward effect, harm and disappointment can be prevented by better judgment in the use of antimicrobials Whitney A. Jones, PharmD Antimicrobial
More informationSepsis is the most common cause of death in
ADDRESSING ANTIMICROBIAL RESISTANCE IN THE INTENSIVE CARE UNIT * John P. Quinn, MD ABSTRACT Two of the more common strategies for optimizing antimicrobial therapy in the intensive care unit (ICU) are antibiotic
More informationManagement of Hospital-acquired Pneumonia
Management of Hospital-acquired Pneumonia Adel Alothman, MB, FRCPC, FACP Asst. Professor, COM, KSAU-HS Head, Infectious Diseases, Department of Medicine King Abdulaziz Medical City Riyadh Saudi Arabia
More informationAntimicrobial Stewardship Advisory Committee Meeting
Antimicrobial Stewardship Advisory Committee Meeting August 25, 2016 3:00 PM-4:30 PM Washington State Dept of Health Room A42 1610 NE 150th St Shoreline, WA 98155 Call in: (571) 317-3116 Access Code: 211-449-029
More informationAntimicrobial Stewardship Program: Local Experience
Antimicrobial Stewardship Program: Local Experience Dr. WU Tak Chiu Associate Consultant Division of Infectious Diseases Department of Medicine Queen Elizabeth Hospital 18th January 2011 QUEEN ELIZABETH
More informationAntimicrobial stewardship: Quick, don t just do something! Stand there!
Antimicrobial stewardship: Quick, don t just do something! Stand there! Stanley I. Martin, MD, FACP, FIDSA Director, Division of Infectious Diseases Director, Antimicrobial Stewardship Program Geisinger
More informationAntibiotic Stewardship in Nursing Homes SAM GUREVITZ PHARM D, CGP ASSOCIATE PROFESSOR BUTLER UNIVERSITY COLLEGE OF PHARMACY AND HEALTH SCIENCE
Antibiotic Stewardship in Nursing Homes SAM GUREVITZ PHARM D, CGP ASSOCIATE PROFESSOR BUTLER UNIVERSITY COLLEGE OF PHARMACY AND HEALTH SCIENCE Crisis: Antibiotic Resistance Success Strategy WWW.optimistic-care.org
More informationAntimicrobial stewardship
Antimicrobial stewardship Magali Dodemont, Pharm. with the support of Wallonie-Bruxelles International WHY IMPLEMENT ANTIMICROBIAL STEWARDSHIP IN HOSPITALS? Optimization of antimicrobial use To limit the
More informationAntimicrobial Cycling. Donald E Low University of Toronto
Antimicrobial Cycling Donald E Low University of Toronto Bad Bugs, No Drugs 1 The Antimicrobial Availability Task Force of the IDSA 1 identified as particularly problematic pathogens A. baumannii and
More informationAntimicrobial Stewardship:
Antimicrobial Stewardship: Inpatient and Outpatient Elements Angela Perhac, PharmD afperhac@carilionclinic.org Disclosure I have no relevant finances to disclose. Objectives Review the core elements of
More informationLinda Taggart MD FRCPC Infectious Diseases Physician Lead Physician, Antimicrobial Stewardship Program St. Michael s Hospital
Linda Taggart MD FRCPC Infectious Diseases Physician Lead Physician, Antimicrobial Stewardship Program St. Michael s Hospital no industry conflicts of interest salary support to lead Antimicrobial Stewardship
More informationRecommendations for Implementation of Antimicrobial Stewardship Restrictive Interventions in Acute Hospitals in Ireland
Recommendations for Implementation of Antimicrobial Stewardship Restrictive Interventions in Acute Hospitals in Ireland A report by the Hospital Antimicrobial Stewardship Working Group, a subgroup of the
More informationMulti-drug resistant microorganisms
Multi-drug resistant microorganisms Arzu TOPELI Director of MICU Hacettepe University Faculty of Medicine, Ankara-Turkey Council Member of WFSICCM Deaths in the US declined by 220 per 100,000 with the
More informationGet Smart For Healthcare
Get Smart For Healthcare Know When Antibiotics Work Marry Bardin, Quality Improvement Advisor June 9, 2015 Why We Need to Improve In-patient Antibiotic Use Antibiotics are misused in hospitals Antibiotic
More informationAntimicrobial stewardship in managing septic patients
Antimicrobial stewardship in managing septic patients November 11, 2017 Samuel L. Aitken, PharmD, BCPS (AQ-ID) Clinical Pharmacy Specialist, Infectious Diseases slaitken@mdanderson.org Conflict of interest
More informationPreserving bacterial susceptibility Implementing Antimicrobial Stewardship Programs Debra A. Goff, Pharm.D., FCCP
Preserving bacterial susceptibility Implementing Antimicrobial Stewardship Programs Debra A. Goff, Pharm.D., FCCP Clinical Associate Professor Infectious Diseases Specialist The Ohio State University Medical
More information9/30/2016. Dr. Janell Mayer, Pharm.D., CGP, BCPS Dr. Lindsey Votaw, Pharm.D., CGP, BCPS
Dr. Janell Mayer, Pharm.D., CGP, BCPS Dr. Lindsey Votaw, Pharm.D., CGP, BCPS 1 2 Untoward Effects of Antibiotics Antibiotic resistance Adverse drug events (ADEs) Hypersensitivity/allergy Drug side effects
More informationUPDATE ON ANTIMICROBIAL STEWARDSHIP REGULATIONS AND IMPLEMENTATION OF AN AMS PROGRAM
UPDATE ON ANTIMICROBIAL STEWARDSHIP REGULATIONS AND IMPLEMENTATION OF AN AMS PROGRAM Diane Rhee, Pharm.D. Associate Professor of Pharmacy Practice Roseman University of Health Sciences Chair, Valley Health
More informationEnhancement of Antimicrobial Stewardship with TheraDoc Clinical Decision Support Software
THERADOC WHITE PAPER Enhancement of Antimicrobial Stewardship with TheraDoc Clinical Decision Support Software Jason Pogue, PharmD, BCPS-ID Clinical Pharmacist Specialist, Infectious Diseases Department
More informationSolution Title: Antibiotic Stewardship: A Journey Toward the Triple Aim
Solution Title: Antibiotic Stewardship: A Journey Toward the Triple Aim Program/Project Description, including Goals What was the problem to be solved? How was it identified? What baseline data existed?
More informationMono- versus Bitherapy for Management of HAP/VAP in the ICU
Mono- versus Bitherapy for Management of HAP/VAP in the ICU Jean Chastre, www.reamedpitie.com Conflicts of interest: Consulting or Lecture fees: Nektar-Bayer, Pfizer, Brahms, Sanofi- Aventis, Janssen-Cilag,
More informationAdvances in Antimicrobial Stewardship (AMS) at University Hospital Southampton
Advances in Antimicrobial Stewardship (AMS) at University Hospital Southampton Dr Julian Sutton Consultant in Infectious Diseases & Medical Microbiology Federation of Infection Societies 1 st December,
More informationThe UK 5-year AMR Strategy - a brief overview - Dr Berit Muller-Pebody National Infection Service Public Health England
The UK 5-year AMR Strategy - a brief overview - Dr Berit Muller-Pebody National Infection Service Public Health England Chief Medical Officer - Annual Report 2013 Antimicrobial resistance poses catastrophic
More informationAntibiotic Resistance. Antibiotic Resistance: A Growing Concern. Antibiotic resistance is not new 3/21/2011
Antibiotic Resistance Antibiotic Resistance: A Growing Concern Judy Ptak RN MSN Infection Prevention Practitioner Dartmouth-Hitchcock Medical Center Lebanon, NH Occurs when a microorganism fails to respond
More informationVaccination as a potential strategy to combat Antimicrobial Resistance in the elderly
Vaccination as a potential strategy to combat Antimicrobial Resistance in the elderly Wilbur Chen, MD, MS 22-23 March 2017 WHO meeting on Immunization of the Elderly The Problem Increasing consumption
More informationLearning Points. Raymond Blum, M.D. Antimicrobial resistance among gram-negative pathogens is increasing
Raymond Blum, M.D. Learning Points Antimicrobial resistance among gram-negative pathogens is increasing Infection with antimicrobial-resistant pathogens is associated with increased mortality, length of
More informationAntimicrobial Stewardship Basics Why, What, Who, and How. Philip Chung, PharmD, MS, BCPS ASAP Community Network Pharmacy Coordinator October 12, 2017
Antimicrobial Stewardship Basics Why, What, Who, and How Philip Chung, PharmD, MS, BCPS ASAP Community Network Pharmacy Coordinator October 12, 2017 Objectives List reasons for developing antimicrobial
More information4/3/2017 CLINICAL PEARLS: UPDATES IN THE MANAGEMENT OF NOSOCOMIAL PNEUMONIA DISCLOSURE LEARNING OBJECTIVES
CLINICAL PEARLS: UPDATES IN THE MANAGEMENT OF NOSOCOMIAL PNEUMONIA BILLIE BARTEL, PHARMD, BCCCP APRIL 7 TH, 2017 DISCLOSURE I have had no financial relationship over the past 12 months with any commercial
More informationNosocomial Infections: What Are the Unmet Needs
Nosocomial Infections: What Are the Unmet Needs Jean Chastre, MD Service de Réanimation Médicale Hôpital Pitié-Salpêtrière, AP-HP, Université Pierre et Marie Curie, Paris 6, France www.reamedpitie.com
More informationGUIDELINES EXECUTIVE SUMMARY
GUIDELINES Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America Guidelines for Developing an Institutional Program to Enhance Antimicrobial Stewardship Timothy
More informationOptimizing Antimicrobial Stewardship Activities Based on Institutional Resources
Optimizing Antimicrobial Stewardship Activities Based on Institutional Resources Andrew Hunter, PharmD, BCPS Infectious Diseases Clinical Pharmacy Specialist Michael E. DeBakey VA Medical Center Andrew.hunter@va.gov
More informationASCENSION TEXAS Antimicrobial Stewardship: Practical Implementation Strategies
ASCENSION TEXAS Antimicrobial Stewardship: Practical Implementation Strategies Theresa Jaso, PharmD, BCPS (AQ-ID) Network Clinical Pharmacy Specialist Infectious Diseases Seton Healthcare Family Ascension
More informationGUIDELINES EXECUTIVE SUMMARY
GUIDELINES Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America Guidelines for Developing an Institutional Program to Enhance Antimicrobial Stewardship Timothy
More informationImpact of the pharmacist on a multidisciplinary team in an antimicrobial stewardship program: a quasi-experimental study
Int J Clin harm (2012) 34:290 294 DOI 10.1007/s11096-012-9621-7 SHORT RESEARCH REORT Impact of the pharmacist on a multidisciplinary team in an antimicrobial stewardship program: a quasi-experimental study
More informationAntimicrobial Stewardship. October 2012
Antimicrobial Stewardship October 2012 Rising Antimicrobial Resistance Methicillin resistant staphylococcus aureus (MRSA) Vancomycin resistant enterococci (VRE) MDR and extremely drug resistant (XDR TB)
More informationApril 25, 2018 Edited by: Gregory K. Perry, PharmD, BCPS-AQID
VOLUME FOUR; ISSUE 4 April 25, 2018 Edited by: Gregory K. Perry, PharmD, BCPS-AQID InPHARMation Pharmacy and Therapeutics Committee Update April 25 th, 2018 Meeting The Pharmacy and Therapeutics Committee
More informationUpdate on Resistance and Epidemiology of Nosocomial Respiratory Pathogens in Asia. Po-Ren Hsueh. National Taiwan University Hospital
Update on Resistance and Epidemiology of Nosocomial Respiratory Pathogens in Asia Po-Ren Hsueh National Taiwan University Hospital Ventilator-associated Pneumonia Microbiological Report Sputum from a
More information03/09/2014. Infection Prevention and Control A Foundation Course. Talk outline
Infection Prevention and Control A Foundation Course 2014 What is healthcare-associated infection (HCAI), antimicrobial resistance (AMR) and multi-drug resistant organisms (MDROs)? Why we should be worried?
More informationAntimicrobial Stewardship in the Hospital Setting
GUIDE TO INFECTION CONTROL IN THE HOSPITAL CHAPTER 12 Antimicrobial Stewardship in the Hospital Setting Authors Dan Markley, DO, MPH, Amy L. Pakyz, PharmD, PhD, Michael Stevens, MD, MPH Chapter Editor
More informationAntimicrobial Stewardship: A Matter of Process or Outcome?
Antimicrobial Stewardship: A Matter of Process or Outcome? Tina M. Khadem, Pharm.D., Elizabeth Dodds Ashley, Pharm.D., M.H.S., Mark J. Wrobel, Pharm.D., and Jack Brown, Pharm.D., M.S. The risk of antimicrobial
More informationANTIBIOTIC STEWARDSHIP
ANTIBIOTIC STEWARDSHIP S.A. Dehghan Manshadi M.D. Assistant Professor of Infectious Diseases and Tropical Medicine Tehran University of Medical Sciences Issues associated with use of antibiotics were recognized
More informationThe Rise of Antibiotic Resistance: Is It Too Late?
The Rise of Antibiotic Resistance: Is It Too Late? Paul D. Holtom, MD Professor of Medicine and Orthopaedics USC Keck School of Medicine None DISCLOSURES THE PROBLEM Antibiotic resistance is one of the
More informationTreatment Guidelines and Outcomes of Hospital- Acquired and Ventilator-Associated Pneumonia
SUPPLEMENT ARTICLE Treatment Guidelines and Outcomes of Hospital- Acquired and Ventilator-Associated Pneumonia Antoni Torres, Miquel Ferrer, and Joan Ramón Badia Pneumology Department, Clinic Institute
More informationAntimicrobial Stewardship 101
Antimicrobial Stewardship 101 Betty P. Lee, Pharm.D. Pediatric Infectious Disease/Antimicrobial Stewardship Pharmacist Lucile Packard Children s Hospital Stanford Disclosure I have no actual or potential
More informationBACTERIAL SUSCEPTIBILITY REPORT: 2016 (January 2016 December 2016)
BACTERIAL SUSCEPTIBILITY REPORT: 2016 (January 2016 December 2016) VA Palo Alto Health Care System April 14, 2017 Trisha Nakasone, PharmD, Pharmacy Service Russell Ryono, PharmD, Public Health Surveillance
More informationAntibiotics in the future tense: The Application of Antibiotic Stewardship in Veterinary Medicine. Mike Apley Kansas State University
Antibiotics in the future tense: The Application of Antibiotic Stewardship in Veterinary Medicine Mike Apley Kansas State University Changes in Food Animal Antibiotic Use How the uses of antibiotics in
More information11/22/2016. Antimicrobial Stewardship Update Disclosures. Outline. No conflicts of interest to disclose
Antimicrobial Stewardship Update 2016 APIC-CI Conference November 17 th, 2016 Jay R. McDonald, MD Chief, ID Section VA St. Louis Health Care System Assistant Professor of medicine Washington University
More informationAntimicrobial Stewardship Program 2 nd Quarter
Antimicrobial Stewardship Program 2 nd Quarter May 19, 2016 Jill Hanson, WHA DeAnn Richards, MetaStar Objectives for Today Hospital Highlight UnityPoint Health - Meriter Status of the state Update on pilot
More informationMultidrug-Resistant Organisms: How Do We Define them? How do We Stop Them?
Multidrug-Resistant Organisms: How Do We Define them? How do We Stop Them? Roberta B. Carey, PhD Centers for Disease Control and Prevention Division of Healthcare Quality Promotion Why worry? MDROs Clinical
More informationAntibiotic usage in nosocomial infections in hospitals. Dr. Birgit Ross Hospital Hygiene University Hospital Essen
Antibiotic usage in nosocomial infections in hospitals Dr. Birgit Ross Hospital Hygiene University Hospital Essen Infection control in healthcare settings - Isolation - Hand Hygiene - Environmental Hygiene
More informationPotential Conflicts of Interest. Schematic. Reporting AST. Clinically-Oriented AST Reporting & Antimicrobial Stewardship
Potential Conflicts of Interest Clinically-Oriented AST Reporting & Antimicrobial Stewardship Hsu Li Yang 27 th September 2013 Research Funding: Pfizer Singapore AstraZeneca Janssen-Cilag Merck, Sharpe
More informationAntibiotic Stewardship Program (ASP) CHRISTUS SETX
Antibiotic Stewardship Program (ASP) CHRISTUS SETX Program Goals I. Judicious use of antibiotics Decrease use of broad spectrum antibiotics and deescalate use based on clinical symptoms Therapeutic duplication:
More information9/9/2015. Disclosure / Contact. Pneumonia Stats. Exploring the Clinical and Regulatory Impact of Pneumonia in Long Term Care
Exploring the Clinical and Regulatory Impact of Pneumonia in Long Term Care Rob Shulman R.Ph. CGP FASCP Director of Consulting Services Remedi SeniorCare William M. Vaughan,RN, BSN Vice President, Education
More informationAntimicrobial Stewardship Esperienza Torinese
Pisa 15 Novembre 2016 Antimicrobial Stewardship Esperienza Torinese Francesco G. De Rosa Dipartimento di Scienze Mediche Università di Torino Antimicrobial Stewardship First introduced by Dale Gerding
More informationSt. Joseph s General Hospital Vegreville. and. Mary Immaculate Care Centre. Antimicrobial Stewardship Report
St. Joseph s General Hospital Vegreville and Mary Immaculate Care Centre Antimicrobial Stewardship Report January to June 217 Introduction Antibiotics are among the most commonly prescribed medications
More informationUnderstanding the Hospital Antibiogram
Understanding the Hospital Antibiogram Sharon Erdman, PharmD Clinical Professor Purdue University College of Pharmacy Infectious Diseases Clinical Pharmacist Eskenazi Health 5 Understanding the Hospital
More information1. List three activities pharmacists can implement to support. 2. Identify potential barriers to implementing antimicrobial
OPTIMIZING ANTIMICROBIAL STEWARDSHIP: IT STARTS IN THE EMERGENCY DEPARTMENT! 1 2 Objectives 1. List three activities pharmacists can implement to support health-system antimicrobial stewardship programs
More informationRelationship Between Antibiotic Consumption and Resistance in European Hospitals
Relationship Between Antibiotic Consumption and Resistance in European Hospitals Dominique L. Monnet National Center for Antimicrobials and Infection Control, Statens Serum Institut, Copenhague, Danemark
More informationDr. Shaiful Azam Sazzad. MD Student (Thesis Part) Critical Care Medicine Dhaka Medical College
Dr. Shaiful Azam Sazzad MD Student (Thesis Part) Critical Care Medicine Dhaka Medical College INTRODUCTION ICU acquired infection account for substantial morbidity, mortality and expense. Infection and
More informationSHC Clinical Pathway: HAP/VAP Flowchart
SHC Clinical Pathway: Hospital-Acquired and Ventilator-Associated Pneumonia SHC Clinical Pathway: HAP/VAP Flowchart v.08-29-2017 Diagnosis Hospitalization (HAP) Pneumonia develops 48 hours following: Endotracheal
More informationAntimicrobial Stewardship Programs The Same, but Different. Sara Nausheen, MD Kevin Kern, PharmD
Antimicrobial Stewardship Programs The Same, but Different Sara Nausheen, MD Kevin Kern, PharmD Antimicrobial Stewardship Programs The Same, but Different Objectives: Outline the overall function of an
More informationEpidemiology and Economics of Antibiotic Resistance
Epidemiology and Economics of Antibiotic Resistance Eili Y. Klein February 17, 2016 Health Watch USA Meeting I. The burden of antibiotic resistance is a growing global threat, but hard numbers are lacking
More informationJournal of Antimicrobial Chemotherapy Advance Access published April 14, 2008
Journal of Antimicrobial Chemotherapy Advance Access published April 14, 2008 Journal of Antimicrobial Chemotherapy doi:10.1093/jac/dkn164 Control of extended-spectrum b-lactamase-producing Klebsiella
More informationAntibiotic stewardship in long term care
Antibiotic stewardship in long term care Shira Doron, MD Associate Professor of Medicine Division of Geographic Medicine and Infectious Diseases Tufts Medical Center Boston, MA Consultant to Massachusetts
More information10 Golden rules of Antibiotic Stewardship in ICU. Jeroen Schouten, MD PhD intensivist, Nijmegen (Neth) Istanbul, Oct 6th 2017
10 Golden rules of Antibiotic Stewardship in ICU Jeroen Schouten, MD PhD intensivist, Nijmegen (Neth) Istanbul, Oct 6th 2017 10 golden rules of Antibiotic Stewardship in the ICU ID, Pharma & Micro advice
More informationLEARNING OBJECTIVES ANTIMICROBIAL USES AND ABUSES INFECTIOUS DISEASE SCARES
LEARNING OBJECTIVES ANTIMICROBIAL USES AND ABUSES Goodbye to the Antibiotic Era? Glenn D. Bedsole, MD, FACP Infectious Disease Consultant 1. Be able to list 6 examples of resistant bacteria that present
More informationNew Drugs for Bad Bugs- Statewide Antibiogram
New Drugs for Bad Bugs- Statewide Antibiogram Felicia Matthews, Pharm.D., BCPS Senior Consultant, Pharmacy Specialty BE MedMined Services Disclosures Employee of BD Corporation MedMined Services Agenda
More informationHot Topics in Antimicrobial Stewardship. Meghan Brett, MD Medical Director, Antimicrobial Stewardship University of New Mexico Hospital
Hot Topics in Antimicrobial Stewardship Meghan Brett, MD Medical Director, Antimicrobial Stewardship University of New Mexico Hospital Antimicrobial Stewardship Goals Primary Goal Optimize clinical outcomes
More informationEVALUATION OF A PEDIATRIC ANTIMICROBIAL STEWARDSHIP PROGRAM IN A TERTIARY CARE MEDICAL CENTER
EVALUATION OF A PEDIATRIC ANTIMICROBIAL STEWARDSHIP PROGRAM IN A TERTIARY CARE MEDICAL CENTER By Chou-Cheng Lai A dissertation submitted to Johns Hopkins University in conformity with the requirements
More informationThe Cost of Antibiotic Resistance: What Every Healthcare Executive Should Know
The Cost of Antibiotic Resistance: What Every Healthcare Executive Should Know JCR National Infection Prevention and Control Conference 2009 Mastering Powerful and Practical Infection Prevention Strategies
More informationHospital Antimicrobial Stewardship Program Assessment Checklist
Hospital Antimicrobial Stewardship Program Assessment Checklist This checklist should be used to determine which aspects of antimicrobial stewarship (AMS) programs are already in place to ensure optimal
More informationGrey Nuns Community Hospital (GNCH) Antimicrobial Stewardship Report
H e a l i n g t h e B o d y E n r i c h i n g t h e M i n d N u r t u r i n g t h e S o u l Grey Nuns Community Hospital (GNCH) Antimicrobial Stewardship Report to 214 Table of Contents I. Introduction..
More informationMercy Medical Center Des Moines, Iowa Department of Pathology. Microbiology Department Antibiotic Susceptibility January December 2016
Mercy Medical Center Des Moines, Iowa Department of Pathology Microbiology Department Antibiotic Susceptibility January December 2016 These statistics are intended solely as a GUIDE to choosing appropriate
More informationEARS Net Report, Quarter
EARS Net Report, Quarter 4 213 March 214 Key Points for 213* Escherichia coli: The proportion of patients with invasive infections caused by E. coli producing extended spectrum β lactamases (ESBLs) increased
More informationKonsequenzen für Bevölkerung und Gesundheitssysteme. Stephan Harbarth Infection Control Program
Konsequenzen für Bevölkerung und Gesundheitssysteme Stephan Harbarth Infection Control Program University of Geneva Hospitals Outline Introduction What data sources are available? AMR-associated outcomes
More informationESISTONO LE HCAP? Francesco Blasi. Sezione Medicina Respiratoria Dipartimento Toraco Polmonare e Cardiocircolatorio Università degli Studi di Milano
ESISTONO LE HCAP? Francesco Blasi Sezione Medicina Respiratoria Dipartimento Toraco Polmonare e Cardiocircolatorio Università degli Studi di Milano Community-acquired pneumonia (CAP): Management issues
More informationWhy Antimicrobial Stewardship?
Antimicrobial Stewardship: Why and How CAPT Arjun Srinivasan, MD Associate Director for Healthcare Associated Infection Prevention Programs Division of Healthcare Quality Promotion Why Antimicrobial Stewardship?
More informationPRACTIC GUIDELINES for APPROPRIATE ANTIBIOTICS USE
PRACTIC GUIDELINES for APPROPRIATE ANTIBIOTICS USE Global Alliance for Infection in Surgery World Society of Emergency Surgery (WSES) and not only!! Aims - 1 Rationalize the risk of antibiotics overuse
More informationMethicillin-Resistant Staphylococcus aureus Nasal Swabs as a Tool in Antimicrobial Stewardship
Methicillin-Resistant Staphylococcus aureus Nasal Swabs as a Tool in Antimicrobial Stewardship Natalie R. Tucker, PharmD Antimicrobial Stewardship Pharmacist Tyson E. Dietrich, PharmD PGY2 Infectious Diseases
More informationAntibiotic utilization and Pseudomonas aeruginosa resistance in intensive care units
NEW MICROBIOLOGICA, 34, 291-298, 2011 Antibiotic utilization and Pseudomonas aeruginosa resistance in intensive care units Vladimíra Vojtová 1, Milan Kolář 2, Kristýna Hricová 2, Radek Uvízl 3, Jan Neiser
More informationAntimicrobial stewardship in companion animals: Welcome to a whole new era
Antimicrobial stewardship in companion animals: Welcome to a whole new era John F. Prescott, University Professor Emeritus, Department of Pathobiology, University of Guelph, Guelph, Ontario NG 2W1 prescott@uoguelph.ca
More informationHuman health impacts of antibiotic use in animal agriculture
Human health impacts of antibiotic use in animal agriculture Beliefs, opinions, and evidence Peter Davies BVSc, PhD College of Veterinary Medicine, University of Minnesota, USA Terminology Antibiotic Compound
More informationWitchcraft for Gram negatives
Witchcraft for Gram negatives Dr Subramanian S MD DNB MNAMS AB (Medicine, Infect Dis) Infectious Diseases Consultant Global Health City, Chennai www.asksubra.com Drug resistance follows the drug like a
More informationSuccessful stewardship in hospital settings
Successful stewardship in hospital settings Pr Charles-Edouard Luyt Service de Réanimation Institut de Cardiologie Groupe Hospitalier Pitié-Salpêtrière Université Pierre et Marie Curie, Paris 6 www.reamedpitie.com
More informationSurveillance of Antimicrobial Resistance among Bacterial Pathogens Isolated from Hospitalized Patients at Chiang Mai University Hospital,
Original Article Vol. 28 No. 1 Surveillance of Antimicrobial Resistance:- Chaiwarith R, et al. 3 Surveillance of Antimicrobial Resistance among Bacterial Pathogens Isolated from Hospitalized Patients at
More informationWorkplan on Antibiotic Usage Management
IMPACT Forum: Antibiotic Guideline in Perspective Workplan on Antibiotic Usage Management Dr. Raymond Yung Consultant Microbiologist PYNEH 20 April 2002 May 2002 Dr. Raymond Yung 1 Objective 1. Heighten
More informationNorthwestern Medicine Central DuPage Hospital Antimicrobial Criteria Updated 11/16/16
Northwestern Medicine Central DuPage Hospital Antimicrobial Criteria Updated 11/16/16 These criteria are based on national and local susceptibility data as well as Infectious Disease Society of America
More informationPharmacist-Driven ASP. Jessica Holt, PharmD, BCPS (AQ-ID) Infectious Diseases Pharmacy Coordinator October 24 th, 2013
Pharmacist-Driven ASP Jessica Holt, PharmD, BCPS (AQ-ID) Infectious Diseases Pharmacy Coordinator October 24 th, 2013 Abbott Northwestern Hospital Largest not-for-profit hospital in the Twin Cities area
More informationBugs, Drugs, and No More Shoulder Shrugs: The Role for Antimicrobial Stewardship in Long-term Care
Bugs, Drugs, and No More Shoulder Shrugs: The Role for Antimicrobial Stewardship in Long-term Care Molly Curran, PharmD, BCPS Clinical Assistant Professor The University of Texas College of Pharmacy Clinical
More informationAntimicrobial Stewardship: efective implementation for improved clinical outcomes
The Challenge of MDR and XDR infections; Barcelona September 2018 Antimicrobial Stewardship: efective implementation for improved clinical outcomes José Miguel Cisneros Herreros Infectious Diseases Department
More informationAntibiotic Stewardship in the LTC Setting
Antibiotic Stewardship in the LTC Setting Joe Litsey, Director of Consulting Services Pharm.D., Board Certified Geriatric Pharmacist Thrifty White Pharmacy Objectives Describe the Antibiotic Stewardship
More informationMisericordia Community Hospital (MCH) Antimicrobial Stewardship Report. July December 2013 Second and Third Quarters 2014
H e a l i n g t h e B o d y E n r i c h i n g t h e M i n d N u r t u r i n g t h e S o u l Misericordia Community Hospital (MCH) Antimicrobial Stewardship Report July December 213 Second and Third Quarters
More informationAntimicrobial Stewardship Strategy:
Antimicrobial Stewardship Strategy: Prospective audit with intervention and feedback Formal assessment of antimicrobial therapy by trained individuals, who make recommendations to the prescribing service
More informationANTIBIOTIC STEWARDSHIP
ANTIBIOTIC STEWARDSHIP Adrie Bekker - Kenya 2018 Department of Pediatric and Child Health, Division of Neonatology University of Stellenbosch, Tygerberg Hospital DEFINITION OF ANTIMICROBIAL STEWARDSHIP
More information