Prevention & Management of Infection post Trans Rectal Ultrasound (TRUS) biopsy
|
|
- Homer Waters
- 6 years ago
- Views:
Transcription
1 Prevention & Management of Infection post Trans Rectal Ultrasound (TRUS) biopsy Dr. Fidelma Fitzpatrick Consultant Microbiologist, Co-chair, NCCP Prostate Bx Infection Project
2 Outline 1. What s the issue post TRUS prostate biopsy? 2. Why national guidelines? 3. Sneak preview of the guidelines!
3
4 Complications post TRUS Generally safe & well-tolerated Post biopsy complications may include Pain Rectal bleeding, Haematuria, Haematospermia Urinary retention Infection Clin Infect Dis. (2013) 57 (2):
5 What type of infectious complications can present post TRUS? Direct inoculation of bacteria from rectal mucosa into prostate, blood vessels, or urinary tract Urinary tract infection Prostatitis Bloodstream infection (+ secondary spread!) Severe sepsis
6 Infections post TRUS? Underreported most managed in community 4.2% had fever in the 2 weeks post TRUS 0.8% hospitalised UTI: 2% -6% 30% 50% also have bloodstream infection Severe sepsis 0.1% 2.2% Clin Infect Dis. (2013) 57 (2):
7 SO WHY IS A MICROBIOLOGIST CHAIRING A NCCP COMMITTEE ON TRUS COMPLICATIONS??
8 The issue = ANTIMICROBIAL RESISTANCE
9 What is the most common bug?
10 WHY NATIONAL GUIDELINES? REPORTS OF ANTIBIOTIC RESISTANT INFECTIONS & NEED FOR STANDARDISATION OF PRACTICE
11 National Survey 10 centres Procedure Type n = 10 TRUS 10 Transperineal 4 Other* 1 *radical prostatectomy, brachytherapy Where? n = 9 Interventional radiology Rapid Access Clinic Urology OPD 2 Endoscopy 1 5 3
12 Antibiotic prophylaxis pre biopsy (n=10) Different regimens All = oral quinolone ciprofloxacin or ofloxacin 5 also use second antibiotic Different dosing schedules & doses Single dose (n=2) X 24 hr (n=4) X 48 hr (n=1) X 72 (n=2) X 5 days (n=1)
13 Risk Assessment for Antibiotic Resistance to Alter Antibiotic Prophylaxis 1 centre piloting ESBL screening (rectal swab) 3/10 (30%) used formal risk assessment tool
14 Risk factors assessed included... History antibiotic resistant bug (n=3) Immunocompromise (n=3) Previous antibiotic use & specifically previous quinolone (n=2) Previous urological procedures (n=2) Previous post biopsy sepsis (n= 1) Indwelling material, abnormality of the renal tract, diabetes, age and recent hospitalisation (n=1)
15 Prevention of Infection post TRUS
16 Prevention Screening versus Risk Assessment 1. Screen ALL patients pre-biopsy 3. Risk factor assessment only & adjust antibiotic prophylaxis accordingly 2. Screen only those with risk factors for antibiotic resistance
17 SO WHAT ARE WE RECOMMENDING? Pre-biopsy screening only if patient requires CRE screening Everybody else Check if risk factors for resistant Enterobacteriaceae
18 SO WHAT ARE WE RECOMMENDING? Pre-biopsy screening only if patient requires CRE screening Everybody else Check if risk factors for resistant Enterobacteriaceae
19 THE ULTIMATE SUPERBUG
20 CRE in Ireland
21 CRE in Ireland colonisations & infections Source: HPSC * Data for 2013 are provisional to the end of Q3
22 WHY IS THIS SUCH A BIG DEAL?
23 Carbapenem-resistant Klebsiella (CRE) in Greece Vatopoulos et al Eurosurveillance 2008
24 Carbapenem-resistant Klebsiella (CRE) in Italy Data source: GM Rossolini, ARHAI Network Meeting, Berlin, Dec 2012
25 CRE - Who should be screened? 1. Previous CRE 2. Transfer from a healthcare facility abroad 3. Admitted to healthcare facility abroad for > 48 hours in the last 12 months 4. Admitted to Irish healthcare facility* for > 48 hours with CRE outbreak in last 12 months
26 Where can you get further information? Type a quote here. Johnny Appleseed
27 CRE risk factors 1. CRE Rectal swab 2. Do not list for biopsy pending swab results 3. MDT discussion if positive
28 SO WHAT ARE WE RECOMMENDING? Pre-biopsy screening only if patient requires CRE screening Everybody else Check if risk factors for resistant Enterobacteriaceae
29 1. CRE risk factors 2. Other Antibiotic Resistance Risk Factors Recent quinolone Patient is healthcare worker Travel abroad last year Previous post Bx infection Past Hx ESBL 3. No Antibiotic Resistance Risk Factors
30 Prevention Antimicrobial Prophylaxis CRE risk factors Other Antibiotic Resistance Risk Factors PO Ciprofloxacin plus Aminoglycoside History AMR/ESBL: check susceptibilities History post-biopsy infection: check old microbiology No Antibiotic Resistance Risk Factors PO Ciprofloxacin 750mg 1 hour pre biopsy
31 Management of Infection
32 Before the patient leaves... Clear WRITTEN information How to recognise infection post biopsy Who to contact if have symptoms of an infection (including out of hours) Letter for GP/ED/Urology in case of infection 1. Antimicrobial prophylaxis used 2. Algorithm for the treatment of potential infection post-trus prostate biopsy
33 Patient follow up post biopsy Units performing TRUS Contact patients within 48 hours by phone & record Record absence/presence of infection at OPD Develop an infection surveillance system Promote awareness of TRUS prostate biopsy Hospital / referring Institutions/GP Circulate management guidelines
34 Management of sepsis post biopsy HISTORY 1. Interval between biopsy & symptom onset. 2. Antibiotics. - TRUS biopsy & current 3.Antibiotic allergies? - document what happened 4. Previous resistant Enterobacteriaceae? 5. Renal function. - what is the baseline creatinine? EXAMINATION 1.Early Warning Score 2. Signs of systemic inflammation 3. Infections other than UTI, especially if >10d post biopsy KEY DECISIONS 1. Is hospital admission required? 2. Are criteria for sepsis/severe sepsis/septic shock evident? 3. Is there history/risk factors for antibiotic resistant Enterobacteriaceae?
35 What investigations should be performed? 1. Blood cultures BEFORE antibiotics 2. Urine culture 3. Bloods: FBC, U&E, CRP. If Sepsis - Add lactate, LFTs, coag screen if patient meets sepsis criteria
36 SEPSIS HOW TO RECOGNISE? Resp > 20 PATIENT HAS 2 OR MORE OF... Temp<36 or >38.3 ( o C) Heart Rate > 90 Acutely altered mental status WCC < 4 or > 12 Bedside glucose >7.7 (no diabetes) PLUS Infection is suspected Ensure Doctor present within 30 mins This patient has SEPSIS COMPLETE SEPSIS SIX WITHIN 1 HOUR
37 Sepsis 6 3 to take Blood cultures before antibiotics Lactate & FBC Urine output measurement 3 to give O 2 IV fluid resuscitation IV antibiotics
38 A: PATIENT REQUIRES ADMISSION 1. FOLLOW SEPSIS PROTOCOL 2. Antibiotics after taking blood cultures INVESTIGATIONS A: TWO ANTIBIOTICS B: DON T GIVE SAME ANTIBIOTIC AS USED FOR BIOPSY PROPHYLAXIS. 3. ALWAYS discuss further antimicrobial therapy decisions once additional microbiology results are back
39 INVESTIGATIONS B: PATIENT DOES NOT REQUIRE ADMISSION 1. If patient has suspected lower UTI WITHOUT signs of systemic inflammation or suspected sepsis: PO nitrofurantoin 100mg qds or PO coamoxiclav 625mg TDS PO or PO fosfomycin 3gm sachet stat only 2. Follow-up MSU results at 48 hours to ensure empiric therapy appropriate
40 Summary Antibiotic resistance in infections post TRUS = on the rise Pre Biopsy 1.? CRE risk factors screen + don t list 2.? Other antibiotic resistant risk factors antibiotic prophylaxis needs to be changed
41 Summary - 2 After biopsy verbal + written patient information If you see a patient unwell after TRUS 1. Think sepsis & act FAST 2. Check what antibiotic prophylaxis they got 3. Give 2 different antibiotics
42 Acknowledgements 10 units for completing the national survey Ms. Eileen Nolan, NCCP NCCP Prostate Bx Infection Project Board
43
Safe Patient Care Keeping our Residents Safe Use Standard Precautions for ALL Residents at ALL times
Safe Patient Care Keeping our Residents Safe 2016 Use Standard Precautions for ALL Residents at ALL times #safepatientcare Do bugs need drugs? Dr Deirdre O Brien Consultant Microbiologist Mercy University
More informationAcute Pyelonephritis POAC Guideline
Acute Pyelonephritis POAC Guideline Refer full regional pathway http://aucklandregion.healthpathways.org.nz/33444 EXCLUSION CRITERIA: COMPLICATED PYELONEPHRITIS Discuss with relevant specialist for advice
More informationGUIDELINES FOR THE MANAGEMENT OF COMMUNITY-ACQUIRED PNEUMONIA IN ADULTS
Version 3.1 GUIDELINES FOR THE MANAGEMENT OF COMMUNITY-ACQUIRED PNEUMONIA IN ADULTS Date ratified June 2008 Updated March 2009 Review date June 2010 Ratified by Authors Consultation Evidence base Changes
More informationFOLLOWING BUNDLE ADMINISTERED WITHIN ONE HOUR.
Patient label DATE and TIME: 1 REVIEW BY Emergency Department SENIOR REGISTRAR (ED BLEEP 5999) +/-Leave Proforma 2 FOLLOWING BUNDLE ADMINISTERED WITHIN ONE HOUR. Bloods for FBC, U+E, CRP, LFT s, Clotting
More informationGASTRO-INTESTINAL TRACT INFECTIONS - ANTIMICROBIAL MANAGEMENT
GASTRO-INTESTINAL TRACT INFECTIONS - ANTIMICROBIAL MANAGEMENT DRAFT AS CURRENTLY OUT FOR CONSULTATION BUT CAN BE UTILISED IN PRESENT FORMAT Name & Title Of Author: Date Revised: Approved by Committee/Group:
More informationANTIBIOTIC PRESCRIBING POLICY FOR DIABETIC FOOT DISEASE IN SECONDARY CARE
ANTIBIOTIC PRESCRIBING POLICY FOR DIABETIC FOOT DISEASE IN SECONDARY CARE Version 1.0 Date ratified June 2009 Review date June 2011 Ratified by Authors Consultation Nottingham Antibiotic Guidelines Committee
More informationAntibiotic Prophylaxis in Spinal Surgery Antibiotic Guidelines. Contents
Antibiotic Prophylaxis in Spinal Antibiotic Guidelines Classification: Clinical Guideline Lead Author: Antibiotic Steering Committee Additional author(s): Authors Division: DCSS & Tertiary Medicine Unique
More informationDr Eleri Davies. Consultant Microbiologist and Infection Control Doctor, Public Health Wales NHS Trust
Dr Eleri Davies Consultant Microbiologist and Infection Control Doctor, Public Health Wales NHS Trust Antimicrobial stewardship What is it? Why is it important? Treatment and management of catheter-associated
More informationCarbapenemase-producing Enterobacteriaceae (CRE) T H E L A T E S T I N T H E G R O W I N G L I S T O F S U P E R B U G S
Carbapenemase-producing Enterobacteriaceae (CRE) T H E L A T E S T I N T H E G R O W I N G L I S T O F S U P E R B U G S CRE Enterobacteriaceae (Gram Negative Bacilli) Citrobacter species Escherichia coli***
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 informationProtocol for Surveillance of Antimicrobial Resistance in Urinary Isolates in Scotland
Protocol for Surveillance of Antimicrobial Resistance in Urinary Isolates in Scotland Version 1.0 23 December 2011 General enquiries and contact details This is the first version (1.0) of the Protocol
More informationAntimicrobial Stewardship in Continuing Care. Urinary Tract Infections Clinical Checklist
Antimicrobial Stewardship in Continuing Care Urinary Tract Infections Clinical Checklist December 2014 What is Antimicrobial Stewardship? Using the: right antimicrobial agent for a given diagnosis at the
More informationDRAFT DRAFT. Paediatric Antibiotic Prescribing Guideline. May
Paediatric Antibiotic Prescribing Guideline www.oxfdahsn.g/children Magdalen Centre Nth, 1 Robert Robinson Avenue, Oxfd Science Park, OX4 4GA, United Kingdom t: +44(0) 1865 784944 e: info@oxfdahsn.g Follow
More informationCork and Kerry SARI Newsletter; Vol. 2 (2), December 2006
Cork and SARI Newsletter; Vol. 2 (2), December 6 Item Type Newsletter Authors Murray, Deirdre;O'Connor, Nuala;Condon, Rosalind Download date 31/1/18 15:27:31 Link to Item http://hdl.handle.net/1147/67296
More informationWho should read this document 2. Key practice points 2. Background/ Scope/ Definitions 2. What is new in this version 2. Policy/Procedure/Guideline 4
Antibiotic Guidelines Antibiotic Prophylaxis in Urology Classification: Clinical Guideline Lead Author: Antibiotic Steering Committee Additional author(s): Authors Division: DCSS & Tertiary Medicine Unique
More informationPIPERACILLIN- TAZOBACTAM INJECTION - SUPPLY PROBLEMS
PIPERACILLIN- TAZOBACTAM INJECTION - SUPPLY PROBLEMS The current supply of piperacillin- tazobactam should be reserved f Microbiology / Infectious Diseases approval and f neutropenic sepsis, severe sepsis
More informationAntibiotic Usage Guidelines in Hospital
SUPPLEMENT TO JAPI december VOL. 58 51 Antibiotic Usage Guidelines in Hospital Camilla Rodrigues * Use of surveillance data information of Hospital antibiotic policy guidelines from Hinduja Hospital. The
More informationThese recommendations were approved for use by the Pharmaceutical and Therapeutics Committee, RCWMCH on 1 February 2017.
Antibiotic regimens for suspected hospital-acquired infection (HAI) outside the Paediatric Intensive Care Unit at Red Cross War Memorial Children s Hospital (RCWMCH) Lead author: Brian Eley Contributing
More informationRational management of community acquired infections
Rational management of community acquired infections Dr Tanu Singhal MD, MSc Consultant Pediatrics and Infectious Disease Kokilaben Dhirubhai Ambani Hospital, Mumbai Why is rational management needed?
More informationFull Title of Guideline. Author: Contact Name and Job Title. Division & Speciality. Review date December 2020
Full Title of Guideline Author: Contact Name and Job Title Division & Speciality Guideline for the treatment of prosthetic joint infections in adults Mr Peter James - Consultant Orthopaedic Surgeon Dr
More informationPneumonia Antibiotic Guidance for Adults PAGL Inclusion Approved at January 2017 PGC
Pneumonia Antibiotic Guidance for Adults PAGL Inclusion Approved at January 2017 PGC APPROVED BY: Policy and Guidelines Committee TRUST REFERENCE: B9/2009 AWP Ref: AWP61 Date (approved): July 2008 REVIEW
More informationWho should read this document 2. Key practice points 2. Background/ Scope/ Definitions 2. What is new in this version 2. Policy/Procedure/Guideline 4
Antibiotic Guidelines Antibiotic Prophylaxis in Urology Classification: Clinical Guideline Lead Author: Antibiotic Steering Committee Additional author(s): Authors Division: DCSS & Tertiary Medicine Unique
More informationInfection Comments First Line Agents Penicillin Allergy History of multiresistant. line treatment: persist for >7 days they may be
Gastrointestinal Infections Infection Comments First Line Agents Penicillin Allergy History of multiresistant Campylobacter Antibiotics not recommended. Erythromycin 250mg PO 6 Alternative to first N/A
More information1. The preferred treatment option for an initial UTI episode in a 22-year-old female patient
1 Chapter 79, Self-Assessment Questions 1. The preferred treatment option for an initial UTI episode in a 22-year-old female patient with normal renal function is: A. Trimethoprim-sulfamethoxazole B. Cefuroxime
More informationVolume. December Infection. Notes. length of. cases as 90% 1 week. tonsillitis. First Line. sore throat / daily for 5 days. quinsy >4000.
Volume 8; Number 22 LINCOLNSHIRE GUIDELINES FOR THE TREATMENT OF COMMONLYY OCCURRING INFECTIONS IN PRIMARY CARE: WINTER 2014/15 In this issue of the PACE Bulletin we present an update of our Guidelines
More informationDuke University Hospital Guideline for Empiric Inpatient Treatment of Cancer- Related Neutropenic Fever in Adult Patients
Duke University Hospital Guideline for Empiric Inpatient Treatment of Cancer- Related Neutropenic Fever in Adult Patients PURPOSE Fever among neutropenic patients is common and a significant cause of morbidity
More informationGuidelines for the Initiation of Empirical Antibiotic therapy in Respiratory Disease (Adults)
Guidelines for the Initiation of Empirical Antibiotic therapy in Respiratory Disease (Adults) Community Acquired Pneumonia Community Acquired Pneumonia 1) Is it pneumonia? ie new symptoms and signs of
More informationrates adjusted for age, sex, infection subclass, and type of antibiotic treatment used) by British Medical Journal Publishing Group
Antibiotic treatment failure in four common infections in UK primary care 1991-2012: longitudinal analysis Craig J Currie BMJ 2014;349:g5493 23 September 2014 More than one in 10 initial antibiotic monotherapies
More informationCentral Ohio Primary Care and Local Specialty Group Working Hand in Glove for Better Patient Outcomes!
Central Ohio Primary Care and Local Specialty Group Working Hand in Glove for Better Patient Outcomes! Rebecca Burk BS(QSM), Laboratory Manager, Central Ohio Primary Care Physicians, Inc. Contributing
More informationA retrospective analysis of urine culture results issued by the microbiology department, Teaching Hospital, Karapitiya
A retrospective analysis of urine culture results issued by the microbiology department, Teaching Hospital, Karapitiya LU Edirisinghe 1, D Vidanagama 2 1 Senior Registrar in Medicine, 2 Consultant Microbiologist,
More informationImpact of Antimicrobial Resistance on Human Health. Robert Cunney HSE HCAI/AMR Programme and Temple Street Children s University Hospital
Impact of Antimicrobial Resistance on Human Health Robert Cunney HSE HCAI/AMR Programme and Temple Street Children s University Hospital AMR in Foodchain Conference, UCD, Dec 2014 Sir Patrick Dun s Hospital
More informationCipro for klebsiella uti
Cipro for klebsiella uti Search Can UTI be an effective treatment for Klebsiella Pneumoniae? It is safe or dangerous to use UTI while suffering from Klebsiella Pneumoniae? 87 discussions on Treato. instock
More informationTo guide safe and appropriate selection of antibiotic therapy for Peritoneal Dialysis patients.
Nephrology Directorate Subject: Objective: Prepared by: Aintree Antibiotic Guidelines for Peritoneal Dialysis (PD): Catheter Insertion, and the Diagnosis and Treatment of PD Peritonitis and Exit-Site Infections.
More informationCurrent Trends in Antimicrobial Resistance and Need for Antimicrobial Stewardship Among Urologists. Edward A. Stenehjem, MD
Current Trends in Antimicrobial Resistance and Need for Antimicrobial Stewardship Among Urologists Edward A. Stenehjem, MD Director, Antibiotic Stewardship, Urban Central Region, Department of Clinical
More informationGuidelines for Treatment of Urinary Tract Infections
Guidelines for Treatment of Urinary Tract Infections Overview This document details the Michigan Hospital Medicine Safety (HMS) Consortium preferred antibiotic choices for treatment of uncomplicated and
More informationSepticaemia Definitions 1
Septicaemia Definitions 1 Term Definition Bacteraemia Systemic Inflammatory response (SIRS) Sepsis Bacteria that can be cultured from the blood stream The systemic response to a wide range of stresses.
More informationUpdate on Fluoroquinolones. Charles Krasner, M.D. June 16, 2016 Antibiotic Stewardship Program -ECHO
Update on Fluoroquinolones Charles Krasner, M.D. June 16, 2016 Antibiotic Stewardship Program -ECHO Potential fluoroquinolone side-effects Increased risk, greater than with most other antibiotics, for
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 informationHost, Syndrome, Bug, Drug: Introducing 2 Frameworks to Approach Infectious Diseases Cases with an Antimicrobial Stewardship Focus
Host, Syndrome, Bug, Drug: Introducing 2 Frameworks to Approach Infectious Diseases Cases with an Antimicrobial Stewardship Focus Montana ACP Meeting 2018 September 8, 2018 Staci Lee, MD, MEHP Billings
More informationMulti-Drug Resistant Gram Negative Organisms POLICY REVIEW DATE EXTENDED Printed copies must not be considered the definitive version
Multi-Drug Resistant Gram Negative Organisms POLICY REVIEW DATE EXTENDED 2018 Printed copies must not be considered the definitive version DOCUMENT CONTROL POLICY NO. IC-122 Policy Group Infection Control
More informationAntibiotic Updates: Part II
Antibiotic Updates: Part II Fredrick M. Abrahamian, DO, FACEP, FIDSA Health Sciences Clinical Professor of Emergency Medicine David Geffen School of Medicine at UCLA Los Angeles, California Financial Disclosures
More informationCommunity Acquired Pneumonia (CAP)
Community Acquired Pneumonia (CAP) The following guidelines have been developed to aid clinicians in the investigation and management of patients with CAP at the Royal Liverpool University Hospital (RLUH).
More informationAppropriate Management of Common Pediatric Infections. Blaise L. Congeni M.D. Akron Children s Hospital Division of Pediatric Infectious Diseases
Appropriate Management of Common Pediatric Infections Blaise L. Congeni M.D. Akron Children s Hospital Division of Pediatric Infectious Diseases It s all about the microorganism The common pathogens Viruses
More informationTrea%ng Sepsis in 2016 Are the Big Guns Losing the War?
Trea%ng Sepsis in 2016 Are the Big Guns Losing the War? ERIC HODGSON FCA (Crit Care) Inkosi Albert Luthuli Central Hospital & NELSON R MANDELA SCHOOL OF MEDICINE DURBAN, KZN Declaration Advisory boards
More informationPrevention and control of antimicrobial resistance in healthcare settings: raising awareness about best practices
Prevention and control of antimicrobial resistance in healthcare settings: raising awareness about best practices Dominique L. Monnet, on behalf of ECDC Antimicrobial Resistance and Healthcare-Associated
More informationHow is Ireland performing on antibiotic prescribing?
European Antibiotic Awareness Campaign 2016 November Webinar Series on Antibiotic Prescribing How is Ireland performing on antibiotic prescribing? Dr Rob Cunney National Clinical Lead HCAI AMR Clinical
More informationUTI Dr S Mathijs Department of Pharmacology
UTI Dr S Mathijs Department of Pharmacology Introduction Responsible for > 7 million consultations annually 15% of all antibiotic prescriptions 40% of all hospital acquired infections Significant burden
More informationCLINICAL PROTOCOL FOR COMMUNITY ACQUIRED PNEUMONIA. SCOPE: Western Australia. CORB score equal or above 1. All criteria must be met:
CLINICAL PROTOCOL F COMMUNITY ACQUIRED PNEUMONIA SCOPE: Western Australia All criteria must be met: Inclusion Criteria Exclusion Criteria CB score equal or above 1. Mild/moderate pneumonia confirmed by
More informationGuidelines for the Medical management of Diabetic Foot Infection
Guidelines for the Medical management of Diabetic Foot Infection Introduction and summary points - Foot infections in diabetic patients usually begin with skin ulceration - However, skin wounds with no
More informationDATA COLLECTION SECTION BY FRONTLINE TEAM. Patient Identifier/ Medical Record number (for facility use only)
Assessment of Appropriateness of ICU Antibiotics (Patient Level Sheet) **Note this is intended for internal purposes only. Please do not return to PQC.** For this assessment, inappropriate antibiotic use
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 informationCephalosporins, Quinolones and Co-amoxiclav Prescribing Audit
Cephalosporins, Quinolones and Co-amoxiclav Prescribing Audit Executive Summary Background Antibiotic resistance poses a significant threat to public health, as antibiotics underpin routine medical practice.
More informationWomen s Antimicrobial Guidelines Summary
Women s Antimicrobial Guidelines Summary 1. Introduction and Who Guideline applies to This guideline has been developed to deliver safe and appropriate empirical use of antibiotics for patients at University
More informationGuidelines for the Empirical Treatment of Sepsis in Adults (excluding Neutropenic Sepsis)
Guidelines for the Empirical Treatment of Sepsis in Adults (excluding Neutropenic Sepsis) Full Title of Guideline: Author (include email and role): Division & Speciality: Scope (Target audience, state
More informationVolume 1; Number 7 November 2007
Volume 1; Number 7 November 2007 CONTENTS Page 1 Page 3 Guidance on the Use of Antibacterial Drugs in Lincolnshire Primary Care: Winter 2007/8 NICE Clinical Guideline 54: Urinary Tract Infection in Children
More informationDr Steve Holden Consultant Microbiologist Nottingham University Hospitals NHS Trust
Dr Steve Holden Consultant Microbiologist Nottingham University Hospitals NHS Trust Clinical Case 38 yrold man Renal replacement (CAPD) since 2011 Unexplained ESRF Visited Pakistan for 3 months end of
More informationNHS Dumfries And Galloway. Surgical Prophylaxis Guidelines
NHS Dumfries And Galloway Surgical Prophylaxis Guidelines The aim of surgical prophylaxis is to reduce rates of surgical site and health-care associated infections and so reduce surgical morbidity and
More informationAntimicrobial Update Stewardship in Primary Care. Clare Colligan Antimicrobial Pharmacist NHS Forth Valley
Antimicrobial Update Stewardship in Primary Care Clare Colligan Antimicrobial Pharmacist NHS Forth Valley Setting the Scene! Consequences of Antibiotic Use? Resistance For an individual patient with
More informationTubo-ovarian abscess in OPAT
Tubo-ovarian abscess in OPAT James Hatcher Consultant in Infectious Diseases and Medical Microbiology OUTLINE What is a tubo-ovarian abscess Current recommendations Our experience and challenges How to
More informationyour hospitals, your health, our priority PARC (Policy Approval and Ratification Committee) STANDARD OPERATING PROCEDURE:
STANDARD OPERATING PROCEDURE: TRUST ANTIBIOTIC TREATMENT SOP SOP NO: TW10/136 SOP 1 VERSION NO: VERSION 6.1 (JANUARY 2013) APPROVING COMMITTEE: INFECTION PREVENTION AND CONTROL COMMITTEE DATE THIS VERSION
More informationGlobal Status of Antimicrobial Resistance with a Focus on Nepal
Global Status of Antimicrobial Resistance with a Focus on Nepal John Ferguson, John Hunter Hospital, University of Newcastle, NSW, Australia Infectious Diseases Physician and Medical Microbiologist SIMON
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 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 informationESBL Positive E. coli and K. pneumoneae are Emerging as Major Pathogens for Urinary Tract Infection
ESBL Positive E. coli and K. pneumoneae are Emerging as Major Pathogens for Urinary Tract Infection Muhammad Abdur Rahim*, Palash Mitra*. Tabassum Samad*. Tufayel Ahmed Chowdhury*. Mehruba Alam Ananna*.
More informationObjectives. Antibiotic Prophylaxis in Urologic Procedures: A Review of the CUA Guidelines & Local Epidemiology of Drug Resistance
Antibiotic Prophylaxis in Urologic Procedures: A Review of the CUA Guidelines & Local Epidemiology of Drug Resistance David Hogarth UBC Urology PGY-1 May 24, 2017 Objectives 1. To review the current CUA
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 informationIntro Who should read this document 2 Key practice points 2 Background 2
Antibiotic Guidelines: Obstetric Anti-Infective Prescribing Guidelines Classification: Clinical Guideline Lead Author: Antibiotic Steering Committee Additional author(s): Kelly Alexander / Frances Garraghan
More informationHospital Acquired Infections in the Era of Antimicrobial Resistance
Hospital Acquired Infections in the Era of Antimicrobial Resistance Datuk Dr Christopher KC Lee Infectious Diseases Unit Department of Medicine Sungai Buloh Hospital Patient Story 23 Year old female admitted
More informationThe Inpatient Management of Febrile Neutropenia
UCSF Medical Center Adult Blood and Marrow Transplant Program 400 Parnassus Avenue, San Francisco, CA 94143 SOP # CL 120.05 The Inpatient Management of Febrile Neutropenia BACKGROUND: Neutropenia results
More informationAntimicrobial therapy in critical care
Antimicrobial therapy in critical care KARLEE JOHNSTON LEAD PHARMACIST DIVISION OF CRITICAL CARE CANBERRA HOSPITAL AND HEALTH SERVICE Outline 1. Let s talk about sepsis 2. PK/PD considerations 3. Selecting
More informationWelcome! 10/26/2015 1
Welcome! Audio for this event is available via ReadyTalk Internet Streaming. No telephone line is required. Computer speakers or headphones are necessary to listen to streaming audio. Limited dial-in lines
More informationGuidelines for Antimicrobial treatment for treatment of confirmed infections adults
Guidelines for Antimicrobial treatment for treatment of confirmed infections adults This guideline gives recommendations for treatment of confirmed infections in adults for children please see the Paediatric
More informationSummary of the latest data on antibiotic resistance in the European Union
Summary of the latest data on antibiotic resistance in the European Union EARS-Net surveillance data November 2017 For most bacteria reported to the European Antimicrobial Resistance Surveillance Network
More informationCarbapenemase-Producing Enterobacteriaceae (CPE)
Carbapenemase-Producing Enterobacteriaceae (CPE) September 21, 2017 Maryam Khan Peel Public Health Madeleine Ashcroft Public Health Ontario Objectives Differentiate the acronyms related to CPE (CPE,CPO,CRE,CRO)
More informationGuidelines for the Initiation of Empirical Antibiotic therapy in Respiratory Disease (Adults)
Guidelines for the Initiation of Empirical Antibiotic therapy in Respiratory Disease (Adults) Community Acquired Community Acquired 1) Is it pneumonia? ie new symptoms and signs of a lower respiratory
More informationUCSF Medical Center Guidelines for Inpatient Management of Febrile Neutropenia
Published on Infectious Diseases Management Program at UCSF (https://idmp.ucsf.edu) Home > UCSF Medical Center Guidelines for Inpatient Management of Febrile Neutropenia UCSF Medical Center Guidelines
More informationALLANBY PROOF GUIDELINES FOR USE SEPSIS SEVERE SEPSIS SEPTIC SHOCK NEUTROPENIA. MULTI ORGAN FAILURE (list organs involved)
of Birth: GUIDELINES FOR USE 1. This pathway aims to optimise delivery of care for adult patients with sepsis by implementing specific interventions to better recognise signs and symptoms of sepsis, and
More informationInappropriate Use of Antibiotics and Clostridium difficile Infection. Jocelyn Srigley, MD, FRCPC November 1, 2012
Inappropriate Use of Antibiotics and Clostridium difficile Infection Jocelyn Srigley, MD, FRCPC November 1, 2012 Financial Disclosures } No conflicts of interest } The study was supported by a Hamilton
More informationSymptoms of cellulitis (n=396) %
Cellulitis and lymphoedema Vaughan Keeley May 2012 What is cellulitis? - also called erysipelas, acute inflammatory episodes etc. - bacterial infection of skin + subcutaneous tissues - more common in people
More informationMANAGEMENT OF PELVIC INFLAMMATORY DISEASE
GYNAECOLOGY SERVICES NORTH CUMBRIA MANAGEMENT OF PELVIC INFLAMMATORY DISEASE Author/Contact DOCUMENT CONTROL Lufti Shamsuddin, ST4 Obs & Gynae Trainee / Nalini Munjuluri, Consultant Gynaecology Tel: 01228
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 Resistance Update for Community Health Services
Antimicrobial Resistance Update for Community Health Services Elizabeth Beech Healthcare Acquired Infection and Antimicrobial Resistance Project Lead NHS England October 2015 elizabeth.beech@nhs.net Superbugs
More informationDiagnosis: Presenting signs and Symptoms include:
PERITONITIS TREATMENT PROTOCOL CARI - Caring for Australasians with Renal Impairment - CARI Guidelines complete list ISPD Guidelines: http://www.ispd.org/lang-en/treatmentguidelines/guidelines Objective
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 informationBest Journal Articles of 2007 www.snipurl.com/southpaedupdate07 Staying in touch with the literature etoc www.snipurl.com/southpaedupdate07 Best Journal Articles of 2007 Is it interesting? Does it make
More informationUpdate on current SAPG projects
Update on current SAPG projects SAPG Network event 2 nd November 2018 Jacqueline Sneddon Scottish Antimicrobial Prescribing Group Safeguarding antibiotics for Scotland, now and for the future Antifungal
More informationAntimicrobial Stewardship. Where are we now and where do we need to go?
Safe Patient Care Bugs and Drugs The ongoing challenge of MDROs and AMR 2017 @SPC2016Cork Antimicrobial Stewardship. Where are we now and where do we need to go? Frank O Riordan Antimicrobial pharmacist,
More informationHalting Infections in Long Term Care
Results of HALT Study 2013 Halting Infections in Long Term Care HALT Seminar Novemeber 2014 DR Nuala O Connor ICGP Lead HCAI AMR DR Bartley Cryan Consultant microbiologist CUH Dr Paul Gallagher Consultant
More informationDEBN Sp. z o.o. 11/F8 Szafarnia Str., Gdansk, POLAND phone: website:
PRODUCT DESCRIPTION I. PROBLEM Transrectal ultrasound-guided prostate biopsy (TRUS-Bx) is a standard method for histological diagnosis of prostate cancer and one of the most commonly practiced urological
More informationTreatment of septic peritonitis
Vet Times The website for the veterinary profession https://www.vettimes.co.uk Treatment of septic peritonitis Author : Andrew Linklater Categories : Companion animal, Vets Date : November 2, 2016 Septic
More informationFlorida Health Care Association District 2 January 13, 2015 A.C. Burke, MA, CIC
Florida Health Care Association District 2 January 13, 2015 A.C. Burke, MA, CIC 11/20/2014 1 To describe carbapenem-resistant Enterobacteriaceae. To identify laboratory detection standards for carbapenem-resistant
More informationOther Beta - lactam Antibiotics
Other Beta - lactam Antibiotics Assistant Professor Dr. Naza M. Ali Lec 5 8 Nov 2017 Lecture outlines Other beta lactam antibiotics Other inhibitors of cell wall synthesis Other beta-lactam Antibiotics
More informationAntimicrobial resistance (EARS-Net)
SURVEILLANCE REPORT Annual Epidemiological Report for 2014 Antimicrobial resistance (EARS-Net) Key facts Over the last four years (2011 to 2014), the percentages of Klebsiella pneumoniae resistant to fluoroquinolones,
More information1/30/ Division of Disease Control and Health Protection. Division of Disease Control and Health Protection
Surveillance, Outbreaks, and Reportable Diseases, Oh My! Assisted Living Facility, Nursing Home and Surveyor Infection Prevention Training February 2015 A.C. Burke, MA, CIC Health Care-Associated Infection
More informationAntibiotic Abyss. Discussion Points. MRSA Treatment Guidelines
Antibiotic Abyss Fredrick M. Abrahamian, D.O., FACEP, FIDSA Professor of Medicine UCLA School of Medicine Director of Education Department of Emergency Medicine Olive View-UCLA Medical Center Sylmar, California
More informationPlease distribute a copy of this information to each provider in your organization.
HEALTH ADVISORY TO: Physicians and other Healthcare Providers Please distribute a copy of this information to each provider in your organization. Questions regarding this information may be directed to
More informationOPTIMIZATION OF PK/PD OF ANTIBIOTICS FOR RESISTANT GRAM-NEGATIVE ORGANISMS
HTIDE CONFERENCE 2018 OPTIMIZATION OF PK/PD OF ANTIBIOTICS FOR RESISTANT GRAM-NEGATIVE ORGANISMS FEDERICO PEA INSTITUTE OF CLINICAL PHARMACOLOGY DEPARTMENT OF MEDICINE, UNIVERSITY OF UDINE, ITALY SANTA
More informationPVL Staph aureusjust a skin/soft tissue problem? Layla Mohammadi Lead Pharmacist, Antimicrobials Lewisham Healthcare NHS Trust
PVL Staph aureusjust a skin/soft tissue problem? Layla Mohammadi Lead Pharmacist, Antimicrobials Lewisham Healthcare NHS Trust Neonatal Case History Neonate born at 26 +2 gestation Spontaneous onset of
More informationPreventing Multi-Drug Resistant Organism (MDRO) Infections. For National Patient Safety Goal
Preventing Multi-Drug Resistant Organism (MDRO) Infections For National Patient Safety Goal 07.03.01 2009 Methicillin Resistant Staphlococcus aureus (MRSA) About 3-8% of the population at large is a carrier
More informationLe infezioni di cute e tessuti molli
Le infezioni di cute e tessuti molli SCELTE e STRATEGIE TERAPEUTICHE Pierluigi Viale Clinica di Malattie Infettive Policlinico S. Orsola Malpighi Treatment of complicated skin and skin structure infections
More information