An Update on National Antibiotic Stewardship Activities
|
|
- Collin Mills
- 5 years ago
- Views:
Transcription
1 National Center for Emerging and Zoonotic Infectious Diseases An Update on National Antibiotic Stewardship Activities CAPT Arjun Srinivasan, MD
2 Antibiotics Are Different From All Other Drugs Antibiotics lose their effectiveness over time- even if we use them perfectly. Every specialty (almost) uses them on a regular basis. They are a shared resource- the use of antibiotics for in one patient can compromise how they work for someone else through the spread of resistance or lead to complications for someone else through spread of C. difficile.
3 Consequences of Any Antibiotic Exposure Selective pressure for antibiotic resistance.increased risk of candidemia. Increased risk for C. difficile infection 7-10 fold increased risk for up to 3 months Adverse drug reactions Disruption of normal gut bacteria. Which could increase the risk of sepsis.
4 Increased Risk of Sepsis After Antibiotic Exposure Disruption of the gut microbiome increases the risk of sepsis in animal models. Retrospective study of ~9 million patients discharged without sepsis in 473 US hospitals. 0.6% were readmitted with sepsis in 90 days. Exposure to broad spectrum antibiotics during hospitalization was independently associated with risk of sepsis: OR= % CI: Baggs, J. et al. Clin Infect Dis 2017
5 It s a Matter of Patient Safety it is more than just about antibiotic resistance What if something bad happens without an antibiotic? What is the number needed to treat? Complications to common respiratory infections are very rare Over 4400 patients with colds need to be treated to prevent 1 case of pneumonia What if something bad happens with an antibiotic? What is the number needed to harm? Antibiotic adverse events can be severe Life-threatening allergic reactions (e.g., anaphylaxis) Antibiotic-associated diarrhea (e.g., C. difficile infection) 1 in 1000 antibiotic prescriptions leads to an ER visit for an adverse event (~200,000 estimated ER visits/year in U.S.) Antibiotic adverse events have long-term consequences for chronic disease: disruption of microbiota and microbiome linked to chronic disease Petersen et al. British Medical Journal. 2007;335(7627): 982. Shehab, et al. Clin Infect Dis Sep 15;47(6): Shehab et al. JAMA 2016:316: Bourgeois, et al. Pediatrics. 2009;124(4):e Vangay, et al. Cell host & microbe 2015; 17(5):
6 Adverse Events from Hospital Antibiotics In a review of 1488 hospitalized patients given antibiotics. 20% of patients experienced at least 1 antibiotic-associated adverse event. 4% of all patients got C. difficile, 6% got an MDRO infection 20% of non-indicated antibiotic regiments were associated with an adverse event, including 7 cases of C. difficile. Every 10 days of antibiotics was associated with a 3% increased risk of an adverse event. Most common in 1 st 30 days: GI (diarrhea, nausea, vomiting): 42% Renal (>1.5 times rise in creatinine): 24% Hematologic (anemia, leukopenia, thrombocytopenia): 15% Tamma et al. JAMA Intern Med, 2017
7 Adverse Events from Hospital Antibiotics 97% of antibiotic adverse events resulted in additional testing and/or additional medical care (prolonged or new hospitalization or clinic and/or ED visit).
8 Community Antibiotic Prescribing Rates per 1000 Population United States, 2014 WA Lowest state: 501 per 1000 OR NV CA AK MT ID WY UT CO AZ NM HI ND SD NE KS OK TX MN WI IA IL MO AR MS LA NY MI PA OH IN WV VA KY NC TN SC AL GA FL ME VT NH MA RI CT NJ DE MD DC Highest state: 1,285 per 1000 prescriptions_per_k ,000 1,021-1,285 Data: IMS Health Xponent
9 55.1% of patients got at least 1 dose. Overall use was 755 DOT/1000 patient days Use did not vary by bed size. Non-teaching hospitals had higher use than teaching. Use of many classes went up: Vancomycin (32%), beta-lactam/inhibitor (26%), 3rd/4th generation cephalosporins (12%) Biggest increase in carbapenem use: 37%.
10 47 million unnecessary antibiotic prescriptions per year
11 Days of Therapy Most Common Reasons for Unnecessary Days of Therapy 576 (30%) of 1941 days of antimicrobial therapy deemed unnecessary Duration of Therapy Longer than Necessary Noninfectious or Nonbacterial Syndrome Treatment of Colonization or Contamination Hecker MT et al. Arch Intern Med. 2003;163:
12 Antibiotic Stewardship and Decreased Risk of Resistant Infections Cipro Standard Antibiotic duration LOS ICU 3 days 10 days 9 days 15 days Antibiotic resistance/ superinfection 14% 38% Study terminated early because attending physicians began to treat standard care group with 3 days of therapy Singh N et al. Am J Respir Crit Care Med. 2000;162:
13 Defined daily doses in hospital inpatients Number of all (HA+CA) CDI cases in >65 yo Impact of Reductions in Antibiotic Prescribing on C. difficile in England 7,000,000 Cephalosporin doses C. difficile in > 65 y.o. Fluoroquinolone doses ,000, ,000,000 4,000,000 3,000,000 2,000,000 1,000,000 70% reduction in C Ashiru-Oredope et al. J Antimicrob Chemother 2012; 67 Suppl 1: i51 i63 Wilcox MH et al. Clinical Infectious Diseases 2012;55(8):
14 Percent Clinical outcomes better with antimicrobial stewardship program AMP UP Appropriate Cure Failure RR 2.8 ( ) RR 1.7 ( ) RR 0.2 ( ) Fishman N. Am J Med. 2006;119:S53. AMP = Antibiotic Management Program UP = Usual Practice
15 The Goal Every patient gets: An antibiotic only when one is needed The right agent At the right dose For the right duration
16 Major Policy Developments for Antibiotic Stewardship: No Longer Whether but How The US has set a national goal for all hospitals to have stewardship programs by CMS issued a final rule requiring nursing homes to have antibiotic stewardship programs. CMS issued a proposed rule requiring hospitals to have antibiotic stewardship programs. The Joint Commission issued a standard requiring all accredited hospitals to have stewardship programs Enforcement began in January of 2017.
17 CDC s Core Elements of Antibiotic Stewardship for Hospitals, Nursing Homes, and Outpatient Settings
18 Number of facilities responding to NHSN Annual Hospital Surveys : Number and percentage meeting all 7 Core Elements 5,000 4,500 4,000 3,500 3,000 2,500 2,000 1,500 1, % Meeting all 7 Not meeting all % 64.1% n=4,184 n=4,569 n=4,781
19
20 Measuring For Improvement- Antibiotic Use Broad (ideally national) assessments of aggregate use. Facility, practice and provider specific assessments of antibiotic administration data Assessments of appropriate antibiotic use.
21 National Healthcare Safety Network Antibiotic Use Option Captures electronic data on antibiotics administered, along with admission/discharge/transfer data. Calculates rates of administration for use: By facilities to monitor interventions on single units or facility wide To collect aggregate information on antibiotic use at a regional and national level Eventually, to create antibiotic use benchmarks.
22 Standardized Antibiotic Administration Ratio (SAAR) CDC s 1st attempt at developing a risk-adjusted benchmarking measure for hospital antibiotic use. SAAR expresses observed antibiotic use compared to predicted use. Expected use is modeled based on hospital characteristics. CDC working with many partners to develop the SAAR measure to try and make it most useful for stewardship. There are challenges with a quality measure that is not all or nothing.
23 Measuring Appropriate Use We all agree that the ultimate goal of stewardship is to improve appropriate use of antibiotics. It will be hard to measure progress towards that goal if we don t have measures of appropriate use.
24 National data from outpatient clinics with diagnoses and medications prescribed. 12.6% of all outpatient visits resulted in an antibiotic prescription. About 30% of all visits that resulted in an antibiotic prescription had no diagnosis that would justify an antibiotic. Viral upper respiratory tract infections prescribed antibiotics in 26% of cases. JAMA. 2016;315(17):
25 Assessing Appropriate Use in Hospitals Is trickier. Simply looking at discharge diagnosis does not usually help assess if antibiotic use was appropriate. Most inappropriate use in hospitals occurs in patients who are either mis-diagnosed with an infection or who have an infection, but are treated incorrectly. That is labor intensive to assess and has not been done nationally.
26 Assessment of Vancomycin Use in 36 Hospitals Patients treated with intravenous vancomycin 185 No diagnostic culture obtained around antibiotic initiation, although standard practice with most infections Diagnostic culture showed no Gram-positive bacterial growth, but patient still treated for long duration (>3 days) (excludes presumed SSTI, which often can be culture negative) Diagnostic culture grew only oxacillin-susceptible Staphylococcus aureus, but patient still treated for long duration (>3 days) (likely missed opportunity to switch antibiotic based on culture result) No. of patients with potential for improvement in prescribing 17 (9.2) 40 (21.6) 9 (4.9) 66 (35.7) MMWR March 7, 2014 / 63(09);
27 Advancing Assessments of Appropriate Use in Hospitals Exploring ways to use electronic health information to assess appropriate antibiotic use. Vancomycin assessment could probably be automated pretty easily. Could we do this for others agents or infections? Unnecessary duplicate antibiotic therapy Overly long durations of therapy Bug-drug mismatch
28 But Programs and Core Elements Won t Solve the Problem Ultimately, improving antibiotic use comes down to implementing interventions that will improve prescribing. The goal of a stewardship program is to create an environment where improvement interventions will be most successful.
29 Key Moments for Antibiotic Stewardship- Hospitals Patients with C. difficile Patients with positive blood cultures Patients being given IV antibiotics at discharge Patients on unnecessarily duplicative therapy. Patients being treated for: Community acquired pneumonia (CAP) Urinary tract infection (UTI) Skin and soft tissue infections Patients who have gotten 3 days of therapy.
30 Stewardship After Day Three Audit and Feedback to Reduce Broad Spectrum Antibiotic Use in an ICU. Gave providers feedback on antibiotics on days 3 and 10 of antibiotics. Mean monthly antibiotic use decreased from 644 DOT/1000 pt days to 503 (P<0.001). C. difficile decreased (11 cases to 4) Meropenem susceptibility increased. ICHE 2012;33:354
31 Targeting Specific Infections In a 2011 survey in ~180 hospitals, CDC and state collaborators reviewed charts of patients who got antibiotics to determine the reason for use: Lower respiratory tract infections: 34.6% Urinary tract infections: 22.3% Skin and soft tissue infections: 16.1% Total for these three: 73%! JAMA. 2014;312(14):
32 Therapy for Skin and Soft Tissue Infections (SSTI) Facility implemented a SSTI diagnosis and treatment guideline. Intervention resulted in: 3 day reduction in antibiotic treatment (13 v 10d) Less use of agents with gram negative and anaerobic activity Better use of diagnostic studies and consults Jenkins TC Arch Intern Med 2011;171(12):
33 Many Patients Diagnosed with Community Acquired Pneumonia Don t Have It 106 patients met criteria for CAP per ED CAP pathway 103 patients had CAP diagnosis by ED physician 76 patients had CAP diagnosis by treating team 68 patients had CAP diagnosis by external adjudication Sara Cosgrove, Johns Hopkins Hospital
34 Duration of Therapy for CAP Guidelines recommend that most patients should get 5-7 days of antibiotics for CAP. Average duration of treatment is 10 days No difference between immune competent and suppressed patients. Simple, prospective intervention for patients being treated for CAP. Treatment duration reduced from 10 d to 7 d (p<0.001) with 148 fewer antibiotic days. CID 2012;54:1581-7
35 Asymptomatic Bacteriuria (ASB) Too Often Treated Like Infection Study Patient Population Lack of Adherence to Guidelines Dalen, 2005 Gandhi, 2009 Cope, 2009 Spivak, 2017 Catheter associated ASB n=29 Patients with UTI diagnosed n=49 Catheter associated ASB n=169 Patients with bacteruria n= % prescribed antibiotics 32.6% did not meet criteria for UTI 32% prescribed antibiotics 72% of patients with ASB got antibiotics Dalen DM et al. Can J Infect Dis Med Microbiol. 2005;16:166. Gandhi T et al. Infect Control Hosp Epidemiol. 2009;30:193. Cope M et al. Clin Infect Dis. 2009;48:1182. Spivak ES et al. Clin Infect Dis, 2017;65:910
36 Kicking CAUTI Developed a simple algorithm to guide sending of urine cultures. Overtreatment of ASB during intervention fell: From 1.6 to 0.6 per 1000 bed-days; (IRR, 0.35; 95% CI, ) Reductions persisted during the maintenance period: 0.4 per 1000 bed-days; (IRR, 0.24; 95% CI, ) P <.001 for both JAMA Intern Med Jul;175(7):
37 Clinicians Face Unique Challenges Related to Antibiotic Prescribing in Nursing Homes. 1 Older adults may not express the classic signs and symptoms of infection Availability of diagnostic tests The decision to initiate antibiotics is frequently made offsite and influenced by family preferences and nursing staff communication Many antibiotic prescriptions (66% in one study 2 ) are started by telephone orders without a physician examination Documentation of the assessment and the decision making process is sometimes limited Key prescribing information was not documented for 38% of antibiotic courses administered 3 1. Crnich et al. Drugs Aging Sep;32(9): Richards et al, J Am Med Dir Assoc Mar-Apr;6(2): Thompson et al. J Am Med Dir Assoc Dec 1;17(12):
38 Opportunity for Improvement: Testing and Treatment for Suspected Urinary Tract Infections in Nursing Homes. Asymptomatic bacteriuria is common in NH residents. 1,2 Urine cultures are positive for bacteria in 25-50% of women and 15-35% of men in NHs. 3 Up to 1/2 of antibiotics prescribed to treat UTI in older adults are unnecessary or inappropriate. 4-7 Foul-smelling or cloudy urine frequently leads to unnecessary urine testing and treatment. 6 Overtesting leads to overdiagnosis of UTI, treatment of asymptomatic bacteriuria, risk for adverse drug events (ADE)and delays in diagnosis Nicolle et al. Int J Antimicrob Agents Aug;28 Suppl 1:S Nicolle et al. Infect Control Hosp Epidemiol Mar;22(3): Nicolle et al, Clin Infect Dis. 2005;40(5): Crnich et al, J Am Geriatr Soc Aug;65(8): Trautner. Nat Rev Urol. 2012;9(2): Nicolle et al, Infect Dis Clin North Am. 1997; 11(3): Eure et al, Infect Control Hosp Epidemiol 2017 Aug;38(8): Wald. JAMA Intern Med May 1;176(5):587-8.
39 Drug Expertise: Support for Antibiotic Stewardship Implementation. Establishing access to individuals with antibiotic expertise: Engage consultant pharmacists Incorporate monitoring of antibiotic use during monthly medication regimen review Provide antibiotic use reports Partner with antibiotic stewardship leads in referring hospitals in the same network Mutually beneficial given transfers of patients with MDROs and C. difficile and desire to reduce readmissions. Develop partnerships with infectious disease consultants in the community who are interested in supporting antibiotic stewardship efforts in NHs
40 Action: Implementing Practices that Improve Testing and Treatment for Suspected Urinary Tract Infections. Implementing protocols for appropriate urine testing can help avoid diagnosing and treating asymptomatic bacteriuria 17 MA LTC facilities implemented tools promoting urine testing based on specific evaluation and indications Urine cultures decreased by 1/4, UTI diagnosis decreased by 1/3 and CDI decreased by ~1/2 Treating residents with clear signs and symptoms of a UTI Multifaceted intervention focused on a diagnostic and treatment algorithm for UTI implemented in 12 NH in Canada led to fewer courses of antibiotics for UTI without increase in mortality or hospital admission 1.17 v 1.59 courses; weighted mean difference -0.49, 95% confidence intervals to Doron et al, Abstract presented at ID week Loeb et al, BMJ 2005;331(7518):669
41 Action: Implementing Practices that Improve Communication: Communicating with Offsite Providers. Assess residents for any infection using standardized tools and criteria Standardized assessment and communication tools will ensure that important clinical information is: Collected when there is a change in the resident s clinical condition or when an infection is suspected Documented in the medical chart Communicated with the offsite provider One example is the SBAR (Situation, Background, Assessment input and Request) 1 A quasi-experimental trial assessing a quality improvement program that included tools to improve nurse-provider communication was conducted. The number of antibiotic prescriptions decreased significantly (adjusted incidence rate ratio = 0.86, 95% confidence interval = ) Shrestha et al. Infect Control Hosp Epidemiol Apr;33(4):401-4
42 Action: Implementing Practices that Improve Communication: Communicating with Emergency Departments and Acute Care Hospitals. There are critical gaps in communication between nursing homes, emergency departments 1, and acute care hospitals Antibiotic stewardship at hospital discharge is important Standardized transfer forms can improve the communication of important information related to resident care when residents are transferred to other healthcare settings Griffiths et al, Int J Nurs Stud Nov;51(11): Dalawari et al, Geriatr Nurs Jul-Aug;32(4): Terrell et al, Acad Emerg Med Feb;12(2):
43 Percent Percent of U.S. Nursing Homes Reporting Implementation of All CDC Core Elements on 2016 Annual NHSN Survey* Number of Core Elements Fulfilled *Preliminary results courtesy of Danielle Palms, adapted from presentation at SHEA Spring Conference 2017; St. Louis, MO. Abstract 9026 Please do not reproduce without permission
44 Outpatient Prescribing Quality in the United States Prescribing of first-line antibiotics ranged from a low of 37% (95% CI, 32%-43%) for adult patients with sinusitis and pharyngitis to a high of 67% (95% CI, 63%-71%) for pediatric patients with otitis media. For all 3 conditions overall, use of first-line agents was 52% (95% CI, 49%-55%). JAMA Intern Med. 2016;176(12): million unnecessary antibiotic prescriptions per year For adults with sinusitis: The median duration of therapy was 10.0 days (interquartile range, days), and 69.6% (95% CI, 63.7%-75.4%) of therapies were prescribed for 10 days or longer. JAMA Intern Med. Published online March 26, 2018
45 Have We Made Progress in Reducing Inappropriate Antibiotic Use? Outpatient antibiotic prescribing rates to children decreased by 13% Outpatient antibiotic prescribing rates to adults have been stable IQVIA pharmacy dispensing data gis.cdc.gov/grasp/psa/indexau.html
46 Outpatient Stewardship Implementation CMS Quality Innovation Network and Quality Improvement Organizations (QIN-QIOs) helping outpatient facilities to implement CDC s Core Elements. ~7000 outpatient practices are participating CDC hosting educational webinars to support effective implementation. CDC funding University of Utah to implement and evaluate CDC s Core Elements of Outpatient Antibiotic Stewardship
47 Outpatient Stewardship Implementation CMS Merit-Based Incentive Payment System Several antibiotic use measures are included as options for clinical performance improvement activities (e.g. three current HEDIS measurespharyngitis testing, avoiding antibiotics for bronchitis and URI). CDC developed an online antibiotic stewardship training course which CMS will provide to clinicians meet improvement activity requirement. Now available on CDC training website. CDC working with National Committee for Quality Assurance to expand antibiotic use HEDIS (Healthcare Effectiveness Data and Information Set) quality measures
48 Public commitment posters: inappropriate prescribing for acute respiratory infections Adjusted absolute reduction: -20% compared to controls, p=0.02 Meeker. JAMA Intern Med. 2014;174(3):
49 Peer Comparison to Top Performers You are a Top Performer: You are in the top 10% of clinicians. You wrote 0 prescriptions out of 21 acute respiratory infection cases that did not warrant antibiotics. You are not a Top Performer: Your inappropriate antibiotic prescribing rate is 15%. Top performers' rate is 0%. You wrote 3 prescriptions out of 20 acute respiratory infection cases that did not warrant antibiotics. Mean antibiotic prescribing for antibiotic-inappropriate diagnoses decreased from 19.9% to 3.7% (-16.3%) Statistically significant versus controls Meeker, Linder, et al. JAMA 2016;315(6): Slide courtesy of Jeff Linder
50 Be Antibiotics Aware A new educational effort to improve antibiotic prescribing and use. CDC launched Be Antibiotics Aware during U.S. Antibiotic Awareness Week in November This initiative emphasizes the following key points: Antibiotics are critical tools for treating a number of infections and for life-threatening conditions, such as sepsis. Antibiotics only treat bacterial infections not viral illnesses like colds and flu. Prescribe or take antibiotics only when necessary prescribe or take the right drug, dose and duration. When antibiotics are not needed, they won t help you and the side effects could still hurt you.
51 Materials & Resources Use and display in doctor s offices (e.g., lobby, waiting room), pharmacies and other health and public settings We ve designed a variety of Be Antibiotics Aware resources that appeal to patients, parents and the public: Web buttons and badges; animated videos and GIF images The Right Tool public service announcements in print, video and radio Brochures, fact sheets, infographics and posters Content for social media, newsletters and press releases To view the online toolkit and download materials, visit Be Antibiotics Aware is an ongoing educational effort so stay tuned for new and exciting additions throughout 2018!
52 There is a misperception that efforts to improve sepsis care and stewardship are in conflict. They should be complimentary. Getting patients with suspected sepsis on the right antibiotic quickly is good stewardship. Working with the stewardship team to determine how to optimize early identification of potentially septic patients and what the best antibiotics are is good sepsis care.
53 Stewardship Education Resources- FREE CME! CDC Training on Antibiotic Stewardship, up to 8 hours of free CE, 4 section throughout Open to all clinicians, pharmacists, physician assistants, nurses, certified health educators, and public health practitioners with an MPH.
54 Here in New Hampshire There is a lot going on to: Improve the collection and dissemination of antibiotic use and resistance data for action. Assess and improve stewardship practices and programs across the spectrum of healthcare. You are about to hear a lot more about all of it! I m impressed by the collaboration and cooperation to get this done- NH is better together!
55 Conclusion There has never been a more important, or better, time to improve antibiotic use. There is some momentum here- how can we build on in it? We need to focus on finding practices, measures and interventions that will have the most impact. Please share your ideas and let us know how we can help!
In Case of Technical Difficulties
Antibiotic Stewardship in Hospitals: CDC Update Wednesday, January 25, 2017 12:00 PM ET In Case of Technical Difficulties If you hear an echo: Make sure you are only logged in once on your computer Select
More informationUpdate on CDC Antibiotic Stewardship Activities
National Center for Emerging and Zoonotic Infectious Diseases Update on CDC Antibiotic Stewardship Activities CAPT Lauri Hicks, DO CAPT Arjun Srinivasan, MD Division of Healthcare Quality Promotion National
More informationAntibiotic Stewardship in Nursing Homes
National Center for Emerging and Zoonotic Infectious Diseases Antibiotic Stewardship in Nursing Homes Greater New York Hospital Association February 15 2018 Sarah Kabbani, MD, MSc Medical Officer, Office
More informationUnited States Outpatient Antibiotic Prescribing and Goal Setting
National Center for Emerging and Zoonotic Infectious Diseases United States Outpatient Antibiotic Prescribing and Goal Setting Katherine Fleming-Dutra, MD Office of Antibiotic Stewardship Division of Healthcare
More informationAntibiotic Stewardship in Human Health- Progress and Opportunities
National Center for Emerging and Zoonotic Infectious Diseases Antibiotic Stewardship in Human Health- Progress and Opportunities CAPT Lauri A. Hicks, D.O. Director, Office of Antibiotic Stewardship Division
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 informationImplementing Antibiotic Stewardship in Rural and Critical Access Hospitals
National Center for Emerging and Zoonotic Infectious Diseases Implementing Antibiotic Stewardship in Rural and Critical Access Hospitals Denise Cardo, MD Director, Division of Healthcare Quality Promotion,
More informationAntibiotic Stewardship and Critical Access Hospitals. Robert White, BA, PT, CPHQ Program Manager TMF Quality Innovation Network
Antibiotic Stewardship and Critical Access Hospitals Robert White, BA, PT, CPHQ Program Manager TMF Quality Innovation Network Antibiotic-Resistant Bacteria A serious threat to public health and the economy
More informationCore Elements of Antibiotic Stewardship for Nursing Homes
Core Elements of Antibiotic Stewardship for Nursing Homes Nimalie D. Stone, MD, MS Medical Epidemiologist for LTC Division of Healthcare Quality Promotion Centers for Disease Control and Prevention Antimicrobial
More informationThe Big Picture: Using Antibiotic Use and Surveillance Data to Better Inform Stewardship in Healthcare Settings
The Big Picture: Using Antibiotic Use and Surveillance Data to Better Inform Stewardship in Healthcare Settings Becky Roberts, MS Get Smart: Know When Antibiotics Work Office of Antibiotic Stewardship
More informationPhysician Rating: ( 23 Votes ) Rate This Article:
From Medscape Infectious Diseases Conquering Antibiotic Overuse An Expert Interview With the CDC Laura A. Stokowski, RN, MS Authors and Disclosures Posted: 11/30/2010 Physician Rating: ( 23 Votes ) Rate
More informationAntimicrobial Stewardship in the Outpatient Setting. ELAINE LADD, PHARMD, ABAAHP, FAARFM OCTOBER 28th, 2016
Antimicrobial Stewardship in the Outpatient Setting ELAINE LADD, PHARMD, ABAAHP, FAARFM OCTOBER 28th, 2016 Abbreviations AMS - Antimicrobial Stewardship Program OP - Outpatient OPS - Outpatient Setting
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 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 information5/15/17. Core Elements of Outpatient Antibiotic Stewardship: Implementing Antibiotic Stewardship Into Your Outpatient Practice.
National Center for Emerging and Zoonotic Infectious Diseases Core Elements of Outpatient Antibiotic Stewardship: Implementing Antibiotic Stewardship Into Your Outpatient Practice Melinda Neuhauser, PharmD,
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 informationAntimicrobial Stewardship in the Long Term Care and Outpatient Settings. Carlos Reyes Sacin, MD, AAHIVS
Antimicrobial Stewardship in the Long Term Care and Outpatient Settings Carlos Reyes Sacin, MD, AAHIVS Disclosure Speaker and consultant in HIV medicine for Gilead and Jansen Pharmaceuticals Objectives
More informationChallenges and opportunities for rapidly advancing reporting and improving inpatient antibiotic use in the U.S.
Challenges and opportunities for rapidly advancing reporting and improving inpatient antibiotic use in the U.S. Overview of benchmarking Antibiotic Use Scott Fridkin, MD, Senior Advisor for Antimicrobial
More informationGeriatric Mental Health Partnership
Geriatric Mental Health Partnership September 8, 2017 First, let s test your knowledge about antibiotics http://www.cdc.gov/getsmart/community/about/quiz.html 2 Get Smart Antibiotics Quiz Antibiotics fight
More informationCore Elements of Outpatient Antibiotic Stewardship Implementing Antibiotic Stewardship Into Your Outpatient Practice
National Center for Emerging and Zoonotic Infectious Diseases Core Elements of Outpatient Antibiotic Stewardship Implementing Antibiotic Stewardship Into Your Outpatient Practice Katherine Fleming-Dutra,
More informationCall-In Number: (888) Access Code:
EDUCATIONAL SERIES: Navigating Infection Control and Antimicrobial Stewardship in Long-Term Care Webinar #2: Introduction to Antimicrobial Stewardship in Long Term Care: What is Antimicrobial Stewardship
More informationMHA/OHA HIIN Antibiotic Stewardship/MDRO Collaborative
MHA/OHA HIIN Antibiotic Stewardship/MDRO Collaborative Place picture here Nov. 14, 2017 Reminders For best sound quality, dial in at 1-800-791-2345 and enter code 11076 Please use the chat box to ask questions!
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 informationUpdates in Antimicrobial Stewardship
Updates in Antimicrobial Stewardship Andrew Hunter, Pharm.D., BCPS Infectious Diseases Clinical Pharmacy Specialist Michael E. DeBakey VA Medical Center andrew.hunter@va.gov Disclosures No disclosures
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 informationAntibiotic Stewardship: The Facility Role and Implementation. Tim Cozad, LPN, Lead LTC Health Facilities Surveyor
Antibiotic Stewardship: The Facility Role and Implementation Tim Cozad, LPN, Lead LTC Health Facilities Surveyor Phase II CMS Regulatory Changes Current information available includes: New Survey Process
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 informationCurrent Regulatory Landscape in Antibiotic Stewardship
Current Regulatory Landscape in Antibiotic Stewardship Elizabeth Dodds Ashley, PharmD, MHS March 4, 2014 CDC Vital Signs Report 2 1 Core Elements of Stewardship Accountability Drug expertise Appointing
More informationWhat is an Antibiotic Stewardship Program?
What is an Antibiotic Stewardship Program? Jane Rogers, R.N. Anne Messer, MPH Learning Session #4 August 15, 2017 National Nursing Home Quality Care Collaborative Change Package Change Bundle: To prevent
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 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 informationTelligen Outpatient Antibiotic Stewardship Initiative. The Renal Network March 1, 2017
Telligen Outpatient Antibiotic Stewardship Initiative The Renal Network March 1, 2017 Who is Telligen? What is the QIN-QIO Program? Telligen: The Medicare Quality Innovation Network (QIN)-Quality Improvement
More informationThe Core Elements of Antibiotic Stewardship for Nursing Homes
The Core Elements of Antibiotic Stewardship for Nursing Homes APPENDIX B: Measures of Antibiotic Prescribing, Use and Outcomes National Center for Emerging and Zoonotic Infectious Diseases Division of
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 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 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 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 informationCMS Antibiotic Stewardship Initiative
CMS Antibiotic Stewardship Initiative Mary Fermazin, MD, MPA Chief Medical Officer Vice President, Health Policy and Quality Measurement Health Services Advisory Group (HSAG) March 11, 2017 Disclosure
More informationAntimicrobial Use Toolkit Webinar M A R C H 1 3,
Antimicrobial Use Toolkit Webinar M A R C H 1 3, 2 0 1 8 Welcome & Housekeeping Thank you for attending! HMS data abstractors Administrators QI staff Pharmacists Hospitalists ID physicians Individuals
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 information4/4/2018. Pathway Health 1. Antibiotics - Are they OVERUSED?? Best Practice Approach to Antibiotic Stewardship: Essential Strategies for Compliance
Best Practice Approach to Antibiotic Stewardship: Essential Strategies for Compliance Laura Chambers, RN, MSN, RAC-CT, CIMT Pathway Health Objectives Upon completion of this presentation, attendees should
More informationAntimicrobial Stewardship
Antimicrobial Stewardship Preventing the Spread of Antibiotic Resistance and Improving Patient Care (Adapted from the Centers for Disease Control and Prevention) What is Stewardship? Antimicrobial stewardship
More informationANTIBIOTICS IN THE ER:
ANTIBIOTICS IN THE ER: EXPLORING THE ROLE OF ANTIMICROBIAL STEWARDSHIP IN THE EMERGENCY DEPARTMENT ANGELINA DAVIS, PHARMD, MS, BCPS (AQ-ID) LIAISON CLINICAL PHARMACIST DUKE ANTIMICROBIAL STEWARDSHIP OUTREACH
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 informationIn Case of Technical Difficulties
Be Antibiotics Aware: Smart Use, Best Care Tuesday, November 14, 2017 12:00 PM ET In Case of Technical Difficulties If you hear an echo: Make sure you are only logged in once on your computer Select one
More information10/9/2017. Evidence-Based Interventions to Reduce Inappropriate Prescription of Antibiotics. Prescribing for Respiratory Tract Infections
Evidence-Based Interventions to Reduce Inappropriate Prescription of Antibiotics Ann Thomas, MD, MPH Oregon Public Health Division Prescribing for Respiratory Tract Infections Antibiotic use is primary
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 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 informationOutpatient Antibiotic Use and Stewardship in Minnesota. Catherine Lexau, PhD, MPH, RN Epidemiologist Principal Emma Leof, MPH CSTE Fellow May 1, 2018
Outpatient Antibiotic Use and Stewardship in Minnesota Catherine Lexau, PhD, MPH, RN Epidemiologist Principal Emma Leof, MPH CSTE Fellow May 1, 2018 Agenda Outpatient Antibiotic Use Summary Measuring Antibiotic
More informationNursing Home Online Training Sessions Session 2: Exploring Antibiotics and Their Role in Fighting Bacterial Infections
National Nursing Home Quality Care Collaborative Nursing Home Online Training Sessions Session 2: Exploring Antibiotics and Their Role in Fighting Bacterial Infections Health Services Advisory Group (HSAG)
More informationAntimicrobial Stewardship
Antimicrobial Stewardship Background Why Antimicrobial Stewardship 30-50% of antibiotic use in hospitals are unnecessary or inappropriate Appropriate antimicrobial use is a medication-safety and patient-safety
More information6/15/2017 PART 1: THE PROBLEM. Objectives. What is Antimicrobial Resistance? Conflicts of Interest Disclosure Statement
Conflicts of Interest Disclosure Statement Getting a grasp on Antibiotic Use and Resistance: Principles of Antimicrobial Stewardship Speaker has nothing to disclose. Jacob M Kesner, PharmD UNMH PGY-2 Infectious
More informationOutpatient Antimicrobial Stewardship. Jeffrey S Gerber, MD, PhD Division of Infectious Diseases The Children s Hospital of Philadelphia
Outpatient Antimicrobial Stewardship Jeffrey S Gerber, MD, PhD Division of Infectious Diseases The Children s Hospital of Philadelphia Overview The case for outpatient antimicrobial stewardship Interventions
More informationAntibiotics in the trenches: An ER Doc s Perspective
Antibiotics in the trenches: An ER Doc s Perspective Peter Currie, MD Medical Director for Quality Emergency Physicians Professional Association (EPPA) Agenda Emergency Medicine Specific Disease Processes
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 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 informationWENDY WILLIAMS, MT(AMT) MSAH DIRECTOR LABORATORY AND PATHOLOGY SERVICES. Appalachian Regional Healthcare System apprhs.org
Incorporating Automation and Rapid Diagnostic Technologies into the Micro Lab's Lean Workflow to Boost Productivity, Shorten Length of Stay, and Improve Antibiotic Utilization WENDY WILLIAMS, MT(AMT) MSAH
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 informationCommonwealth of Kentucky Antibiotic Stewardship Practice Assessment For Long-Term Care Facilities
Commonwealth of Kentucky Antibiotic Stewardship Practice Assessment For Long-Term Care Facilities Introduction As the problem of antibiotic resistance continues to worsen in all healthcare setting, we
More informationPresenter: Marc Meyer, BPharm, RPh, CIC, FAPIC Clinical Pharmacists, Infection Preventionist, Antibiotic Stewardship Pharmacist Southwest Health
Presenter: Marc Meyer, BPharm, RPh, CIC, FAPIC Clinical Pharmacists, Infection Preventionist, Antibiotic Stewardship Pharmacist Southwest Health System, Cortez, Colorado None How do AU vendors and NHSN
More informationIt s Time to Regulate Antimicrobial Stewardship Standards in Acute Care Settings. Emily Heil, PharmD, BCPS-AQ ID, AAHIVP
It s Time to Regulate Antimicrobial Stewardship Standards in Acute Care Settings Emily Heil, PharmD, BCPS-AQ ID, AAHIVP Conflict of Interest I have no conflicts of interest to disclose related to the content
More informationAn Approach to Appropriate Antibiotic Prescribing in Outpatient and LTC Settings?
An Approach to Appropriate Antibiotic Prescribing in Outpatient and LTC Settings? Dr. Andrew Morris Antimicrobial Stewardship ProgramMt. Sinai Hospital University Health Network amorris@mtsinai.on.ca andrew.morris@uhn.ca
More informationAntibiotic Resistance in the Post-Acute and Long-Term Care Settings: Strategies for Stewardship
Antibiotic Resistance in the Post-Acute and Long-Term Care Settings: Strategies for Stewardship J. Hudson Garrett Jr., PhD, MSN, MPH, FNP-BC, PLNC, CDONA, IP-BC, GDCN, CDP, CADDCT, CALN, VA-BC, AS-BC,
More informationANTIMICROBIAL STEWARDSHIP: THE ROLE OF THE CLINICIAN SAM GUREVITZ PHARM D, CGP BUTLER UNIVERSITY COLLEGE OF PHARMACY AND HEALTH SCIENCES
ANTIMICROBIAL STEWARDSHIP: THE ROLE OF THE CLINICIAN SAM GUREVITZ PHARM D, CGP BUTLER UNIVERSITY COLLEGE OF PHARMACY AND HEALTH SCIENCES 1 Crisis: Antibiotic Resistance Success Strategy 2 OBJECTIVES Discuss
More informationDefine evidence based practices for selection and duration of antibiotics to treat suspected or confirmed neonatal sepsis
GLOBAL AIM: Antibiotic Stewardship Perinatal Quality Improvement Teams (PQITs) will share strategies and lessons learned to develop potentially better practices and employ QI methodologies to establish
More informationObjective 1/20/2016. Expanding Antimicrobial Stewardship into the Outpatient Setting. Disclosure Statement of Financial Interest
Expanding Antimicrobial Stewardship into the Outpatient Setting Michael E. Klepser, Pharm.D., FCCP Professor Pharmacy Practice Ferris State University College of Pharmacy Disclosure Statement of Financial
More informationCommunity-Associated C. difficile Infection: Think Outside the Hospital. Maria Bye, MPH Epidemiologist May 1, 2018
Community-Associated C. difficile Infection: Think Outside the Hospital Maria Bye, MPH Epidemiologist Maria.Bye@state.mn.us 651-201-4085 May 1, 2018 Clostridium difficile Clostridium difficile Clostridium
More informationInterdisciplinary Communication in Antimicrobial Stewardship. Jennifer Liao, PharmD September 29, 2017 Patient Safety Academy
Interdisciplinary Communication in Antimicrobial Stewardship Jennifer Liao, PharmD September 29, 2017 Patient Safety Academy Objectives 1. Define antimicrobial stewardship (AMS) teams across various settings
More informationPreventing and Responding to Antibiotic Resistant Infections in New Hampshire
Preventing and Responding to Antibiotic Resistant Infections in New Hampshire Benjamin P. Chan, MD, MPH NH Dept. of Health & Human Services Division of Public Health Services May 23, 2017 To bring a greater
More informationPharmacist Coordinated Antimicrobial Therapy: OPAT and Transitions of Care
Pharmacist Coordinated Antimicrobial Therapy: OPAT and Transitions of Care Jennifer McCann, PharmD, BCCCP State Director of Clinical Pharmacy Services St. Vincent Health Indiana Conflicts of Interest No
More informationAntibiotics: Take a Time Out
Antibiotics: Take a Time Out Christine LaRocca, MD Telligen April 27, 2018 This material was prepared by Telligen, the Medicare Quality Innovation Network Quality Improvement Organization, under contract
More informationMonthly Webinar. Tuesday 16th January 2018, 16:00. That Was The Year That Was : Selections from the 2017 Antimicrobial Stewardship Literature
Monthly Webinar Tuesday 16th January 2018, 16:00 That Was The Year That Was : Selections from the 2017 Antimicrobial Stewardship Literature Audio dial-in (phone): 01 526 0058 Instructions Interactive Please
More informationAntimicrobial Stewardship Program. Jason G. Newland MD, MEd Miranda Nelson, PharmD
Antimicrobial Stewardship Program Jason G. Newland MD, MEd Miranda Nelson, PharmD The Children's Mercy Hospital, 2015 Antibiotic Timeline Clatworthy 2007 Antibiotic Use in Freestanding Children s Hospitals
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 informationOutbreaks Due to Unpasteurized Dairy Products in the United States
Outbreaks Due to Unpasteurized Dairy Products in the United States Casey Barton Behravesh, DVM, DrPH, DACVPM LCDR, US Public Health Service Enteric Diseases Epidemiology Branch National Center for Zoonotic,
More informationWho is the Antimicrobial Steward?
Who is the Antimicrobial Steward? J. Njeri Wainaina, MD FACP Assistant Professor of Medicine Division of Infectious Diseases and Section of Perioperative Medicine Disclosures None 1 Objectives Highlight
More informationAntimicrobial Stewardship: Setting minimum expectations for optimizing antimicrobial use and addressing resistance
Antimicrobial Stewardship: Setting minimum expectations for optimizing antimicrobial use and addressing resistance Loria Pollack, MD, MPH Centers for Disease Control and Prevention Division of Healthcare
More informationUnderstand the application of Antibiotic Stewardship regulations in LTC. Understand past barriers to antibiotic management concepts
Objectives Understand the application of Antibiotic Stewardship regulations in LTC Understand past barriers to antibiotic management concepts Understand benefits of adoption of antibiotic stewardship regulations
More information3/1/2016. Antibiotics --When Less is More. Most Urgent Threats. Serious Threats
Antibiotics --When Less is More Ralph Gonzales, MD, MSPH Associate Dean, Clinical Innovation School of Medicine VP, Clinical Innovation, UCSF Health Most Urgent Threats Serious Threats Multidrug-Resistant
More informationEVIDENCE BASED MEDICINE: ANTIBIOTIC RESISTANCE IN THE ELDERLY CHETHANA KAMATH GERIATRIC MEDICINE WEEK
EVIDENCE BASED MEDICINE: ANTIBIOTIC RESISTANCE IN THE ELDERLY CHETHANA KAMATH GERIATRIC MEDICINE WEEK EPIDEMIOLOGY AND BACKGROUND Every year, more than 2 million people in the United States acquire antibiotic-resistant
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 informationAppropriate Antimicrobial Use in California: The Path of Least Resistance
Appropriate Antimicrobial Use in California: The Path of Least Resistance BEACON Fall Exchange November 9, 2011 Kavita K. Trivedi, MD Healthcare Associated Infections Program California Department of Public
More informationUsing Data to Track Antibiotic Use and Outcomes
Using Data to Track Antibiotic Use and Outcomes Michelle Nemec, PharmD Thrifty White Drug Pharmacy Objectives Describe the Antibiotic Stewardship Core Element of tracking and the specific interventions
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 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 informationPromoting Appropriate Antimicrobial Prescribing in Secondary Care
Promoting Appropriate Antimicrobial Prescribing in Secondary Care Stuart Brown Healthcare Acquired Infection and Antimicrobial Resistance Project Lead NHS England March 2015 Introduction Background ESPAUR
More informationDisclosures. Astellas. The Medicines Company. Theravance Biopharma
Disclosures Astellas The Medicines Company Theravance Biopharma Objectives Define antimicrobial stewardship using nationally accepted criteria Identify strategies to provide antimicrobial stewardship Review
More informationAntibiotic Stewardship in LTC What does this mean?
Antibiotic Stewardship in LTC What does this mean? Kieran Moore FCFP,FRCPC, Diane Lu CCFP KFLA Public Health Disclosure The findings and conclusions represent those of the presenter and may not necessarily
More informationThe International Collaborative Conference in Clinical Microbiology & Infectious Diseases
The International Collaborative Conference in Clinical Microbiology & Infectious Diseases PLUS: Antimicrobial stewardship in hospitals: Improving outcomes through better education and implementation of
More informationAntimicrobial Stewardship
Antimicrobial Stewardship Report: 11 th August 2016 Issue: As part of ensuring compliance with the National Safety and Quality Health Service Standards (NSQHS), Yea & District Memorial Hospital is required
More informationGET SMART Clinician-Patient Communication about Antibiotics
GET SMART Clinician-Patient Communication about Antibiotics Wednesday, May 23, 11:30 12:30 Webinar Will Begin Shortly. Slides may be downloaded at: http://www.healthcarefornewengland.org/event/getsmart_abx/
More informationMeasuring Antibiotic Use in NHSN
Measuring Antibiotic Use in NHSN Jonathan R. Edwards, MStat. Research Mathematical Statistician Division of Healthcare Quality Promotion National Center for Emerging and Zoonotic Infectious Diseases SHEA
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 informationExecutive Summary: A Point Prevalence Survey of Antimicrobial Use: Benchmarking and Patterns of Use to Support Antimicrobial Stewardship Efforts
Executive Summary: A Point Prevalence Survey of Antimicrobial Use: Benchmarking and Patterns of Use to Support Antimicrobial Stewardship Efforts Investigational Team: Diane Brideau-Laughlin BSc(Pharm),
More informationAntimicrobial Stewardship: Stopping the Spread of Antibiotic Resistance
Antimicrobial Stewardship: Stopping the Spread of Antibiotic Resistance Natalie Weber, PharmD PGY2 Critical Care Pharmacy Resident September 22, 2016 The speaker has no actual or potential conflicts of
More informationIMPLEMENTATION AND ASSESSMENT OF A GUIDELINE-BASED TREATMENT ALGORITHM FOR COMMUNITY-ACQUIRED PNEUMONIA (CAP)
IMPLEMENTATION AND ASSESSMENT OF A GUIDELINE-BASED TREATMENT ALGORITHM FOR COMMUNITY-ACQUIRED PNEUMONIA (CAP) Lucas Schonsberg, PharmD PGY-1 Pharmacy Practice Resident Providence St. Patrick Hospital Missoula,
More informationNHSN 2015 Rebaseline and TDH Updates. Ashley Fell, MPH
NHSN 2015 Rebaseline and TDH Updates Ashley Fell, MPH Standardized Infection Ratio (SIR) SIR = Observed O HAIs Predicted P HAIs 2 National Baseline Years 2015 (New) NHSN Baseline All HAI Types: CLABSI,
More informationANTIMICROBIAL STEWARDSHIP FOR AMBULATORY CARE SETTINGS
ANTIMICROBIAL STEWARDSHIP FOR AMBULATORY CARE SETTINGS Jeffrey S Gerber, MD, PhD Children s Hospital of Philadelphia University of Pennsylvania School of Medicine DISCLOSURE STATEMENT I have no conflicts
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 informationAntibiotic Stewardship Beyond Hospital Walls
Antibiotic Stewardship Beyond Hospital Walls Katie Burenheide Foster, PharmD, MS, BCPS, FCCM Pharmacy Clinical Manager & PGY1 Pharmacy Residency Director OBJECTIVES 1. Review what Antibiotic Stewardship
More information