What Can ICPs do for stewardship

Size: px
Start display at page:

Download "What Can ICPs do for stewardship"

Transcription

1 What Can ICPs do for stewardship Harnessing, THE FORCE of ICPs Dr. Jennifer Grant March 4, 2016

2

3 Black hole of resistance C. difficile

4

5 How Did We Get Here?

6 How Did We Get Here? S. pneumoniae, S. aureus Penicillin

7 How Did We Get Here? Penicillin Resistant S. pneumoniae, S. aureus Cephalosporins

8 How Did We Get Here? Cef R S. pneumoniae, MRSA Vancomycin

9 How Did We Get Here? Vanco R S. pneumoniae, VRSA Daptomycin, Linezolid

10 How Did We Get Here?

11 How Did We Get Here?

12 How Did We Get Here?

13 How Did We Get Here?

14 How Did We Get Here?

15 How Did We Get Here?

16 How Did We Get Here?

17 What Can We Do????

18 Stewardship vs. Infection Control Stewardship Making the wisest antibiotic choices for current and future patients Reducing the production of resistant organisms Preventing super infections and adverse events Improving the quality of patient care Infection Control Monitoring epidemiology of infections Preventing the spread of resistant organisms Reducing adverse events related to infection Improving the quality of patient care

19 Stewardship vs. Infection Control Stewardship Making the wisest antibiotic choices for current and future patients Reducing the production of resistant organisms Preventing super infections and adverse events Improving the quality of patient care Infection Control Monitoring epidemiology of infections Preventing the spread of resistant organisms Reducing adverse events related to infection Improving the quality of patient care

20 Our Common Goals Reducing production and spread of resistance Reducing adverse events for patients Reducing nosocomial infections Improving patient care Decreasing costs Improving patient flow

21 Our Different Approaches Personal Protective Equipment Hand Hygiene Surveillance Environmental Cleaning Education

22 Our Different Approaches Guidelines and Treatment pathways Antibiotic restrictions Audit and Feedback Multi-disciplinary teamwork Education

23 What does this look like?

24 Avoid Raw Pork

25 Where We Can Intervene Decreased Selection Decreased use of selecting agents antibacterials Decreased use of Antibiotics Food Production Courses of Therapy Duration of Therapy Spectrum of therapy Responsible Drug Disposal Decreased Transmission Decreased exposure Food withdrawl times Farm environmental control Vaccinations Hand Washing Normal Hygiene Practices at home Advanced Hygiene in Health care

26 Decreased Use of Selecting Agents Antibacterial Products More toxic Select for resistance Affect environment Offer little benefit Are more expensive Are heavily advertised Falsely allay fears

27 Decreased Use of Selecting Agents Antibacterial Products More toxic Select for resistance Affect environment Offer little benefit Are more expensive Are heavily advertised Falsely allay fears

28 Where We Can Intervene Decreased Selection Decreased use of selecting agents antibacterials Decreased use of Antibiotics Food Production Courses of Therapy Duration of Therapy Spectrum of therapy Responsible Drug Disposal Decreased Transmission Decreased exposure Food withdrawl times Farm environmental control Vaccinations Hand Washing Normal Hygiene Practices at home Advanced Hygiene in Health care

29 Where We Can Intervene Decreased Selection Decreased use of selecting agents antibacterials Decreased use of Antibiotics Food Production Courses of Therapy Duration of Therapy Spectrum of therapy Responsible Drug Disposal Decreased Transmission Decreased exposure Food withdrawl times Farm environmental control Vaccinations Hand Washing Normal Hygiene Practices at home Advanced Hygiene in Health care

30 Decreased Use of Antibiotics Standards and monitoring

31

32 Decreased use of antibiotics Point Stop or significantly decrease agricultural use Decrease courses, duration or spectrum of therapy Counter-point Decreased food supply, increasing cost Increased risk for patients Easier said than done Solution: Requires change in approach including better hygiene for animals, more oversight and better follow-up and support for prescribers

33

34 Know The Latest Guidelines Prescribe the Narrowest Spectrum Drug for the Shortest period of time to treat infections Continuously re-evaluate prescriptions Make use of phone consultation and other support

35 Top 3 Conditions Not to Treat Asymptomatic Bactiuria Most commonly overtreated infection Requires symptoms and positive UA R/O everything before attributing ALC to UTI Viral Respiratory Tract Infections Includes COPD without purulence Chronic wounds No matter how icky if not cellulitis

36 Where We Can Intervene Decreased Selection Decreased use of selecting agents antibacterials Decreased use of Antibiotics Food Production Courses of Therapy Duration of Therapy Spectrum of therapy Responsible Drug Disposal Decreased Transmission Decreased exposure Food withdrawl times Farm environmental control Vaccinations Hand Washing Normal Hygiene Practices at home Advanced Hygiene in Health care

37 Where We Can Intervene Decreased Selection Decreased use of selecting agents antibacterials Decreased use of Antibiotics Food Production Courses of Therapy Duration of Therapy Spectrum of therapy Responsible Drug Disposal Decreased Transmission Decreased exposure Food withdrawl times Farm environmental control Vaccinations Hand Washing Normal Hygiene Practices at home Advanced Hygiene in Health care

38

39 Animal Husbandry

40 Farm Biosecurity

41 Where We Can Intervene Decreased Selection Decreased use of selecting agents antibacterials Decreased use of Antibiotics Food Production Courses of Therapy Duration of Therapy Spectrum of therapy Responsible Drug Disposal Decreased Transmission Decreased exposure Food withdrawl times Farm environmental control Vaccinations Hand Washing Normal Hygiene Practices at home Advanced Hygiene in Health care

42 Where We Can Intervene Decreased Selection Decreased use of selecting agents antibacterials Decreased use of Antibiotics Food Production Courses of Therapy Duration of Therapy Spectrum of therapy Responsible Drug Disposal Decreased Transmission Decreased exposure Food withdrawl times Farm environmental control Vaccinations Hand Washing Normal Hygiene Practices at home Advanced Hygiene in Health care

43 Responsible Drug Disposal

44 Where We Can Intervene Decreased Selection Decreased use of selecting agents antibacterials Decreased use of Antibiotics Food Production Courses of Therapy Duration of Therapy Spectrum of therapy Responsible Drug Disposal Decreased Transmission Decreased exposure Food withdrawl times Farm environmental control Vaccinations Hand Washing Normal Hygiene Practices at home Advanced Hygiene in Health care

45 Where We Can Intervene Decreased Selection Decreased use of selecting agents antibacterials Decreased use of Antibiotics Food Production Courses of Therapy Duration of Therapy Spectrum of therapy Responsible Drug Disposal Decreased Transmission Decreased exposure Food withdrawl times Farm environmental control Vaccinations Hand Washing Normal Hygiene Practices at home Advanced Hygiene in Health care

46 Vaccinate Eligible Patients Pneumococcus Meningococcus Influenza... Are all vaccines that can help prevent resistance

47 Where We Can Intervene Decreased Selection Decreased use of selecting agents antibacterials Decreased use of Antibiotics Food Production Courses of Therapy Duration of Therapy Spectrum of therapy Responsible Drug Disposal Decreased Transmission Decreased exposure Food withdrawl times Farm environmental control Vaccinations Hand Washing Normal Hygiene Practices at home Advanced Hygiene in Health care

48 Where We Can Intervene Decreased Selection Decreased use of selecting agents antibacterials Decreased use of Antibiotics Food Production Courses of Therapy Duration of Therapy Spectrum of therapy Responsible Drug Disposal Decreased Transmission Decreased exposure Food withdrawl times Farm environmental control Vaccinations Hand Washing Normal Hygiene Practices at home Advanced Hygiene in Health care

49 Hand Washing Nuff said

50 Where We Can Intervene Decreased Selection Decreased use of selecting agents antibacterials Decreased use of Antibiotics Food Production Courses of Therapy Duration of Therapy Spectrum of therapy Responsible Drug Disposal Decreased Transmission Decreased exposure Food withdrawl times Farm environmental control Vaccinations Hand Washing Normal Hygiene Practices at home Advanced Hygiene in Health care

51 Where We Can Intervene Decreased Selection Decreased use of selecting agents antibacterials Decreased use of Antibiotics Food Production Courses of Therapy Duration of Therapy Spectrum of therapy Responsible Drug Disposal Decreased Transmission Decreased exposure Food withdrawl times Farm environmental control Vaccinations Hand Washing Normal Hygiene Practices at home Advanced Hygiene in Health care

52 What Not to Do Scare patients Stigmatize patients Not address concerns Hospital grade cleaning PPE/precautions at home

53 What Not to Do There is no point in insisting on this: If your clients are doing this:

54 Where We Can Intervene Decreased Selection Decreased use of selecting agents antibacterials Decreased use of Antibiotics Food Production Courses of Therapy Duration of Therapy Spectrum of therapy Responsible Drug Disposal Decreased Transmission Decreased exposure Food withdrawl times Farm environmental control Vaccinations Hand Washing Normal Hygiene Practices at home Advanced Hygiene in Health care

55 Where We Can Intervene Decreased Selection Decreased use of selecting agents antibacterials Decreased use of Antibiotics Food Production Courses of Therapy Duration of Therapy Spectrum of therapy Responsible Drug Disposal Decreased Transmission Decreased exposure Food withdrawl times Farm environmental control Vaccinations Hand Washing Normal Hygiene Practices at home Advanced Hygiene in Health care

56 Advanced Hygiene Guidelines for: Office Practice Long Term Care Clinics Home Health Care

57 What Else Can You Do?: Be Active Politically Antimicrobials on farms Local initiatives to reduce antimicrobial use Teach at local schools etc. when possible Make Changes in your Life Use regular soap at home Buy antibiotic free meat Dispose of phamaceuticals responsibly

58 And remember Always Always Always COOK YOUR CHICKEN

59 The End

60 Questions? Discussion

Antimicrobial Stewardship

Antimicrobial 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 information

ANTIMICROBIAL 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 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 information

Antibiotic stewardship in long term care

Antibiotic 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 information

Antibiotic Stewardship in LTC What does this mean?

Antibiotic 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 information

Antimicrobial Stewardship

Antimicrobial Stewardship Antimicrobial Stewardship Antimicrobial Stewardship Studies have estimated that 30 50% of antibiotics prescribed in acutecare hospitals are unnecessary or inappropriate 1 Antimicrobial stewardship definition:

More information

Antimicrobial 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 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 information

The Rise of Antibiotic Resistance: Is It Too Late?

The 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 information

Antimicrobial stewardship: Quick, don t just do something! Stand there!

Antimicrobial 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 information

Halting Infections in Long Term Care

Halting 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 information

03/09/2014. Infection Prevention and Control A Foundation Course. Talk outline

03/09/2014. 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 information

Antibiotic Resistance. Antibiotic Resistance: A Growing Concern. Antibiotic resistance is not new 3/21/2011

Antibiotic 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 information

St. 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 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 information

Antibiotic Stewardship Program (ASP) CHRISTUS SETX

Antibiotic 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 information

Antimicrobial Stewardship. October 2012

Antimicrobial 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 information

Multi-Drug Resistant Organisms (MDRO)

Multi-Drug Resistant Organisms (MDRO) Multi-Drug Resistant Organisms (MDRO) 2016 What are MDROs? Multi-drug resistant organisms, or MDROs, are bacteria resistant to current antibiotic therapy and therefore difficult to treat. MDROs can cause

More information

Multidrug-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? 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 information

Safe Patient Care Keeping our Residents Safe Use Standard Precautions for ALL Residents at ALL times

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 information

Infection Control & Prevention

Infection Control & Prevention Infection Control & Prevention Objectives: Define the term multi-drug resistant organism (MDRO). Recognize risk factors for developing MDROs. Describe the clinical manifestations and medical treatment

More information

Antimicrobial Stewardship Program: Local Experience

Antimicrobial 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 information

Challenges 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. 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 information

Antimicrobial 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 Sara Nausheen, MD Kevin Kern, PharmD Antimicrobial Stewardship Programs The Same, but Different Objectives: Outline the overall function of an

More information

Antimicrobial Update. Alison MacDonald Area Antimicrobial Pharmacist NHS Highland April 2018

Antimicrobial Update. Alison MacDonald Area Antimicrobial Pharmacist NHS Highland April 2018 Antimicrobial Update Alison MacDonald Area Antimicrobial Pharmacist NHS Highland alisonc.macdonald@nhs.net April 2018 Starter Questions Setting the scene... What if antibiotics were no longer effective?

More information

PRINCIPLES OF ANTIMICROBIAL STEWARDSHIP FOR ASSISTED LIVING. Albert Riddle, MD, CMD Riddle Medical LLC

PRINCIPLES OF ANTIMICROBIAL STEWARDSHIP FOR ASSISTED LIVING. Albert Riddle, MD, CMD Riddle Medical LLC PRINCIPLES OF ANTIMICROBIAL STEWARDSHIP FOR ASSISTED LIVING Albert Riddle, MD, CMD Riddle Medical LLC 2 CASE STUDY OF A URI Infection Control Issues in Assisted Living Facilities 3 THE CASE OF FLORENCE

More information

Antimicrobial Resistance Update for Community Health Services

Antimicrobial 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 information

Appropriate 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 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 information

Commonwealth of Kentucky Antibiotic Stewardship Practice Assessment For Long-Term Care Facilities

Commonwealth 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 information

Meropenem for all? Midge Asogan ICU Fellow (also ID AT)

Meropenem for all? Midge Asogan ICU Fellow (also ID AT) Meropenem for all? Midge Asogan ICU Fellow (also ID AT) Infections Common reason for presentation to ICU Community acquired - vs nosocomial - new infection acquired within hospital environment Treatment

More information

11/22/2016. Antimicrobial Stewardship Update Disclosures. Outline. No conflicts of interest to disclose

11/22/2016. 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 information

Antimicrobial stewardship

Antimicrobial 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 information

The Three R s Rethink..Reduce..Rocephin

The Three R s Rethink..Reduce..Rocephin The Three R s Rethink..Reduce..Rocephin By: Alisa Cuff RN,BN,CIC and John Bautista B.Sc. (Chem), B.Sc.Pharm, M.Sc.Pharm IPAC National Conference 2017 Newfoundland and Labrador Regional Health Authorities

More information

9/30/2016. Dr. Janell Mayer, Pharm.D., CGP, BCPS Dr. Lindsey Votaw, Pharm.D., CGP, BCPS

9/30/2016. 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 information

Overview of C. difficile infections. Kurt B. Stevenson, MD MPH Professor Division of Infectious Diseases

Overview of C. difficile infections. Kurt B. Stevenson, MD MPH Professor Division of Infectious Diseases Overview of C. difficile infections Kurt B. Stevenson, MD MPH Professor Division of Infectious Diseases Conflicts of Interest I have no financial conflicts of interest related to this topic and presentation.

More information

Antibiotics 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 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 information

Antibiotic resistance is one of the biggest threats to global health, food security, and development today.

Antibiotic resistance is one of the biggest threats to global health, food security, and development today. Antibiotic resistance Fact sheet Updated November 2017 Key facts Antibiotic resistance is one of the biggest threats to global health, food security, and development today. Antibiotic resistance can affect

More information

Antimicrobial 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 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 information

Infection Prevention Highlights for the Medical Staff. Pamela Rohrbach MSN, RN, CIC Director of Infection Prevention

Infection Prevention Highlights for the Medical Staff. Pamela Rohrbach MSN, RN, CIC Director of Infection Prevention Highlights for the Medical Staff Pamela Rohrbach MSN, RN, CIC Director of Infection Prevention Standard Precautions every patient every time a. Hand Hygiene b. Use of Personal Protective Equipment (PPE)

More information

Understand the application of Antibiotic Stewardship regulations in LTC. Understand past barriers to antibiotic management concepts

Understand 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 information

Consequences of Antimicrobial Resistant Bacteria. Antimicrobial Resistance. Molecular Genetics of Antimicrobial Resistance. Topics to be Covered

Consequences of Antimicrobial Resistant Bacteria. Antimicrobial Resistance. Molecular Genetics of Antimicrobial Resistance. Topics to be Covered Antimicrobial Resistance Consequences of Antimicrobial Resistant Bacteria Change in the approach to the administration of empiric antimicrobial therapy Increased number of hospitalizations Increased length

More information

3/1/2016. Antibiotics --When Less is More. Most Urgent Threats. Serious Threats

3/1/2016. 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 information

Vaccination as a potential strategy to combat Antimicrobial Resistance in the elderly

Vaccination 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 information

Community-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 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 information

Antimicrobial Resistance

Antimicrobial Resistance Antimicrobial Resistance Consequences of Antimicrobial Resistant Bacteria Change in the approach to the administration of empiric antimicrobial therapy Increased number of hospitalizations Increased length

More information

Antimicrobial Resistance Acquisition of Foreign DNA

Antimicrobial Resistance Acquisition of Foreign DNA Antimicrobial Resistance Acquisition of Foreign DNA Levy, Scientific American Horizontal gene transfer is common, even between Gram positive and negative bacteria Plasmid - transfer of single or multiple

More information

8/17/2016 ABOUT US REDUCTION OF CLOSTRIDIUM DIFFICILE THROUGH THE USE OF AN ANTIMICROBIAL STEWARDSHIP PROGRAM

8/17/2016 ABOUT US REDUCTION OF CLOSTRIDIUM DIFFICILE THROUGH THE USE OF AN ANTIMICROBIAL STEWARDSHIP PROGRAM Mary Moore, MS CIC MT (ASCP) Infection Prevention Coordinator Great River Medical Center, West Burlington REDUCTION OF CLOSTRIDIUM DIFFICILE THROUGH THE USE OF AN ANTIMICROBIAL STEWARDSHIP PROGRAM ABOUT

More information

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

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 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 information

Antibiotic Stewardship at MetroWest Medical Center. Colleen Grocer, RPh, BCOP Co-Chair, Antibiotic Stewardship Committee

Antibiotic Stewardship at MetroWest Medical Center. Colleen Grocer, RPh, BCOP Co-Chair, Antibiotic Stewardship Committee Antibiotic Stewardship at MetroWest Medical Center Colleen Grocer, RPh, BCOP Co-Chair, Antibiotic Stewardship Committee Antibiotic Stewardship Committee Subcommittee of Pharmacy and Therapeutics. Also

More information

CHAPTER:1 THE RATIONAL USE OF ANTIBIOTICS. BY Mrs. K.SHAILAJA., M. PHARM., LECTURER DEPT OF PHARMACY PRACTICE, SRM COLLEGE OF PHARMACY

CHAPTER:1 THE RATIONAL USE OF ANTIBIOTICS. BY Mrs. K.SHAILAJA., M. PHARM., LECTURER DEPT OF PHARMACY PRACTICE, SRM COLLEGE OF PHARMACY CHAPTER:1 THE RATIONAL USE OF ANTIBIOTICS BY Mrs. K.SHAILAJA., M. PHARM., LECTURER DEPT OF PHARMACY PRACTICE, SRM COLLEGE OF PHARMACY Antibiotics One of the most commonly used group of drugs In USA 23

More information

GUIDELINES FOR THE MANAGEMENT OF COMMUNITY-ACQUIRED PNEUMONIA IN ADULTS

GUIDELINES 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 information

Inappropriate 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 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 information

Terry Talks Nutrition: Infectious microbes

Terry Talks Nutrition: Infectious microbes Terry Talks Nutrition: Infectious microbes Meet the Microbes Microbes = very tiny living things that can only be seen under a microscope 4 types of disease-causing microbes Bacteria Viruses Yeast (fungi)

More information

ANTIBIOTIC STEWARDSHIP

ANTIBIOTIC 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 information

An Approach to Appropriate Antibiotic Prescribing in Outpatient and LTC Settings?

An 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 information

running head: SUPERBUGS Humphreys 1

running head: SUPERBUGS Humphreys 1 running head: SUPERBUGS Humphreys 1 Superbugs GCH 360 Term Paper Assignment Kelly Humphreys April 30, 2014 SUPERBUGS Humphreys 2 Introduction The World Health Organization (WHO) recognizes antibiotic resistance

More information

Multidrug Resistant Organisms (MDROs) and Clostridium difficile (C. diff)

Multidrug Resistant Organisms (MDROs) and Clostridium difficile (C. diff) PATIENT & CAREGIVER EDUCATION Multidrug Resistant Organisms (MDROs) and Clostridium difficile (C. diff) This information explains multidrug resistant organisms (MDROs) and Clostridium difficile (C. diff),

More information

Antibiotics in the trenches: An ER Doc s Perspective

Antibiotics 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 information

Talk outline. History of resistance. The start of antibiotic resistance: Penicillin. Bacterial evolution vs mankind s ingenuity

Talk outline. History of resistance. The start of antibiotic resistance: Penicillin. Bacterial evolution vs mankind s ingenuity At UN, global leaders commit to act on antimicrobial resistance 21 September 2016 Antibiotic resistance: the need for innovative global and local policy in response to market failure. Dr. Ken Harvey MB

More information

Prudent Use of Antibiotics in Long Term Care Residents with Suspected UTI

Prudent Use of Antibiotics in Long Term Care Residents with Suspected UTI Prudent Use of Antibiotics in Long Term Care Residents with Suspected UTI Shira Doron, MD Assistant Professor of Medicine Division of Geographic Medicine and Infectious Diseases Tufts Medical Center Boston,

More information

Optimizing Antibiotic Stewardship in the ED

Optimizing Antibiotic Stewardship in the ED Optimizing Antibiotic Stewardship in the ED Michael Pulia, MD MS FAAEM FACEP Director, UW EM Antibiotic Stewardship Research Program Chair, AAEM Antimicrobial Stewardship Task Force @DrMichaelPulia Learning

More information

Florida 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 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 information

An audit of the quality of antimicrobial prescribing

An audit of the quality of antimicrobial prescribing An audit of the quality of antimicrobial prescribing Rakhee Patel, Antimicrobial Pharmacist Alison Williams, Antimicrobial Technician & Dr Armando Gonzalez-Ruiz May 2011 ICE Score 2 Introduction & Aims

More information

MID 23. Antimicrobial Resistance. Consequences of Antimicrobial Resistant Bacteria. Molecular Genetics of Antimicrobial Resistance

MID 23. Antimicrobial Resistance. Consequences of Antimicrobial Resistant Bacteria. Molecular Genetics of Antimicrobial Resistance Antimicrobial Resistance Molecular Genetics of Antimicrobial Resistance Micro evolutionary change - point mutations Beta-lactamase mutation extends spectrum of the enzyme rpob gene (RNA polymerase) mutation

More information

Antimicrobial 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 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 information

Antibiotic 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 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 information

4/3/2017 CLINICAL PEARLS: UPDATES IN THE MANAGEMENT OF NOSOCOMIAL PNEUMONIA DISCLOSURE LEARNING OBJECTIVES

4/3/2017 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 information

Objective 1/20/2016. Expanding Antimicrobial Stewardship into the Outpatient Setting. Disclosure Statement of Financial Interest

Objective 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 information

Volume 1; Number 7 November 2007

Volume 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 information

Antimicrobial resistance and the need for stewardship. Dr Nick Brown RCP Acute Medicine conference, 16 April 2018

Antimicrobial resistance and the need for stewardship. Dr Nick Brown RCP Acute Medicine conference, 16 April 2018 Antimicrobial resistance and the need for stewardship Dr Nick Brown RCP Acute Medicine conference, 16 April 2018 Fleming s laboratory, St Mary s Hospital, London (Photo N M Brown ) It is not difficult

More information

Executive 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 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 information

MRSA Outbreak in Firefighters

MRSA Outbreak in Firefighters MRSA Outbreak in Firefighters Angie Carranza Munger, MD Resident, Occupational and Environmental Medicine The University of Colorado, Denver and National Jewish Health Candidate, Masters of Public Health

More information

Antibiotic Stewardship in the Hospital Setting

Antibiotic 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 information

What can we learn from point prevalence surveys? Mark Gilchrist Consultant Pharmacist Infectious Diseases

What can we learn from point prevalence surveys? Mark Gilchrist Consultant Pharmacist Infectious Diseases What can we learn from point prevalence surveys? Mark Gilchrist Consultant Pharmacist Infectious Diseases Imperial College Healthcare NHS Trust mark.gilchrist@imperial.nhs.uk Outline Placing point prevalence

More information

Healthcare Facilities and Healthcare Professionals. Public

Healthcare Facilities and Healthcare Professionals. Public Document Title: DOH Guidelines for Antimicrobial Stewardship Programs Document Ref. Number: DOH/ASP/GL/1.0 Version: 1.0 Approval Date: 13/12/2017 Effective Date: 14/12/2017 Document Owner: Applies to:

More information

Misericordia Community Hospital (MCH) Antimicrobial Stewardship Report. July December 2013 Second and Third Quarters 2014

Misericordia 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 information

Recommendations 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 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 information

Collecting and Interpreting Stewardship Data: Breakout Session

Collecting 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 information

Antibiotic resistance: the rise of the superbugs

Antibiotic resistance: the rise of the superbugs Antibiotic resistance: the rise of the superbugs Allen Cheng Associate Professor of Infectious Diseases Epidemiology, Alfred Health; Monash University About me Specialist in infectious diseases Head, Infection

More information

Grey Nuns Community Hospital (GNCH) Antimicrobial Stewardship July December 2017

Grey Nuns Community Hospital (GNCH) Antimicrobial Stewardship July December 2017 Grey Nuns Community Hospital (GNCH) Antimicrobial Stewardship July December 217 Table of Contents Table of Contents... 2 I. Executive Summary... 3 II. GNCH Total Antimicrobial Utilization... 4 III. GNCH

More information

EVIDENCE 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 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 information

Dr 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 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 information

Antibiotic 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 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 information

American Association of Feline Practitioners American Animal Hospital Association

American Association of Feline Practitioners American Animal Hospital Association American Association of Feline Practitioners American Animal Hospital Association Basic Guidelines of Judicious Therapeutic Use of Antimicrobials August 1, 2006 Introduction The Basic Guidelines to Judicious

More information

What bugs are keeping YOU up at night?

What bugs are keeping YOU up at night? What bugs are keeping YOU up at night? Barbara DeBaun, RN, MSN, CIC 26 th Annual Medical Surgical Nursing Conference South San Francisco, CA April 15, 2016 Objectives Describe the top three infectious

More information

Does Screening for MRSA Colonization Have A Role In Healthcare-Associated Infection Prevention Programs?

Does Screening for MRSA Colonization Have A Role In Healthcare-Associated Infection Prevention Programs? Does Screening for MRSA Colonization Have A Role In Healthcare-Associated Infection Prevention Programs? John A. Jernigan, MD, MS Division of Healthcare Quality Promotion Centers for Disease Control and

More information

It 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 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 information

How is Ireland performing on antibiotic prescribing?

How 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 information

CLINICAL AUDIT. Prescribing amoxicillin clavulanate appropriately

CLINICAL AUDIT. Prescribing amoxicillin clavulanate appropriately CLINICAL AUDIT Prescribing amoxicillin clavulanate appropriately Valid to September 2018 bpac nz better medicin e Background Amoxicillin clavulanate is a broad spectrum antibiotic used in primary care

More information

Introduction. Antimicrobial Usage ESPAUR 2014 Previous data validation Quality Premiums Draft tool CDDFT Experience.

Introduction. Antimicrobial Usage ESPAUR 2014 Previous data validation Quality Premiums Draft tool CDDFT Experience. Secondary Care Data Validation: What do commissioners need to know? Stuart Brown Healthcare Acquired Infection and Antimicrobial Resistance Project Lead NHS England March 2014 Introduction Antimicrobial

More information

Hand washing/hand hygiene reduces the number of microorganisms on the hands and is the most important practice to prevent the spread of infection.

Hand washing/hand hygiene reduces the number of microorganisms on the hands and is the most important practice to prevent the spread of infection. 1. Hand Hygiene Quick Reference Chart Hand washing/hand hygiene reduces the number of microorganisms on the hands and is the most important practice to prevent the spread of infection. WHEN Before: Direct

More information

Healthcare-associated infections surveillance report

Healthcare-associated infections surveillance report Healthcare-associated infections surveillance report Methicillin-resistant Staphylococcus aureus (MRSA) Update, Q3 of 2017/18 Summary Table Q3 2017/18 Previous quarter (Q2 2017/18) Same quarter of previous

More information

Preventing Multi-Drug Resistant Organism (MDRO) Infections. For National Patient Safety Goal

Preventing 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 information

Impact of Antimicrobial Stewardship Program

Impact of Antimicrobial Stewardship Program Impact of Antimicrobial Stewardship Program Ripal Joshi, Pharm.D. AAHIVP Tampa General Hospital January 28, 2016 Objectives Provide an overview on antimicrobial stewardship programs (ASP) Describe the

More information

Summary of the latest data on antibiotic resistance in the European Union

Summary 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 information

Optimizing Antimicrobial Stewardship Activities Based on Institutional Resources

Optimizing 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 information

Grey Nuns Community Hospital (GNCH) Antimicrobial Stewardship Report

Grey 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 information

Antimicrobial Resistance Prevention (Action Package: Prevent-1) Putting AMR on the priority list: Sweden Dr. Nils Anders Tegnell, Director, The

Antimicrobial Resistance Prevention (Action Package: Prevent-1) Putting AMR on the priority list: Sweden Dr. Nils Anders Tegnell, Director, The Antimicrobial Resistance Prevention (Action Package: Prevent-1) Putting AMR on the priority list: Sweden Dr Nils Anders Tegnell, Director, The Public Health Agency of Sweden The Global Challenge Antibiotics

More information

18/08/2016. Safe Patient Care. Keeping our Residents Safe. Background. Infection Prevention and Control developing over the last 40 years

18/08/2016. Safe Patient Care. Keeping our Residents Safe. Background. Infection Prevention and Control developing over the last 40 years Safe Patient Care Keeping our Residents Safe 2016 Keeping our Residents Safe Infection Prevention and Control developing over the last 40 years Basic principles well established Background 1873: [Nursing

More information

Reducing nosocomial infections and improving rational use of antibiotics in children in Indonesia

Reducing nosocomial infections and improving rational use of antibiotics in children in Indonesia Yemeni International Congress on Infectious Disease (YICID), 2014 Reducing nosocomial infections and improving rational use of antibiotics in children in Indonesia Background and rationale Study of a multifaceted

More information

LIVING IN A POST-ANTIBIOTIC ERA: the impact on public health

LIVING IN A POST-ANTIBIOTIC ERA: the impact on public health LIVING IN A POST-ANTIBIOTIC ERA: the impact on public health WELCOME This booklet was created by the Biochemical Society and the Society for General Microbiology as part of a series of public debates around

More information

Dr Steve Holden Consultant Microbiologist Nottingham University Hospitals NHS Trust

Dr 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 information

MEASURING ANTIBIOTIC USE IN LTCFS

MEASURING ANTIBIOTIC USE IN LTCFS MEASURING ANTIBIOTIC USE IN LTCFS ELIZABETH DODDS ASHLEY, PHARMD, MHS LIAISON CLINICAL PHARMACIST dason.medicine.duke.edu Sources for Antibiotic Data in Nursing Homes Purchasing data -Can be difficult

More information