Article
Immunology
Rebekah W. Moehring, Elizabeth S. Dodds Ashley, Angelina E. Davis, April Pridgen Dyer, Alice Parish, Xinru Ren, Yuliya Lokhnygina, Lauri A. Hicks, Arjun Srinivasan, Deverick J. Anderson
Summary: An electronic definition of antibiotic de-escalation was derived and applied in a retrospective study among 5 hospitals, showing variation in de-escalation rates among hospitals, units, and diagnoses. Critical care units exhibited higher rates of both de-escalation and escalation compared to general wards. This electronic metric may be useful for assessing stewardship opportunities and impact.
CLINICAL INFECTIOUS DISEASES
(2021)
Article
Immunology
Rebekah W. Moehring, Michael E. Yarrington, Bobby G. Warren, Yuliya Lokhnygina, Erica Atkinson, Allison Bankston, Julia Collucio, Michael Z. David, Angelina E. Davis, Janice Davis, Brandon Dionne, April P. Dyer, Travis M. Jones, Michael Klompas, David W. Kubiak, John Marsalis, Jacqueline Omorogbe, Patricia Orajaka, Alice Parish, Todd Parker, Jeffrey C. Pearson, Tonya Pearson, Christina Sarubbi, Christian Shaw, Justin Spivey, Robert Wolf, Rebekah H. Wrenn, Elizabeth S. Dodds Ashley, Deverick J. Anderson
Summary: This randomized trial evaluated the effect of an opt-out intervention on suspected sepsis in hospitalized adults. The intervention led to a decrease in unnecessary antibiotic use and showed similar outcomes in terms of antibiotic treatment days for patients who continued antibiotic therapy. No evidence of harm was found.
CLINICAL INFECTIOUS DISEASES
(2023)
Article
Medicine, General & Internal
Silvia Corcione, Simone Mornese Pinna, Tommaso Lupia, Alice Trentalange, Erika Germano, Rossana Cavallo, Enrico Lupia, Francesco Giuseppe De Rosa
Summary: The study found that antimicrobial de-escalation in emergency medicine wards is safe and effective in reducing in-hospital mortality rates. Appropriate initial treatment regimens and ADE strategies were associated with reduced risk of mortality in patients.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Immunology
Adam L. Hersh, Laura M. King, Daniel J. Shapiro, Lauri A. Hicks, Katherine E. Fleming-Dutra
Summary: The percentage of unnecessary antibiotic prescriptions in US physician offices and emergency departments decreased slightly from 30% in 2010-2011 to 28% in 2014-2015. However, there was a greater decrease in children from 32% to 19%, while unnecessary prescribing in adults remained unchanged.
CLINICAL INFECTIOUS DISEASES
(2021)
Article
Immunology
Anke Verlinden, Hilde Jansens, Herman Goossens, Sebastien Anguille, Zwi N. Berneman, Wilfried A. Schroyens, Alain P. Gadisseur
Summary: The implementation of antibiotic de-escalation and discontinuation based on the ECIL-4 recommendations in high-risk hematological patients was found to be safe and effective. There was no increase in infectious complications, and total antibiotic exposure was significantly reduced.
OPEN FORUM INFECTIOUS DISEASES
(2022)
Article
Infectious Diseases
Aditi M. Panditrao, Nusrat Shafiq, Suparna Chatterjee, Ashish Pathak, Niyati Trivedi, Balakrishnan Sadasivam, Nilima Kshirsagar, Rajni Kaul, Manisha Biswal, Ashish Kakkar, Samir Malhotra, Pankaj Arora, Shweta Talati, Navneet Dhaliwal, Avijit Hazra, Ratinder Jhaj, Ahmad Najmi, Navin Pandey, Raja Chakraverty, Saman Pathan, Janki Chauhan, Aditya Mathur
Summary: This multicentre inpatient point prevalence survey conducted in India revealed a high usage of antimicrobials, especially in resource-poor settings, with targets identified for improving surgical prophylaxis and reducing unnecessary antibiotic use.
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
(2021)
Article
Immunology
Lauren Dutcher, Kathleen Degnan, Afia B. Adu-Gyamfi, Ebbing Lautenbach, Leigh Cressman, Michael Z. David, Valerie Cluzet, Julia E. Szymczak, David A. Pegues, Warren Bilker, Pam Tolomeo, Keith W. Hamilton
Summary: A provider-targeted intervention implemented in primary care practices can effectively reduce antibiotic prescribing for respiratory tract infections without affecting prescribing for infections that likely require antibiotics.
CLINICAL INFECTIOUS DISEASES
(2022)
Article
Immunology
Jessica L. Seidelman, Nicholas A. Turner, Rebekah H. Wrenn, Christina Sarubbi, Deverick J. Anderson, Daniel J. Sexton, Rebekah W. Moehring
Summary: Weekly multidisciplinary antibiotic stewardship rounds in the intensive care units were associated with a small reduction in antibiotic use, with differential effects observed among specialty units. Customizing antibiotic stewardship rounds to match unit-specific population, workflow, and culture is important for maximizing effectiveness.
CLINICAL INFECTIOUS DISEASES
(2022)
Article
Infectious Diseases
Peter Mallett, Danielle McMichael, Yingfen Hsia, Paul Moriarty
Summary: This study described the trends of antimicrobial consumption in paediatric and neonatal inpatient care in Northern Ireland between September 2015 and September 2020. The research created a baseline dataset for paediatric and neonatal units and found that paediatric consumption accounted for approximately 10% of total antimicrobial consumption in hospital care. Variation in consumption rates between units and an increasing proportion of Watch and Reserve antibiotic consumption in some areas were observed.
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
(2022)
Article
Infectious Diseases
Tim Catton, Helen Umpleby, Ahilanandan Dushianthan, Kordo Saeed
Summary: This survey aimed to assess the availability of microbiology, infection, AMS services, and antimicrobial prescribing practices in the UK ICUs. The results showed variations in infection rounds, antibiotic guidance, biomarker availability, duration of antibiotic prescriptions, electronic prescription system, and local antibiotic surveillance data among the ICUs. The survey highlights the importance of collaboration and sharing of experiences to support the safe use of antimicrobials in the ICU.
Article
Public, Environmental & Occupational Health
Anna Olczak-Pienkowska, Waleria Hryniewicz
Summary: This study analyzed the regional antibiotic consumption in primary care in Poland from 2013 to 2017, and found strong correlations with factors such as employment, population mobility, number of outpatient consultations, and number of dentists. Identified risk factors for increased antibiotic consumption should be targeted for interventions promoting rational antibiotic policies.
FRONTIERS IN PUBLIC HEALTH
(2021)
Article
Immunology
Rebekah W. Moehring, Michael E. Yarrington, Angelina E. Davis, April P. Dyer, Melissa D. Johnson, Travis M. Jones, S. Shaefer Spires, Deverick J. Anderson, Daniel J. Sexton, Elizabeth S. Dodds Ashley
Summary: The study established a collaborative, consultative network to support hospital Antimicrobial Stewardship Programs (ASP). Results showed that participating hospitals increased ASP activities over 42 months, leading to a decline in antimicrobial use. There was significant variation in antimicrobial use among different hospitals.
CLINICAL INFECTIOUS DISEASES
(2021)
Article
Medicine, General & Internal
Sarah Walker, Benedict Steffens, David Sander, Wolfgang A. Wetsch
Summary: This study aimed to evaluate the quality parameters of blood culture diagnostics in a surgical intensive care unit and optimize the diagnostic process by implementing a diagnostic stewardship bundle. After implementation, the number of culture sets and venipunctures per diagnostic episode significantly increased, while the positivity and contamination rates slightly decreased. Further measures are needed to reduce contamination rates and optimize bottle filling.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Immunology
Abhishek Deshpande, Sandra S. Richter, Sarah Haessler, Peter K. Lindenauer, Pei-Chun Yu, Marya D. Zilberberg, Peter B. Imrey, Thomas Higgins, Michael B. Rothberg
Summary: The study evaluated the practices of antibiotic de-escalation and its association with outcomes in patients hospitalized with pneumonia, finding that only a minority of eligible patients had antibiotics de-escalated by day 4 after negative cultures, with wide variation in de-escalation rates between hospitals. Substantial changes in practice are needed to adhere to guidelines.
CLINICAL INFECTIOUS DISEASES
(2021)
Article
Immunology
Sara Y. Tartof, Lie Hong Chen, Yun Tian, Rong Wei, Theresa Im, Kalvin Yu, Gunter Rieg, Zoe Bider-Canfield, Frances Wong, Harpreet S. Takhar, Lei Qian
Summary: This retrospective cohort study examined the impact of an antibiotic stewardship program (ASP) on antibiotic usage and infection rates of drug-resistant organisms in a healthcare setting. Results showed a decrease in overall antibiotic use post-ASP implementation, but an increase in vancomycin-resistant enterococci infections. The study suggests that successful reduction in antibiotic consumption through ASPs may not necessarily lead to a decrease in antibiotic-resistant infections.
CLINICAL INFECTIOUS DISEASES
(2021)