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201. Antimicrobial Stewardship Programs in Outpatient Settings

Antimicrobial Stewardship Programs in Outpatient Settings Management Briefs eBrief-no79 -- Enter search terms Button to search HSRD ® Inside VA Budget and Performance Inside the News Room National Observances Special Events » » » » » Management Briefs eBrief-no79 -- Health Services Research & Development Management eBrief no. 79 » Issue 79 March 2014 A Systematic Review: Antimicrobial Stewardship Programs in Outpatient Settings The majority of antimicrobials prescribed to humans originate (...) in outpatient settings. In making prescribing decisions, primary care providers are faced with patient expectations, and with patient and provider lack of awareness of antimicrobial resistance and lack of understanding of the seriousness of the antimicrobial resistance problem. An antimicrobial stewardship program (ASP) is a focused effort by a healthcare system or a portion of a system (e.g., a primary care clinic, a hospital) to optimize the use of antimicrobial agents in order to improve patient outcomes

2013 Veterans Affairs - R&D

202. Systematic review: ?-blockers and antibiotics, alone or in combination, improve symptoms in men with chronic prostatitis/chronic pelvic pain syndrome

Systematic review: ?-blockers and antibiotics, alone or in combination, improve symptoms in men with chronic prostatitis/chronic pelvic pain syndrome α-blockers and antibiotics, alone or in combination, improve symptoms in men with chronic prostatitis/chronic pelvic pain syndrome | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use (...) cookies, please see our . Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here α-blockers and antibiotics, alone or in combination, improve symptoms in men with chronic prostatitis/chronic

2011 Evidence-Based Medicine

203. Systematic review: Acute otitis media: antibiotics are moderately effective and mildly increase the risk of adverse effects; prevalence of different causative bacteria changed after introduction of the heptavalent pneumococcal conjugate vaccine

Systematic review: Acute otitis media: antibiotics are moderately effective and mildly increase the risk of adverse effects; prevalence of different causative bacteria changed after introduction of the heptavalent pneumococcal conjugate vaccine Acute otitis media: antibiotics are moderately effective and mildly increase the risk of adverse effects; prevalence of different causative bacteria changed after introduction of the heptavalent pneumococcal conjugate vaccine | BMJ Evidence-Based (...) of institutional accounts Username * Password * your user name or password? You are here Acute otitis media: antibiotics are moderately effective and mildly increase the risk of adverse effects; prevalence of different causative bacteria changed after introduction of the heptavalent pneumococcal conjugate vaccine Article Text Therapeutics Systematic review Acute otitis media: antibiotics are moderately effective and mildly increase the risk of adverse effects; prevalence of different causative bacteria changed

2011 Evidence-Based Medicine

204. Timing of antibiotic administration in community-acquired pneumonia

Timing of antibiotic administration in community-acquired pneumonia BestBets: Timing of antibiotic administration in community-acquired pneumonia Timing of antibiotic administration in community-acquired pneumonia Report By: Yat Sim Jasmine Ng - Visiting Scholar Search checked by Colin Graham - Professor of Emergency Medicine Institution: Accident and Emergency Medicine Academic Unit, The Chinese University of Hong Kong Date Submitted: 13th September 2006 Date Completed: 20th January 2011 Last (...) Modified: 20th January 2011 Status: Green (complete) Three Part Question In [adult patients presenting to the hospital with suspected community-acquired pneumonia (CAP) requiring admission], does [antibiotic administration within a specific time window] [reduce patient morbidity and mortality]? Clinical Scenario A 70 year-old lady presents to the emergency department(ED) with 2 days of fever, shortness of breath, and cough productive of green sputum. CXR confirms right basal pneumonia. She requires

2011 BestBETS

205. Antibiotic use to prevent Weil's Disease after immersion in water

Antibiotic use to prevent Weil's Disease after immersion in water BestBets: Do wrist splints need to have a thumb extension when immobilising suspected scaphoid fractures? Do wrist splints need to have a thumb extension when immobilising suspected scaphoid fractures? Report By: Saif Al-Nahhas - CT3 Emergency Medicine Search checked by Jason Smith - Consultant Emergency Medicine Institution: Derriford Hospital, Plymouth Current web editor: Stewart Teece - Clinical Research Fellow Date Submitted

2011 BestBETS

206. Local antibiotic use as an adjunct to scaling and root planing for periodontitis

periodontitis but no serious comorbidities. Specialty/Discipline (Periodontics) (Dental Hygiene) Keywords periodontitis, antibiotics, antimicrobials ID# 885 Date of submission: 05/06/2011 E-mail coomes@uthscsa.edu Author Angela Coomes Co-author(s) Co-author(s) e-mail Faculty mentor/Co-author S. Thomas Deahl, II, DMD, PhD Faculty mentor/Co-author e-mail DEAHL@uthscsa.edu Basic Science Rationale (Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question (...) Local antibiotic use as an adjunct to scaling and root planing for periodontitis UTCAT885, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Local Antibiotic Use As An Adjunct To Scaling And Root Planning For Periodontitis Clinical Question In an adult patient with chronic periodontitis, is local antibiotic therapy plus scaling and root planning more effective in improving attachment than scaling and root planning alone

2011 UTHSCSA Dental School CAT Library

207. Comparison of antibacterial and toxic effects of various root canal irrigants

Comparison of antibacterial and toxic effects of various root canal irrigants UTCAT811, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Comparison of Antibacterial and Toxic Effects of Clorhexidine and Sodium Hypochlorite Root Canal Irrigants in Primary Teeth Clinical Question In a patient with primary dentition, does irrigating the root canal system with concentrated chlorhexidine provide better anti-microbial

2011 UTHSCSA Dental School CAT Library

208. Disinfection by triple antibiotic paste during regenerative endodontic treatment

Disinfection by triple antibiotic paste during regenerative endodontic treatment UTCAT827, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Disinfection By Triple Antibiotic Paste During Regenerative Endodontic Treatment Clinical Question In treating a patient with an immature permanent tooth with pulpal necrosis, will a regenerative endodontic treatment with disinfection by a triple antibiotic paste compared (...) with calcium hydroxide paste, or formocresol paste produce better results in root development? Clinical Bottom Line Treating the root canal with a triple antibiotic paste produces better results in root development than calcium hydroxide or formocresol treatment. (See Comments on the CAT below) Best Evidence (you may view more info by clicking on the PubMed ID link) PubMed ID Author / Year Patient Group Study type (level of evidence) #1) Bose/2009 48 cases of regenerative endo and a control of 40 Case

2011 UTHSCSA Dental School CAT Library

209. Antibiotics (Prophylactic) for ICU Respiratory Infections

Antibiotics (Prophylactic) for ICU Respiratory Infections Antibiotics (Prophylactic) for ICU Respiratory Infections – TheNNTTheNNT Prophylactic Antibiotics for Reducing ICU Respiratory Tract Infections and Mortality in Adults 18 for mortality In Summary, for those who received both topical and systemic antibiotics: Benefits in NNT 75% saw no benefit 6% were helped by being saved from death 25% were helped by preventing one respiratory tract infection 1 in 18 were helped (life saved) 1 in 4 were (...) . The administration of prophylactic antibiotics has been proposed as a treatment regimen to help prevent such infections. This Cochrane Review includes 36 trials (n = 6914) that occurred in the ICU setting. These studies examined the use of prophylactic antibiotics, administered systemically, topically or in combination. One study of 934 patients (de Jonge et al. 2003) also looked for the emergence of any antibiotic resistant microorganisms that may have occurred during the 2-year trial period. Administration

2011 theNNT

210. Antibiotics for Open Fractures

advocating the use of early antibiotics in open finger fractures. Furthermore, the issues of antibiotic side effects and of developing antimicrobial resistance in this patient population have not been examined. In summary, while this evidence does not represent a robust or valid enough dataset to suggest a ‘standard of care’ it is reasonable to utilize antibiotic treatment for open fractures until additional data better elucidate both the benefits and harms associated with this approach. Author: Dan (...) Antibiotics for Open Fractures Antibiotics for Open Fractures – TheNNTTheNNT Early Antibiotic Use in Open Fractures 16 for infection In Summary, for those who received the antibiotics: Benefits in NNT 93.5% saw no benefit 6.5% were helped by avoiding an early infection of the fracture site 1 in 16 were helped (avoided early fracture site infection) Harms in NNT An unknown % were harmed by medication side effects/adverse reaction An unknown number were harmed (medication side effects/adverse

2011 theNNT

211. Antibiotics for Cirrhotics with Upper GI Bleeds

Antibiotics for Cirrhotics with Upper GI Bleeds Antibiotics for Cirrhotics with Upper GI Bleeds – TheNNTTheNNT Prophylactic Antibiotics for Cirrhotics with Upper GI Bleed 22 for mortality In Summary, for those who received the antibiotics: Benefits in NNT 77% saw no benefit 4.7% were helped by preventing death 23% were helped by preventing infection 1 in 22 were helped (life saved) 1 in 4 were helped (infection prevented) Harms in NNT An unknown number were harmed by medication effects (...) contributor to this mortality. Patients with cirrhosis are also known to have impaired immune function and increased translocation of bacteria from the gut into the bloodstream, thus the administration of prophylactic antibiotics during the bleeding event has been proposed as a treatment to help prevent such infections. This Cochrane Review includes 12 trials (n = 1241) involving cirrhotic patients with upper GI bleeding. Of the 12 included trials, only 1 was placebo controlled, the other 11 examined

2011 theNNT

212. Antibiotics for Animal Bites

Antibiotics for Animal Bites Antibiotics for Animal Bites – TheNNTTheNNT Antibiotics for Prophylaxis of Animal Bites No benefit found In Summary, for those who took the antibiotics: Benefits in NNT 100% saw no benefit 0% were helped by avoiding infection None were helped (infection prevented) Harms in NNT An unknown number were harmed by medication effects An unknown number were harmed (medication effects) View As: NNT % Source: Efficacy Endpoints: Proven bacterial infection plus positive (...) microbiological cultures Harm Endpoints: Not reported Narrative: Mammals are known to harbor a variety of bacterial species in their oral cavities, and infections in mammalian bite wounds are both potentially aggressive and common. This raises an important question: can antibiotics, when given following a bite but before signs of infection, prevent skin and soft tissue infections? This systematic review included eight randomized trials (total n = 522) six of which (n = 463) enrolled only subjects with dog

2011 theNNT

213. The Role of Prophylactic Antibiotics in Compound Fractures of the Distal Phalanges of the Hand

The Role of Prophylactic Antibiotics in Compound Fractures of the Distal Phalanges of the Hand BestBets: The Role of Prophylactic Antibiotics in Compound Fractures of the Distal Phalanges of the Hand The Role of Prophylactic Antibiotics in Compound Fractures of the Distal Phalanges of the Hand Report By: Dr. Andrew Wilkinson - (FTSTA ACCS Year 2) Search checked by Dr. Richard Parris - Consultant in Emergency Medicine Institution: Royal Bolton Hospital, Bolton, UK Date Submitted: 15th September (...) 2006 Date Completed: 3rd May 2011 Last Modified: 3rd June 2011 Status: Green (complete) Three Part Question In [patients with compound fractures of the distal phalanges] are [antibiotics] required to [prevent osteomyelitis]. Clinical Scenario A patient presents with a fingertip injury that includes a laceration to the nail bed. The X-ray demonstrates a fracture of the distal phalanx. Should the patient receive antibiotics to prevent osteomyelitis, after appropriate wound toilet and closure? Search

2011 BestBETS

214. Cry wolf! The new fable of bad use of antimicrobials and the return of the pre-antibiotic era?

Cry wolf! The new fable of bad use of antimicrobials and the return of the pre-antibiotic era? Volumen 18. DTB Navarre. Vol 18, No 2. March - April 2010 - navarra.es Castellano | Euskara | Français | English Use the search tool! Search engine : : : : : : DTB Navarre. Vol 18, No 2. March - April 2010 DTB Navarre. Vol 18, No 2. March - April 2010 Content tools Share it Cry wolf! The new fable of bad use of antimicrobials and the return of the pre-antibiotic era? There is considerable evidence (...) that shows a correlation between the use of antimicrobial therapy and the increase in the prevalence of resistant microorganisms. The global rates in the use of antibiotics in Navarre are similar to the average rate in European countries, but there are great differences between different primary care doctors. Possible improvements in antibiotic prescribing include the use of rapid diagnostic tests for bacterial pharyngitis or tonsillitis, delayed use of antibiotics in case of acute otitis media, no use

2010 Drug and Therapeutics Bulletin of Navarre (Spain)

215. Limited evidence for efficacy of antibiotics for Shigella dysentery

Limited evidence for efficacy of antibiotics for Shigella dysentery PEARLS Practical Evidence About Real Life Situations PEARLS are succinct summaries of Cochrane Systematic Reviews for primary care practitioners. They Limited evidence for efficacy of antibiotics for Shigella dysentery Clinical question How effective are antibiotics for treating Shigella dysentery? Bottom line There was limited evidence that antibiotics reduce the duration of diarrhoea and the duration of fever compared (...) to no antibiotic. There was inadequate evidence regarding the role of antibiotics in preventing relapses. There were no serious adverse events reported for any of the 13 antibiotics studied. The choice of antibiotic to use as first line against Shigella dysentery should be governed by periodically updated local antibiotic sensitivity patterns of Shigella isolates. Other supportive and preventive measures recommended by the WHO should also be instituted along with antibiotics (eg, health education and hand

2011 Cochrane PEARLS

216. Prophylactic antibiotics effective for women undergoing caesarean section

of endometritis following both elective and nonelective caesarean section by two-thirds to three-quarters and the incidence of wound infection by up to three-quarters. Postpartum febrile morbidity and the incidence of urinary tract infections were also decreased. Fewer serious complications were identified. The administration of prophylactic antibiotics before or after clamping of the cord seemed equally effective for women undergoing caesarean section. The antimicrobial agents most often used in the trials (...) Prophylactic antibiotics effective for women undergoing caesarean section PEARLS Practical Evidence About Real Life Situations PEARLS are succinct summaries of Cochrane Systematic Reviews for primary care practitioners. They Prophylactic antibiotics effective for women undergoing caesarean section Clinical question How effective are prophylactic antibiotics for women undergoing caesarean section? Bottom line Compared with no treatment, prophylactic antibiotics reduced the incidence

2011 Cochrane PEARLS

217. Small beneficial effects from antibiotic treatment of acute maxillary sinusitis.

Small beneficial effects from antibiotic treatment of acute maxillary sinusitis. Small beneficial effects from antibiotic treatment of acute maxillary sinusitis. ADA Websites Access news, member benefits and ADA policy Attend ADA's premier event Access cutting-edge continuing education courses Find evidence to support your clinical decisions Access member-only practice content Investing in better oral health for all. Together. Take advantage of endorsed, discounted business products Purchase (...) ADA products Access oral-health information for the public and ADA Find-A-Dentist Partnerships and Commissions Learn about ADA CERP recognition, look up CERP recognized CE providers and find CE courses. Explore CODA's role and find accredited schools and programs Learn about the examinations used in licensing dentists and dental hygienists Learn about recognized dental specialties and certifying boards Evidence Education * Associated Topics Small beneficial effects from antibiotic treatment

2010 ADA Center for Evidence-Based Dentistry

218. Prescription of antibiotics for prophylaxis to prevent bacterial endocarditis

Prescription of antibiotics for prophylaxis to prevent bacterial endocarditis Prescription of antibiotics for prophylaxis to prevent bacterial endocarditis ADA Websites Access news, member benefits and ADA policy Attend ADA's premier event Access cutting-edge continuing education courses Find evidence to support your clinical decisions Access member-only practice content Investing in better oral health for all. Together. Take advantage of endorsed, discounted business products Purchase ADA (...) products Access oral-health information for the public and ADA Find-A-Dentist Partnerships and Commissions Learn about ADA CERP recognition, look up CERP recognized CE providers and find CE courses. Explore CODA's role and find accredited schools and programs Learn about the examinations used in licensing dentists and dental hygienists Learn about recognized dental specialties and certifying boards Evidence Education * Associated Topics Prescription of antibiotics for prophylaxis to prevent bacterial

2010 ADA Center for Evidence-Based Dentistry

219. Inconclusive evidence for the association between systemic antibiotics and periodontal healing of replanted avulsed teeth

Inconclusive evidence for the association between systemic antibiotics and periodontal healing of replanted avulsed teeth Inconclusive evidence for the association between systemic antibiotics and periodontal healing of replanted avulsed teeth ADA Websites Access news, member benefits and ADA policy Attend ADA's premier event Access cutting-edge continuing education courses Find evidence to support your clinical decisions Access member-only practice content Investing in better oral health (...) Education * Associated Topics Inconclusive evidence for the association between systemic antibiotics and periodontal healing of replanted avulsed teeth Donald L. Chi D.D.S., PhD . Overview Systematic Review Conclusion There was limited evidence to demonstrate the healing benefits associated with systemic antibiotics for replanted avulsed teeth. Critical Summary Assessment The review found no significant difference in periodontal healing between patients with a replanted avulsed tooth who were treated

2010 ADA Center for Evidence-Based Dentistry

220. Patients who received preoperative antibiotics showed fewer early implant failures

Patients who received preoperative antibiotics showed fewer early implant failures Orally administered amoxicillin decreases the risk of implant failures ADA Websites Access news, member benefits and ADA policy Attend ADA's premier event Access cutting-edge continuing education courses Find evidence to support your clinical decisions Access member-only practice content Investing in better oral health for all. Together. Take advantage of endorsed, discounted business products Purchase ADA (...) failures Stacy Geisler DDS, PhD . Overview Systematic Review Conclusion Evidence suggests that 2 grams of amoxicillin administered orally one hour before implant placement surgery significantly reduces the failure of dental implants placed in ordinary conditions. Critical Summary Assessment The authors conducted a of two clinical trials, resulting in a finding that antibiotics had a significant effect in decreasing the risk of implant failure. Evidence Quality Rating Limited Evidence This summary

2010 ADA Center for Evidence-Based Dentistry

Evidence-based Synopses

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