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121. Topical Antibiotics for Impetigo: A Review of the Clinical Effectiveness and Guidelines

Topical Antibiotics for Impetigo: A Review of the Clinical Effectiveness and Guidelines Topical Antibiotics for Impetigo: A Review of the Clinical Effectiveness and Guidelines | CADTH.ca Find the information you need Topical Antibiotics for Impetigo: A Review of the Clinical Effectiveness and Guidelines Topical Antibiotics for Impetigo: A Review of the Clinical Effectiveness and Guidelines Published on: February 21, 2017 Project Number: RC0851-000 Product Line: Research Type: Drug Report Type (...) : Summary with Critical Appraisal Result type: Report Question What is the clinical effectiveness of topical antibiotics for patients with impetigo? What are the evidence-based guidelines regarding the use of topical antibiotics for the treatment of impetigo? Key Message The evidence identified in this report supports the clinical efficacy of topical antibiotics, specifically mupirocin and fusidic acid, for the treatment of impetigo. Insufficient evidence was identified to support the clinical efficacy

2017 Canadian Agency for Drugs and Technologies in Health - Rapid Review

122. The Timing of Early Antibiotics and Hospital Mortality in Sepsis

The Timing of Early Antibiotics and Hospital Mortality in Sepsis PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2017 PedsCCM Evidence-Based Journal Club

123. Game Changer? How Many Days of Antibiotics is Best for Treating Community Acquired Pneumonia?

Game Changer? How Many Days of Antibiotics is Best for Treating Community Acquired Pneumonia? Game Changer? How Many Days of Antibiotics is Best for Treating Community Acquired Pneumonia? – Clinical Correlations Search Game Changer? How Many Days of Antibiotics is Best for Treating Community Acquired Pneumonia? January 16, 2018 6 min read By Calvin Ngai, MD Peer Reviewed A 71-year-old Caucasian woman with hypertension presented with a 2-day history of productive cough and fever. She was living (...) alone and had no history of any recent hospitalizations. On examination, she was alert and oriented but slightly tachypneic; her lungs were clear to auscultation bilaterally. Laboratory tests were significant for a white blood cell count of 18,000 m L with 89% neutrophils. The chest x-ray showed a right lower lobe infiltrate. She was admitted and started on antibiotics for treatment of community acquired pneumonia (CAP). She improved clinically, and after remaining afebrile for 48 hours, she

2018 Clinical Correlations

124. Maternal and child health: Procalcitonin-guided decision-making results in a significant reduction of antibiotic therapy and hospital stay in neonates with suspected early-onset sepsis

Maternal and child health: Procalcitonin-guided decision-making results in a significant reduction of antibiotic therapy and hospital stay in neonates with suspected early-onset sepsis Procalcitonin-guided decision-making results in a significant reduction of antibiotic therapy and hospital stay in neonates with suspected early-onset sepsis | 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 (...) in a significant reduction of antibiotic therapy and hospital stay in neonates with suspected early-onset sepsis Article Text Commentary Maternal and child health Procalcitonin-guided decision-making results in a significant reduction of antibiotic therapy and hospital stay in neonates with suspected early-onset sepsis Meret Merker 1 , 2 , Rebekka Bolliger 1 , 2 , Philipp Schuetz 1 , 2 Statistics from Altmetric.com Commentary on : Stocker M, van Herk W, El Helou S, et al . Procalcitonin-guided decision making

2018 Evidence-Based Medicine

125. Are Latino Cultural Beliefs Increasing Antibiotic Resistance in the US?

of the excessive use of antibiotics, as exposure to multiple antibacterial agents provides the selective pressure for the rise and spread of these pathogens. 1 Studies have shown that the overuse of antibiotics is a consequence of the increased worldwide availability of these agents and 1 This issue is particularly relevant in Latin American countries, . 2 Given the increase in the numbers of Latino immigrants, it is important to examine their perceptions of medicine and antibiotic use in order to devise (...) better strategies to control the rise of antimicrobial resistant pathogens—a major global public health problem. Latin American countries have fewer restrictions on the sale of antimicrobial agents, and the existing . 3 This enables the self-diagnosing and self-medicating practices that many members of the Latino community are accustomed to. Furthermore, cultural beliefs and misconceptions regarding the purpose and function of antibiotics play a major role in their misuse among the Latino population

2018 Clinical Correlations

126. ClearGuard HD Antimicrobial Barrier Cap for preventing haemodialysis catheter-related bloodstream infections

port or vascular access device catheter hub before and after accessing the system using 2% chlorhexidine gluconate in 70% alcohol. The hub should be cleaned for 15 seconds and allowed to dry before access. If the manufacturer's recommendations prohibit the use of alcohol with their catheter, an aqueous solution of chlorhexidine gluconate should be considered. The recommendations also state that antibiotic lock solutions and systemic antimicrobial prophylaxis should not be used routinely to prevent (...) ClearGuard HD Antimicrobial Barrier Cap for preventing haemodialysis catheter-related bloodstream infections ClearGuard HD Antimicrobial Barrier Cap for preventing haemodialysis catheter-related bloodstream infections Medtech innovation briefing Published: 3 November 2020 www.nice.org.uk/guidance/mib234 pathways Summary Summary • The technology technology described in this briefing is ClearGuard HD Antimicrobial Barrier Cap. It is a central venous catheter cap with chlorhexidine acetate coated

2020 National Institute for Health and Clinical Excellence - Advice

127. Antimicrobial prescribing: imipenem with cilastatin and relebactam

information. Imipenem with cilastatin and relebactam (Recarbrio, Merck Sharp & Dohme B.V) is given intravenously and is a combination of a broad-spectrum carbapenem antibiotic (imipenem); an inhibitor of dehydropeptidase-I, the renal enzyme that metabolises and inactivates imipenem (cilastatin); and a beta-lactamase inhibitor (relebactam). Only imipenem has antibacterial activity. Imipenem with cilastatin and relebactam has a marketing authorisation for treating infections caused by aerobic gram-negative (...) Antimicrobial prescribing: imipenem with cilastatin and relebactam Antimicrobial prescribing: imipenem with cilastatin and relebactam Evidence summary Published: 28 October 2020 www.nice.org.uk/guidance/es30 pathways Product overview Product overview The content of this evidence summary was up-to-date in October 2020. See summaries of product characteristics (SPCs), British national formulary (BNF) or the Medicines and Healthcare products Regulatory Agency (MHRA) or NICE websites for up-to-date

2020 National Institute for Health and Clinical Excellence - Advice

128. Antimicrobial prescribing: ceftolozane with tazobactam for treating hospital-acquired pneumonia, including ventilator-associated pneumonia

for Antimicrobial Utilisation and Resistance (ESPAUR) Report 2018 to 2019 states that monitoring the use of new antibiotics and detecting emerging resistance to these medicines is a crucial component of antimicrobial usage surveillance to inform antimicrobial stewardship activities and preserve treatment effectiveness. Although susceptibility testing for ceftolozane with tazobactam is currently uncommon and selective (following resistance to first- and second-line antibiotics), resistance has nonetheless been (...) ) is Antimicrobial prescribing: ceftolozane with tazobactam for treating hospital-acquired pneumonia, including ventilator-associated pneumonia (ES22) © NICE 2020. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 5 of 6£402.18 (BNF, November 2019). The acquisition costs (excluding VAT) of many other IV antibiotics that are used for HAP and VAP (caused or suspected to be caused by Gram-negative pathogens) are lower than that of ceftolozane

2020 National Institute for Health and Clinical Excellence - Advice

129. Selection and co-selection of antibiotic resistances among Escherichia coli by antibiotic use in primary care: An ecological analysis. Full Text available with Trip Pro

Selection and co-selection of antibiotic resistances among Escherichia coli by antibiotic use in primary care: An ecological analysis. The majority of studies that link antibiotic usage and resistance focus on simple associations between the resistance against a specific antibiotic and the use of that specific antibiotic. However, the relationship between antibiotic use and resistance is more complex. Here we evaluate selection and co-selection by assessing which antibiotics, including those (...) mainly prescribed for respiratory tract infections, are associated with increased resistance to various antibiotics among Escherichia coli isolated from urinary samples.Monthly primary care prescribing data were obtained from National Health Service (NHS) Digital. Positive E. coli records from urine samples in English primary care (n = 888,207) between April 2014 and January 2016 were obtained from the Second Generation Surveillance System. Elastic net regularization was used to evaluate associations

2019 PLoS ONE

130. Reduced user fees for antibiotics under age 5 in Hungary: Effect on antibiotic use and imbalances in the implementation. Full Text available with Trip Pro

Reduced user fees for antibiotics under age 5 in Hungary: Effect on antibiotic use and imbalances in the implementation. In August 2016, new prescription guidelines were introduced in Hungary to reduce the co-payments for antibiotics among children aged 0-4. This study aims at analysing the implementation of this policy and its effect on the use of antibiotics.The analysis is based on administrative prescription records between January 2010-February 2018, covering the entire population (...) of Hungary aged 0-7. Spatial autocorrelation indices are calculated and settlement level regression models are estimated to analyse the spatial variation in the application of the new guidelines. The effect of reduced co-payments on antibiotic use is estimated with a difference-in-differences type model: the treatment and control groups are children aged 0-4 and 5-7, respectively; the treatment and control periods are August 2016-February 2018 and January 2010-July 2016, respectively.The new prescription

2019 PLoS ONE

131. "Without antibiotics, I cannot treat": A qualitative study of antibiotic use in Paschim Bardhaman district of West Bengal, India. Full Text available with Trip Pro

"Without antibiotics, I cannot treat": A qualitative study of antibiotic use in Paschim Bardhaman district of West Bengal, India. Misuse of antibiotics is a well-known driver of antibiotic resistance. Given the decentralized model of the Indian health system and the shortage of allopathic doctors in rural areas, a wide variety of healthcare providers cater to the needs of patients in urban and rural settings. This qualitative study explores the drivers of antibiotic use among formal (...) and deductive manner.Our results indicate that patients demand antibiotics from healthcare providers and seek the fastest cure possible, which influences the prescription choices of healthcare providers, particularly informal health providers. Many allopathic doctors provide antibiotics without any clinical indication due to inconsistent follow up, lack of testing facilities, risk of secondary infections, and unhygienic living conditions. Pharmaceutical company representatives actively network with informal

2019 PLoS ONE

132. Antibiotic use practice and predictors of hospital outcome among patients with systemic bacterial infection: Identifying targets for antibiotic and health care resource stewardship. Full Text available with Trip Pro

Antibiotic use practice and predictors of hospital outcome among patients with systemic bacterial infection: Identifying targets for antibiotic and health care resource stewardship. Malpractice and excess use of antimicrobials have been associated with multiple costs, including the development of resistant bacteria, which has become a threat to the human health. The aim of this study, therefore, was to assess the antibiotic use practice and to identify predictors of hospital outcome to uncover (...) infections, in which pneumonia is the most common. Cephalosporins were the most widely prescribed class of drugs in all the wards. Initial antibiotics were empiric in almost all of the cases. About 28% of the ward and 59% of the ICU patients died during the in-hospital stay. The mean length of stay (LoS) was 18.5+12.2 in the wards and 8.9+4.9 days in the ICU. Whilst digestive disease (AOR = 6.94, 95% CI: 2.24, 21.49), different signs and symptoms of disease (AOR = 2.43, 95% CI: 1.30, 4.56), sepsis (AOR

2019 PLoS ONE

133. Impact of pharmacist-led antibiotic stewardship interventions on compliance with surgical antibiotic prophylaxis in obstetric and gynecologic surgeries in Nigeria. Full Text available with Trip Pro

Impact of pharmacist-led antibiotic stewardship interventions on compliance with surgical antibiotic prophylaxis in obstetric and gynecologic surgeries in Nigeria. Inappropriate and excessive use of surgical antibiotic prophylaxis are associated with the emergence of antibiotic resistance. Antibiotic prophylaxis malpractices are common in obstetrics and gynecology settings and antibiotic stewardship is used to correct such malpractice.To evaluate the impact of antibiotic stewardship (...) interventions on compliance with surgical antibiotic prophylaxis practice in obstetrics and gynecology surgeries.A prospective pre- and post-intervention study was conducted in two tertiary hospitals between May and December 2016. The duration of the each period was 3 months. Antibiotic stewardship interventions including development of a protocol, educational meeting and audit and feedback were implemented. Data were collected using the patient records and analyzed with SPSS version 23.A total of 226

2019 PLoS ONE

134. Emergence of antibiotic resistance in immunocompromised host populations: A case study of emerging antibiotic resistant tuberculosis in AIDS patients. Full Text available with Trip Pro

Emergence of antibiotic resistance in immunocompromised host populations: A case study of emerging antibiotic resistant tuberculosis in AIDS patients. The evolution of antibiotic resistance is far outpacing the development of new antibiotics, causing global public health concern about infections that will increasingly be unresponsive to antimicrobials. This risk of emerging antibiotic resistance may be meaningfully altered in highly AIDS-immunocompromised populations. Such populations (...) fundamentally alter the bacterial evolutionary landscape in two ways, which we seek to model and analyze. First, widespread, population-level immunoincompetence creates a novel host environment with disrupted selective pressures. Second, within AIDS-prevalent populations, the recommendation that antibiotics be taken to treat and prevent opportunistic infection raises the risk of selection for drug-resistant pathogens.To determine the impact of HIV/AIDS on the emergence of antibiotic resistance-specifically

2019 PLoS ONE

135. Pediatric Antibiotic Prescribing in China According to the 2019 World Health Organization Access, Watch, and Reserve (AWaRe) Antibiotic Categories. (Abstract)

Pediatric Antibiotic Prescribing in China According to the 2019 World Health Organization Access, Watch, and Reserve (AWaRe) Antibiotic Categories. To assess clinical indication-specific antibiotic prescribing in pediatric practice in China based on the World Health Organization (WHO) Access, Watch, and Reserve (AWaRe) metrics and to detect potential problem areas.Pediatric prescription records on the 16th of each month during 2018 were sampled for all encounters at outpatient and emergency (...) departments of 16 tertiary care hospitals via hospital information systems. Antibiotic prescribing patterns were analyzed across and within diagnostic conditions according to WHO AWaRe metrics and Anatomical Therapeutic Chemical (ATC) classification.A total of 260 001 pediatric encounters were assessed, and antibiotics were prescribed in 94 453 (36.3%). In 35 167 encounters (37.2%), at least 1 intravenous antibiotic was administered. WHO Watch group antibiotics accounted for 82.2% (n = 84 176) of all

2020 Journal of Pediatrics

136. When antibiotics fail: a clinical and microbiological perspective on antibiotic tolerance and persistence of Staphylococcus aureus. (Abstract)

When antibiotics fail: a clinical and microbiological perspective on antibiotic tolerance and persistence of Staphylococcus aureus. Staphylococcus aureus is a major human pathogen causing a vast array of infections with significant mortality. Its versatile physiology enables it to adapt to various environments. Specific physiological changes are thought to underlie the frequent failure of antimicrobial therapy despite susceptibility in standard microbiological assays. Bacteria capable (...) of surviving high antibiotic concentrations despite having a genetically susceptible background are described as 'antibiotic tolerant'. In this review, we put current knowledge on environmental triggers and molecular mechanisms of increased antibiotic survival of S. aureus into its clinical context. We discuss animal and clinical evidence of its significance and outline strategies to overcome infections with antibiotic-tolerant S. aureus.© The Author(s) 2020. Published by Oxford University Press on behalf

2020 Journal of Antimicrobial Chemotherapy

137. Association of a clinician's antibiotic prescribing rate with patients' future likelihood of seeking care and receipt of antibiotics. Full Text available with Trip Pro

Association of a clinician's antibiotic prescribing rate with patients' future likelihood of seeking care and receipt of antibiotics. One underexplored driver of inappropriate antibiotic prescribing for acute respiratory illnesses (ARI) is patients' prior care experiences. When patients receive antibiotics for an ARI, patients may attribute their clinical improvement to the antibiotics, regardless of their true benefit. These experiences, and experiences of family members, may drive whether (...) patients seek care or request antibiotics when they have subsequent ARIs.Using encounter data from a national United States insurer, we identified patients <65 years old with an index ARI urgent care center (UCC) visit. We categorized clinicians within each UCC into quartiles based on their ARI antibiotic prescribing rate. Exploiting the quasi-random assignment of patients to a clinician within an UCC, we examined the association between the clinician's antibiotic prescribing rate to the patients

2020 Clinical Infectious Diseases

138. Antibiotic stewardship implementation and patient-level antibiotic use at hospitals with and without on-site Infectious Disease specialists. Full Text available with Trip Pro

)]. Total antibacterial exposure (inpatient plus post-discharge) was lower among patients at ID versus non-ID sites [OR 0.92 (95% CI, 0.86-0.99)].Patients at hospitals with an ID specialist received antibiotics in a way more consistent with stewardship principles. The presence of an ID specialist may be important to effective antibiotic stewardship.Published by Oxford University Press for the Infectious Diseases Society of America 2020. This work is written by (a) US Government employee(s (...) Antibiotic stewardship implementation and patient-level antibiotic use at hospitals with and without on-site Infectious Disease specialists. Many US hospitals lack Infectious Disease (ID) specialists, which may hinder antibiotic stewardship efforts. We sought to compare patient-level antibiotic exposure at Veterans Health Administration (VHA) hospitals with and without an on-site ID specialist, defined as an ID physician and/or ID pharmacist.This retrospective VHA cohort included all acute-care

2020 Clinical Infectious Diseases

139. The effect of renal replacement therapy and antibiotic dose on antibiotic concentrations in critically ill patients: Data from the multinational SMARRT Study. Full Text available with Trip Pro

The effect of renal replacement therapy and antibiotic dose on antibiotic concentrations in critically ill patients: Data from the multinational SMARRT Study. The optimal dosing of antibiotics in critically ill patients receiving renal replacement therapy (RRT) remains unclear. In this study, we describe the variability in RRT techniques and antibiotic dosing in critically ill patients receiving RRT and to relate observed trough antibiotic concentrations to optimal targets.We performed (...) a prospective, observational, multi-national, pharmacokinetic study in 29 intensive care units from 14 countries. We collected demographic, clinical and RRT data. We measured trough antibiotic concentrations of meropenem, piperacillin-tazobactam and vancomycin and related them to high and low target trough concentrations.We studied 381 patients and obtained 508 trough antibiotic concentrations. There was wide variability (4-8 fold) in antibiotic dosing regimens; RRT prescription, and estimated endogenous

2020 Clinical Infectious Diseases

140. Distinguishing the roles of antibiotic stewardship and reductions in outpatient visits in generating a five-year decline in antibiotic prescribing. (Abstract)

Distinguishing the roles of antibiotic stewardship and reductions in outpatient visits in generating a five-year decline in antibiotic prescribing. The mechanisms driving the recent decline in outpatient antibiotic prescribing are unknown. We estimated the extent to which reductions in the number of antibiotic prescriptions filled per outpatient visit (stewardship) and reductions in the monthly rate of outpatient visits (observed disease) for infectious disease conditions each contributed (...) to the decline in outpatient antibiotic prescribing in Massachusetts between 2011 and 2015.Outpatient medical and pharmacy claims from the Massachusetts All-Payer Claims Database were used to estimate rates of antibiotic prescribing and outpatient visits for 20 medical conditions and their contributions to the overall decline in antibiotic prescribing. Trends were compared to those in the National Ambulatory Medical Care Survey (NAMCS).Between 2011 and 2015, the January and July antibiotic prescribing rates

2020 Clinical Infectious Diseases

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