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Objectives: To identify the impact of introducing antimicrobial stewardship (AMS) ward rounds.
Methods: We used an interrupted time-series approach to investigate the impact of implementing AMS ward rounds with in-person feedback from a multi-disciplinary team in Hospital-1, also comparing to Hospital-2 in the same city where AMS ward rounds were not yet implemented. Regression models were used to identify predictors of advice given, whether advice was followed, and associations between advice uptake and length of stay.
The antibiotic de-escalation strategy in patients with multidrug-resistant bacterial colonization after allogeneic stem cell transplantation.
Front Microbiol
January 2025
BMT Unit, Azienda Ospedaliera Villa Sofia-Cervello, Palermo, Italy.
Colonization by multidrug-resistant (MDR) bacteria and related bloodstream infections (BSI) are associated with a high rate of mortality in patients with hematological malignancies after intensive chemotherapy and allogeneic stem cell transplantation (allo-SCT). In this retrospective study, we analyzed the outcomes of patients colonized with MDR bacteria (primarily carbapenem-resistant , KPC), before allo-SCT. We also investigated the feasibility and safety of an antimicrobial de-escalating approach in these patients.
View Article and Find Full Text PDFPharmacist-led antibiotic interventions in infectious disease patients: a Pakistani tertiary care antimicrobial stewardship study.
J Pharm Policy Pract
January 2025
Shifa College of Pharmaceutical Sciences, Shifa Tameer e Milat University, Pakistan.
Background: Antibiotics are widely used medications among infectious disease patients; therefore, proper monitoring and assessment are critical for ensuring rational use. Antimicrobial stewardship addresses the rational and appropriate use of antibiotics, which reinforces overall health outcomes. Ongoing antimicrobial resistance scenarios are an alarming condition for healthcare, necessitating continued practice of such assessments.
View Article and Find Full Text PDFAntimicrobial stewardship: from theory to reality in a resource-limited setting (and beyond).
Front Antibiot
October 2024
Hospital Epidemiology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Correct use of antibiotics is paramount to present global health. Among other actions, antimicrobial stewardship emphasizes de-escalation and suspension whenever possible. Nonetheless, roadblocks can be encountered (e.
View Article and Find Full Text PDFObjectives: Intensive care unit (ICU) clinicians stop antibiotics more often, with a negative infection: point-of-care test (PCR-POCT). Simulated cases of diagnostic uncertainty regarding infection resolution led clinicians to choose options such as procalcitonin (PCT) and/or PCR-POCTs +/- de-escalation to aid stop decisions. We hypothesised that a direct infection indicator, PCR-POCT, would influence stop judgements more than indirect PCT.
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