This document discusses antibiotic resistance and the need for improved antibiotic stewardship programs. It notes that up to 50% of antibiotic use is inappropriate and leads to adverse outcomes for patients like C. difficile infections and increased resistance. The document promotes optimizing antibiotic use through improved prescribing practices and developing antibiotic stewardship programs in healthcare facilities. The goals are to improve patient outcomes, reduce resistance, and lower costs by ensuring the right antibiotic is used for the right duration.
More than half of all hospital patients are treated with antibiotics and prescribing practices vary widely, even within hospitals. Efforts to rationalize antibiotic use have been stymied by delays in obtaining specific diagnoses, by the volume of prescriptions written each day and by the difficulty of extracting meaningful data from scattered clinical, laboratory and pharmacy records. But the push is on – from the White House, the CDC, infectious disease specialists, the industry – for more judicious use of antibiotics through antibiotic stewardship programs.
Hear how leading health care institutions have moved from education to active surveillance to intervention, reducing infections and lowering costs.
Advisor Live: Antimicrobial Stewardship - Why Now and How?Premier Inc.
This 90-minute webinar discusses strategies and tools for implementing antimicrobial stewardship programs, including methods for measuring antimicrobial use and resistance.
Join Premier’s free Advisor Live® webinar series for a special Get Smart About Antibiotics Week presentation on Thursday, November 19 from 12-1:30 p.m. EST. The panel for this 90-minute webinar will discuss strategies and tools for implementing antimicrobial stewardship programs, including methods for measuring antimicrobial use and resistance.
EXPERT PRESENTERS:
- Gina Pugliese, RN, MS, vice president, Premier Safety Institute®, moderator
- Arjun Srinivasan, MD, (CAPT, USPHS) medical director of the CDC’s Get Smart for Healthcare program, will highlight the national focus on antibiotic stewardship and reasons for the current urgency
- Michael Postelnick, RPh, BCPS AQ- Infectious Diseases, clinical manager and senior infectious diseases pharmacist for Northwestern Memorial Hospital, will share lessons learned from implementing their antibiotic stewardship program
- Craig Barrett, Pharm.D., BCPS, director safety solutions for Premier, Inc. will share strategies from Premier member hospitals striving for antimicrobial stewardship
Dr. Steve Solomon - Metrics and Decision-Making for Antibiotic Stewardship in...John Blue
Metrics and Decision-Making for Antibiotic Stewardship in Human Medicine - Dr. Steve Solomon, Centers for Disease Control & Prevention, Currently serves as Director of the Office of Antimicrobial Resistance in the Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, in the Office of Infectious Diseases at CDC., from the 2014 NIAA Symposium on Antibiotics Use and Resistance: Moving Forward Through Shared Stewardship, November 12-14, 2014, Atlanta, Georgia, USA.
More presentations at http://www.swinecast.com/2014-niaa-antibiotics-moving-forward-through-shared-stewardship
Advisor Live: Advancing Antimicrobial StewardshipPremier Inc.
Fight antibiotic resistance! Join us and participate in Get Smart About Antibiotics Week 2016. Medical epidemiologist Dr. Kavita Trivedi will share her deep wealth of knowledge to help your organization implement and meet the challenges of antimicrobial stewardship.
- Current regulatory environment
- Implementation tools available
- Implementation challenges
More than half of all hospital patients are treated with antibiotics and prescribing practices vary widely, even within hospitals. Efforts to rationalize antibiotic use have been stymied by delays in obtaining specific diagnoses, by the volume of prescriptions written each day and by the difficulty of extracting meaningful data from scattered clinical, laboratory and pharmacy records. But the push is on – from the White House, the CDC, infectious disease specialists, the industry – for more judicious use of antibiotics through antibiotic stewardship programs.
Hear how leading health care institutions have moved from education to active surveillance to intervention, reducing infections and lowering costs.
Advisor Live: Antimicrobial Stewardship - Why Now and How?Premier Inc.
This 90-minute webinar discusses strategies and tools for implementing antimicrobial stewardship programs, including methods for measuring antimicrobial use and resistance.
Join Premier’s free Advisor Live® webinar series for a special Get Smart About Antibiotics Week presentation on Thursday, November 19 from 12-1:30 p.m. EST. The panel for this 90-minute webinar will discuss strategies and tools for implementing antimicrobial stewardship programs, including methods for measuring antimicrobial use and resistance.
EXPERT PRESENTERS:
- Gina Pugliese, RN, MS, vice president, Premier Safety Institute®, moderator
- Arjun Srinivasan, MD, (CAPT, USPHS) medical director of the CDC’s Get Smart for Healthcare program, will highlight the national focus on antibiotic stewardship and reasons for the current urgency
- Michael Postelnick, RPh, BCPS AQ- Infectious Diseases, clinical manager and senior infectious diseases pharmacist for Northwestern Memorial Hospital, will share lessons learned from implementing their antibiotic stewardship program
- Craig Barrett, Pharm.D., BCPS, director safety solutions for Premier, Inc. will share strategies from Premier member hospitals striving for antimicrobial stewardship
Dr. Steve Solomon - Metrics and Decision-Making for Antibiotic Stewardship in...John Blue
Metrics and Decision-Making for Antibiotic Stewardship in Human Medicine - Dr. Steve Solomon, Centers for Disease Control & Prevention, Currently serves as Director of the Office of Antimicrobial Resistance in the Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, in the Office of Infectious Diseases at CDC., from the 2014 NIAA Symposium on Antibiotics Use and Resistance: Moving Forward Through Shared Stewardship, November 12-14, 2014, Atlanta, Georgia, USA.
More presentations at http://www.swinecast.com/2014-niaa-antibiotics-moving-forward-through-shared-stewardship
Advisor Live: Advancing Antimicrobial StewardshipPremier Inc.
Fight antibiotic resistance! Join us and participate in Get Smart About Antibiotics Week 2016. Medical epidemiologist Dr. Kavita Trivedi will share her deep wealth of knowledge to help your organization implement and meet the challenges of antimicrobial stewardship.
- Current regulatory environment
- Implementation tools available
- Implementation challenges
Dr. Marion A. Kainer - Antimicrobial Stewardship - the State Health Departmen...John Blue
Antimicrobial Stewardship - the State Health Department Perspective - Dr. Marion A. Kainer, Director, Healthcare Associated Infections and Antimicrobial Resistance Program, Tennessee Department of Health, from the 2015 NIAA Antibiotic Symposium - Stewardship: From Metrics to Management, November 3-5, 2015, Atlanta, Georgia, USA.
More presentations at http://swinecast.com/2015-niaa-symposium-antibiotics-stewardship-from-metrics-to-management
Antibiotic Stewardship: A National and International ImperativePYA, P.C.
J. Michael Keegan, MD, an infectious disease specialist who leads the antibiotic stewardship team at PYA, discussed antibiotic stewardship at the South Dakota Pharmacists Association’s (SDPHA) Annual Convention in Deadwood, South Dakota.
Dr.sherin elsherbiny
Senior registrar clinical microbiology
AMR coordinator
Infection control auditor
Riyadh region
Meeqat General Hospital ,Madina,KSA
NHS Improvement AMS Workshop London 5th May4 All of Us
Hosted by both NHS Improvement and Public Health England, this workshop, intended for NHS staff involved with antimicrobial stewardship activities within primary care; commissioning organisations; acute, community and mental health care provider organisations.
1. Learn about what is new in 2016-17 – AMR CQUIN & Quality Premium; PHE Fingertips; Behavioural strategies for AMR
2. Sharing success – learn about what worked well
3. Discuss what this means for your local health economy
4. Start planning local AMR networks – what might these look like? How to get started
Role of PK PD in Antibiotic Stewardship Program with case study. This presentation gives an comprehensive overview about role of PK PD in antibiotic stewardship program.
• Describe the role of antibiotic use in the
development of resistance
• Review toxicity of commonly used antibiotics
• Understand the prevalence and clinical impact
of carbapenem resistant enterobacteriaceae
• State the prognosis antimicrobial resistant
Staph aureus infections
Antibiotics are most common therapeutic agents used in hospitals across world, however, microbial world is becoming resistant day by day, posing special challenges to clinicians specially working in ICU set ups. There are multiple ways to curb this menace, if approached together in antibiotic stewardship way, can bring about wonders and retain therapeutic potentials of these drugs.
Presentation from the 3rd Joint Meeting of the Antimicrobial Resistance and Healthcare-Associated Infections (ARHAI) Networks, organised by the European Centre of Disease Prevention and Control - Stockholm, 11-13 February 2015
Dr. Marion A. Kainer - Antimicrobial Stewardship - the State Health Departmen...John Blue
Antimicrobial Stewardship - the State Health Department Perspective - Dr. Marion A. Kainer, Director, Healthcare Associated Infections and Antimicrobial Resistance Program, Tennessee Department of Health, from the 2015 NIAA Antibiotic Symposium - Stewardship: From Metrics to Management, November 3-5, 2015, Atlanta, Georgia, USA.
More presentations at http://swinecast.com/2015-niaa-symposium-antibiotics-stewardship-from-metrics-to-management
Antibiotic Stewardship: A National and International ImperativePYA, P.C.
J. Michael Keegan, MD, an infectious disease specialist who leads the antibiotic stewardship team at PYA, discussed antibiotic stewardship at the South Dakota Pharmacists Association’s (SDPHA) Annual Convention in Deadwood, South Dakota.
Dr.sherin elsherbiny
Senior registrar clinical microbiology
AMR coordinator
Infection control auditor
Riyadh region
Meeqat General Hospital ,Madina,KSA
NHS Improvement AMS Workshop London 5th May4 All of Us
Hosted by both NHS Improvement and Public Health England, this workshop, intended for NHS staff involved with antimicrobial stewardship activities within primary care; commissioning organisations; acute, community and mental health care provider organisations.
1. Learn about what is new in 2016-17 – AMR CQUIN & Quality Premium; PHE Fingertips; Behavioural strategies for AMR
2. Sharing success – learn about what worked well
3. Discuss what this means for your local health economy
4. Start planning local AMR networks – what might these look like? How to get started
Role of PK PD in Antibiotic Stewardship Program with case study. This presentation gives an comprehensive overview about role of PK PD in antibiotic stewardship program.
• Describe the role of antibiotic use in the
development of resistance
• Review toxicity of commonly used antibiotics
• Understand the prevalence and clinical impact
of carbapenem resistant enterobacteriaceae
• State the prognosis antimicrobial resistant
Staph aureus infections
Antibiotics are most common therapeutic agents used in hospitals across world, however, microbial world is becoming resistant day by day, posing special challenges to clinicians specially working in ICU set ups. There are multiple ways to curb this menace, if approached together in antibiotic stewardship way, can bring about wonders and retain therapeutic potentials of these drugs.
Presentation from the 3rd Joint Meeting of the Antimicrobial Resistance and Healthcare-Associated Infections (ARHAI) Networks, organised by the European Centre of Disease Prevention and Control - Stockholm, 11-13 February 2015
Possible Reuse of Anesthesia Breathing Circuits on Multiple Patients Under Ge...Steve Koontz
Power point presentation about the possible reuse of anesthesia breathing circuits by Steve Koontz, Director of Sales Training, ARC Medical. August 2012
PneumoniaCheck by ARC Medical, The link between diagnosis and treatment of Pn...Steve Koontz
The Need:
Pneumonia is a leading cause of death in children worldwide. Over 2 million children die from pneumonia each year and one child dies every 20 seconds. The problem with current diagnosis methods is one of sampling. Mouth and nose samples have contaminating bacteria, which result in many false positives. Additionally, the samples are unable to identify the pathogen; hospital stays are lengthened increasing the chances that cases will become complicated. Since the pathogen cannot be identified, patients receive broad-spectrum antibiotics, which are often unnecessary and can cause antibiotic resistance. Other methods, such as a chest x-ray, can identify fluid in the lungs, but cannot identify the specific pathogen causing the pneumonia.
The Device:
PneumoniaCheck uses fluid mechanics to separate the upper airway particles from the lower airway particles. The separation means that only a lung specimen is captured on the filter at the end of the device. This filter can then be analyzed using traditional microbiology methods or mor sensitive molecular DNA analysis to identify the specific pathogen causing pneumonia, or other lower respiratory infections. The ability to identify the specific pathogen will allow for more targeted antibiotic treatment or none at all if viral, which should reduce antibiotic resistance and other complications. PneumoniaCheck is an easy-to-use, noninvasive, disposable solution for collecting respiratory specimens to help reduce one of the world’s largest health problems. PneumoniaCheck may be used on patients three feet and taller.
This is a presentation to review and summarize the mobile websites that I have involved in. It includes many practical skills and my own experiences in the development of mobile websites.
Immigrant Citizens Survey: Key Findings by Thomas HuddlestonTom Huddleston
www.immigrantsurvey.org
The Immigrant Citizens Survey asks immigrants to assess their aspirations and needs for integration and then evaluate how effective policies are in meeting them. The survey results cover 15 EU cities in Belgium, France, Germany, Hungary, Italy, Portugal, and Spain.
Culture, the ultimate competitive advantageJohn E. Smith
Jim Goodnight, CEO of SAS Institute, famously stated that "95% of my assets drive out the front gate every evening. It’s my job to bring them back." These "assets" that Mr. Goodnight speaks of are his employees, his team members. Ranked #1 for the second year in a row on the 2011 Forbes' Best Places to Work list, SAS and Mr. Goodnight are undoubtedly doing something right. Corporate Culture, Engagement, and Energy are the 3 fundamental principles driving not only SAS, but a majority of the top leaders on the Forbes list.
Over the last century, the United States has made a switch; we are no longer the leader of industrial/operational efficiency, but instead, our major competitive advantage is innovation. This innovation starts with a bet. Companies must be willing to place a bet on culture and the belief that shifting time, resources, and money into team member happiness and engagement will, ultimately, deliver higher revenue and increase overall profitability.
Employee engagement can be the biggest competitive advantage for company success. Culture, the Ultimate Competitive Advantage focuses on how culture and engagement can drive a company to a stage 5 success via recruiting, sales, marketing, communication, performance, overhead, and other departments. This Engagement Effect can amount to a 20% or more gain in all faucets of a business. The presentations demonstrates how this Engagement Effect can unleash an unprecedented potential for growth, what differentiates the top 100 companies from the next lower 100 companies on the Forbes list, and what the return on cultural investment can do for the bottom-line.
Awareness Session On Antimicrobial resistance “Antimicrobials: Spread Awaren...Nimra zaman
The World Antimicrobial Awareness Week (WAAW) was introduced by the World Health Organization (WHO) to increase global awareness of antimicrobial resistance.
The WAAW takes place every year from 18-24th of November.
The theme of World Antimicrobial Awareness Week (WAAW) 2021 is ‘Spread Awareness, Stop Resistance’.
During this week best practices are shared among the general public, health workers and policy makers to show the importance of stopping the further emergence and spread of antibiotic resistance.
CDC Key Prevention Strategies for Antimicrobial Resistance Prevent Infection Step 1: Vaccinate Fact:
Influenza and pneumococcal vaccination of at-risk hospital patients and influenza vaccination of healthcare personnel will prevent infections.
Step 2: Get the catheters out Fact:
Catheters and other invasive devices are the # 1 exogenous cause of hospital-onset infections.
Diagnose & Treat Infection Effectively Step 3: Target the pathogen
Fact:
Appropriate antimicrobial therapy saves lives.
Step 4: Access the experts Fact:
Infectious diseases expert input improves the outcome of serious infections.
•
Use Antimicrobials Wisely
Step 5: Practice antimicrobial control Fact:
Programs to improve antimicrobial use are effective. (Antimicrobial Stewardship)
•
Step 6: Use local data
Fact:
The prevalence of resistance can vary by locality, patient population, hospital unit, and length of stay.
•
•
Step 7: Treat infection, not contamination Fact:
A major cause of antimicrobial overuse is “treatment” of contaminated cultures.
Step 8: Treat infection, not colonization Fact:
Step 9: Know when to say “no” to vancomycin Fact:
Vancomycin overuse promotes emergence, selection,and spread of resistant pathogens.
•
Step 10: Stop antimicrobial treatment Fact:
Failure to stop unnecessary antimicrobial treatment contributes to overuse and resistance.
Prevent Transmission
Step 11: Isolate the pathogen Fact:
Patient-to-patient spread of pathogens can be prevented.
•
Step 12: Break the chain of infection Fact:
Healthcare personnel can spread antimicrobial-resistant pathogens from patient to patient
Antimicrobial stewardship; is an activity that includes appropriate selection, dosing, route, and duration of antimicrobial therapy…..
Why is Antimicrobial Stewardship Important?
200-300 million antibiotics are prescribed annually….45% for outpatient use
25-40% of hospitalized patients receive antibiotics
10-70% are unnecessary or suboptimal
5% of hospitalized patients who receive antibiotics experience an Adverse reaction.
Health insurance companies will no longer reimburse for hospital acquired conditions deemed preventable.
Why is an antibiotic policy necessary?
To improve patient care by considered use of antibiotics for prophylaxis and therapy.
To rationalize the use of antibiotics.
To prevent or retard the emergence of resistant strains.
To improve education of junior doctors by providing guidelines for appropriate therapy
What are the clinical uses of antibiotics :
1. Therapeutic use:-
It is administration of an antimicrobial agent where substantial microbial infection has occurred.
2. Prophylactic Use:-
It is the use of antimicrobial agent before any infection has occurred to prevent a subsequent infection.
The Antimicrobial Stewardship Program (ASP) should be administered by multidisciplinary team (AST) composed of:
an infectious diseases (ID)physician
a clinical pharmacist with ID training,
a clinical microbiologist,
an IC professional,
Antibioti
overuse and misuse of antibiotic put all of us at danger, and help to develop drug-resistant bacteria, so-called superbugs. which ultimately increase the cost of health care. so the third world countries are facing a burden of an extra charge of expenditure and unusual death
AARC Clinical Practice Guideline
Humidification during Mechanical Ventilation
HMV 1.0 PROCEDURE:
The addition of heat and moisture to inspired gases delivered to the patient during mechanical ventilatory support via an artificial airway
HMV 2.0 DESCRIPTION/DEFINITION:
When the upper airway is bypassed, humidification during mechanical ventilation is necessary to prevent hypothermia, inspissation of airway secretions, destruction of airway epithelium, and atelectasis.(1-7) This may be accomplished using either a heated humidifier or a heat and moisture exchanger (HME). (HMEs are also known as hygroscopic condenser humidifiers, or artificial noses). The chosen device should provide a minimum of 30 mg H2O/L of delivered gas at 30°C.(8,29) Heated humidifiers operate actively to increase the heat and water vapor content of inspired gas.(11-14) HMEs operate passively by storing heat and moisture from the patient's exhaled gas and releasing it to the inhaled gas.(I5-25)
2. National Center for Emerging and Zoonotic Infectious Diseases
Division of Healthcare Quality Promotion
Used with permission from:
Centers for Disease Control and Prevention; CDC
24/7: Savings Lives, Protecting People TM
3. Mission- Get Smart for Healthcare
To optimize the use of antimicrobial agents in in-
patient healthcare settings.
4. Antibiotics are misused
in hospitals
“It has been recognized for several decades
that up to 50% of antimicrobial use
is inappropriate.”
• IDSA/SHEA Guidelines for Antimicrobial Stewardship Programs
• http://www.journals.uchicago.edu/doi/pdf/10.1086/510393
5. Why we need to improve
in-patient antibiotic use
• Antibiotics are misused in hospitals
• Antibiotic misuse adversely impacts patients and
society
• Improving antibiotic use improves patient outcomes
and saves money
• Improving antibiotic use is a public health imperative
6. Antibiotics are misuse
in a variety of ways
• Given when they are not needed
• Continued when they are no longer necessary
• Given at the wrong dose
• Broad spectrum agents are used to treat very
susceptible bacteria
• The wrong antibiotic is given to treat an infection
7. Antibiotic misuse adversely impacts
patients- C. difficile
• Antibiotic exposure is the single most important risk
factor for the development of Clostridium difficile
associated disease (CDAD).1
• Up to 85% of patients with CDAD have antibiotic
exposure in the 28 days before infection.1
1. Chang HT et al. Infect Control Hosp Epidemiol 2007; 28:926–931.
8. Antibiotic exposure increases the
risks of resistance
Pathogen and Antibiotic Exposure Increased Risk
Carbapenem Resistant Enterobactericeae
and Carbapenems
15 fold 1
ESBL producing organisms and Cephalosoprins 6- 29 fold 3,4
Patel G et al. Infect Control Hosp Epidemiol 2008;29:1099-1106
Zaoutis TE et al. Pediatrics 2005;114:942-9
Talon D et al. Clin Microbiol Infect 2000;6:376-84
9. Antibiotic misuse adversely impacts
patients- resistance
• Increasing use of antibiotics increases the prevalence
of resistant bacteria in hospitals.
• Antibiotic resistance increases mortality.
• Getting an antibiotic increases a patient’s chance of
becoming colonized or infected with a resistant
organism.
10. Antibiotic misuse adversely impacts
patients - adverse events
• In 2008, there were 142,000 visits to emergency
departments for adverse events attributed to
antibiotics.1
• National estimates for in-patient adverse events are
not available, but there are many reports of serious
adverse events (aside from C. difficile infection) from
in-patient antibiotic use.
1 Shehab N et al. Clinical Infectious Diseases 2008; 15:735-43
11. Clinical outcomes better with
antimicrobial management program
0
20
40
60
80
100
Appropriate Cure Failure
AMP
UP
RR 2.8 (2.1-3.8) RR 1.7 (1.3-2.1) RR 0.2 (0.1-0.4)
Percent
AMP = Antibiotic Management Program UP = Usual Practice
Fishman N. Am J Med. 2006;119:S53.
12. Improving antibiotic use
saves money
• “Comprehensive programs have consistently
demonstrated a decrease in antimicrobial use with
annual savings of $200,000 - $900,000”
• IDSA/SHEA Guidelines for Antimicrobial Stewardship Programs
• http://www.journals.uchicago.edu/doi/pdf/10.1086/510393
13. Improving antibiotic use is a public
health imperative
• Antibiotics are the only drug where use in one
patient can impact the effectiveness in another.
• If everyone does not use antibiotics well, we will all
suffer the consequences.
• Antibiotics are a shared resource, (and becoming a
scarce resource).
• Using antibiotics properly is analogous to developing
and maintaining good roads.
14. Goals- Get Smart for Healthcare
• Improve patient safety through better treatment of
infections.
• Reduce the emergence of anti-microbial resistant
pathogens and Clostridium difficile.
• Heighten awareness of the challenges posed by
antimicrobial resistance in healthcare and encourage
better use of antimicrobials as one solution.
16. Development of the National Action Plan
The National Action Plan was developed
in response to Executive Order 13676:
Combating Antibiotic - Resistant
Bacteria which was issued by President
Barack Obama on September 18, 2014
in conjunction with the National
Strategy for Combating Antibiotic-
Resistant Bacteria.
17
17. The goals of the National Action Plan
Significant Outcomes of Goal 1
Reduction of inappropriate antibiotic
use by 50% in outpatient settings and
by 20% in inpatient settings.
18
18. The goals of the National Action Plan
1. Slow the emergence of resistant
bacteria and prevent the spread of
resistant infections.
2. Strengthen national One-Health
Surveillance efforts to combat
resistance.
19
19. The goals of the National Action Plan
3. Advance development and use of
rapid and innovative diagnostic tests for
identification and characterization of
resistant bacteria.
20
20. The goals of the National Action Plan
4. Accelerate basic and applied
research and development for new
antibiotics, other therapeutics and
vaccines.
5. Improve international collaboration
and capacities for antibiotic-resistance
prevention, surveillance, control, and
antibiotic research and development.
21
21. The goals of the National Action Plan
Sub-Objective 1.1.1B:
• Get Smart: Know When Antibiotics
Work.
Many antibiotics prescribed in doctors’
offices, clinics, and other outpatient
settings are not needed. This program
focuses on appropriate antibiotic
prescribing and use for common
illnesses in children and adults.
22
22. The goals of the National Action Plan
Sub-Objective 1.1.1B:
• Get Smart for Healthcare.
Many patients in hospitals, nursing
homes, and other healthcare facilities
receive antibiotics to fight infections,
but these drugs are often prescribed
incorrectly.
23
23. The goals of the National Action Plan
Sub-Objective 1.1.1B:
• Get Smart for Healthcare.
This program helps clinicians prescribe
the right drugs for the right patients at
the right doses and times.
24
25. Antibiotics
Myth 1. They can cure colds and the
flu.
• Not so. Antibiotics work against only
bacterial infections, not viral ones
such as colds, the flu, most sore
throats, and many sinus and ear
infections.
26
STOP SUPERBUGS NOW; Myths about antibiotics; No, they won't
help with the cold or flu, and other common misconceptions.
Teresa Carr; Consumer Reports; Published: June 25, 2015
26. Antibiotics
Myth 2. They have few side effects.
• Almost 1 in 5 emergency-room visits
for drug side effects stems from
antibiotics. In children, the drugs are
the leading cause of such visits.
27
STOP SUPERBUGS NOW; Myths about antibiotics; No, they won't
help with the cold or flu, and other common misconceptions.
Teresa Carr; Consumer Reports; Published: June 25, 2015
27. Antibiotics
• Those side effects include diarrhea,
yeast infections, and in rare cases,
nerve damage, torn tendons.
• Allergic reactions that include rashes,
swelling of the face or throat, and
breathing problems.
28
STOP SUPERBUGS NOW; Myths about antibiotics; No, they won't
help with the cold or flu, and other common misconceptions.
Teresa Carr; Consumer Reports; Published: June 25, 2015
28. Antibiotics
• The drugs can kill off good bacteria,
increasing the risk of some
infections, including C. difficile.
• At least 250,000 people a year now
develop C. diff. infections linked to
antibiotic use, and 14,000 die as a
result. 4
29
STOP SUPERBUGS NOW; Myths about antibiotics; No, they won't
help with the cold or flu, and other common misconceptions.
Teresa Carr; Consumer Reports; Published: June 25, 2015
29. Antibiotics
Myth 3. A ‘full course’ lasts at least a
week.
• Not always. A shorter course can work for
some infections, such as certain urinary
tract, ear, and sinus infections.
• So ask your doctor for the shortest course
and lowest dose of antibiotics necessary
to treat your infection.
30
STOP SUPERBUGS NOW; Myths about antibiotics; No, they won't
help with the cold or flu, and other common misconceptions.
Teresa Carr; Consumer Reports; Published: June 25, 2015
30. Antibiotics
Myth 4. It’s OK to take leftover
medication.
• Nope. First, you may not need an
antibiotic at all. And if you do, the
leftovers may not be the right type
or dose for your infection.
31
STOP SUPERBUGS NOW; Myths about antibiotics; No, they won't
help with the cold or flu, and other common misconceptions.
Teresa Carr; Consumer Reports; Published: June 25, 2015
31. Antibiotics
• Taking them could allow the growth
of harmful and resistant bacteria.
• Return unused antibiotics to the
pharmacy or mix them with coffee
grounds or cat litter and toss in the
trash.
32
STOP SUPERBUGS NOW; Myths about antibiotics; No, they won't
help with the cold or flu, and other common misconceptions.
Teresa Carr; Consumer Reports; Published: June 25, 2015
32. Antibiotics
Myth 5. All bacterial infections require
drugs.
• Mild ones sometimes clear up on
their own. So ask your doctor
whether you could try waiting it
out.
33
STOP SUPERBUGS NOW; Myths about antibiotics; No, they won't
help with the cold or flu, and other common misconceptions.
Teresa Carr; Consumer Reports; Published: June 25, 2015
33. Antibiotics
Myth 6. The more bacteria a drug kills,
the better.
• Wrong. So-called broad-spectrum
drugs, such as ceftriaxone, cipro-
floxacin and levofloxacin, should be
reserved for hard-to-treat infections.
34
STOP SUPERBUGS NOW; Myths about antibiotics; No, they won't
help with the cold or flu, and other common misconceptions.
Teresa Carr; Consumer Reports; Published: June 25, 2015
34. Pathogen Cases
Streptococcus pneumoniae 20-60%
Haemophilus influenza 3-10%
Staphylococcus aureus 3-5%
Gram-negative bacilli 3-10%
Legionella species 2-8%
Mycoplasma pneumoniae 1-6%
Chlamydia pneumoniae 4-6%
Viruses 2-15%
Aspiration 6-10%
Others 3-5%
Adapted from Mandell LA, Bartlett JG, Dowell SF, et al: Update of practice guidelines for the management of community-acquired
pneumonia in immunocompetent adults. Clin Infect Dis 2003;37:1405-1433.
Many pathogens: Which to treat?
35
36. • Medical history
• Physical exam
• Chest x-rays
• Blood tests
• Blood culture
• Sputum collection
• CT – chest computed tomography
Current methods to determine
if patients have pneumonia
37
Current methods to determine
if patients have pneumonia
37. • Thoracentesis –
Pleural fluid culture
• Pulse oximetry
• Nasal swab
• Throat swab
• Urine antigen
• Bronchoscopy - BAL
Current methods to determine
if patients have pneumonia
38
Current methods to determine
if patients have pneumonia
38. • Specimens are very often
contaminated from the upper
respiratory resulting in many false
positives.
• This leads to broad antibiotic
treatment because the actual
pathogen causing the pneumonia is
usually never identified.
39
Current sampling data
is not reliable or accurate
39. • Chest x-rays can reveal areas of
opacity (seen as white) which
represent consolidation.
• Pneumonia is not always seen on x-
rays, either because the disease is
only in its initial stages, or because it
involves a part of the lung not easily
seen by x-ray.
• X-rays cannot identify pathogens.
Routine chest x-rays
40
43. The Need
• Pneumonia is a leading cause of
death in children worldwide. Over 2
million children die from pneumonia
each year and one child dies every 20
seconds.
• The problem with current diagnosis
methods is one of sampling. Mouth
and nose samples have
contaminating bacteria, which result
in many false positives.
44
44. The Need
• Additionally, the samples are unable
to identify the pathogen; hospital
stays are lengthened increasing the
chances that cases will become
complicated.
• Since the pathogen cannot be
identified, patients receive broad-
spectrum antibiotics, which are often
unnecessary and can cause antibiotic
resistance.
45
45. The Need
• Other methods, such as a chest x-ray,
can identify fluid in the lungs, but
cannot identify the specific pathogen
causing the pneumonia.
46
46. The Need
• Antibiotic resistance is one of the
world's most pressing public health
threats.
• Antibiotics are the most important
tool we have to combat life-
threatening bacterial disease, but
using antibiotics can also result in side
effects.
47
47. The Need
• Antibiotic use leads to new drug-
resistant germs and increased risks to
patients.
• Patients, healthcare providers,
hospital administrators and policy
makers must work together to
employ safe and effective strategies
for improving antibiotic use—
ultimately saving lives.
48
48. The Need
“Antimicrobial resistance is one of our
most serious health threats.
Infections from resistant bacteria are
now too common, and some pathogens
have even become resistant to multiple
types or classes of antibiotics.”
Dr. Tom Frieden, MD, MPH
Director, U.S. Centers for Disease Control and Prevention
Meeting the Challenges of Drug-Resistant Diseases in Developing Countries
Committee on Foreign Affairs Subcommittee on Africa, Global Health, Human
Rights, and International Organizations
United States House of Representatives
April 23, 2013
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50. • Pneumonia kills more children than
any other disease. Unfortunately,
the pathogen cannot be identified in
most patients.
• Thepathogens causing pneumonia
are difficult to identify because a
high quality specimen from the
lower lung is difficult to obtain due
to contamination of the sample.
Development of
PneumoniaCheck
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51. • PneumoniaCheck was developed and
designed to collect aerosolspecimens
selectively from the lower lung
generated during deep cough.
• This technology allows
PneumoniaCheck to effectively
separate the upper respiratory tract
from the aerosols in the lung by
>90%.
Development of
PneumoniaCheck
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52. • PneumoniaCheck utilizes a
separation reservoir and specially
designed mouthpiece to segregate
contents from the upper airway and
the lower lungs.
Development of
PneumoniaCheck
53
53. • PneumoniaCheck includes several
specially designed features to exclude
oral contaminants from the sample
and a filter to collect theaerosolized
pathogens from the lower lungs.
• The filter can collect >99.97% of virus
and bacteria sized particles from the
sampled lower lung aerosols.
Development of
PneumoniaCheck
54
54. • PC saves time and money
diagnosing pneumonia; however, it
is NOT a diagnostic device.
Development of
PneumoniaCheck
55
56. The Device
• PneumoniaCheck uses fluid
mechanics to separate the upper
airway particles from the lower
airway particles.
• The separation means that only a
lung specimen is captured on the
filter media at the end of the device.
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57. The Device
• This filter can then be analyzed using
traditional microbiology methods or
more sensitive molecular DNA
analysis to identify the specific
pathogen causing pneumonia, or
other lower respiratory infections.
58
58. The Device
• The ability to identify the specific
pathogen will allow for more
targeted antibiotic treatment or none
at all if viral, which should reduce
antibiotic resistance and other
complications.
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59. The Device
• PneumoniaCheck is an easy-to-use,
noninvasive, disposable solution for
collecting respiratory specimens to
help reduce one of the world’s
largest health problems.
• PneumoniaCheck may be used on
patients three feet and taller.
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61. • To use PneumoniaCheck, a patient
simply coughs deeply into the
mouthpiece and expels the
remaining air in his or her lungs.
• This action can be repeated as
many times as necessary to collect
a sufficient sample of lower
respiratory aerosolized pathogens.
• Recommend collecting 10 coughs
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62. • The air from the upper respiratory is
collected in a reservoir, and aerosols
from the lower respiratory are
captured on a microbial filter.
• The filter can then be sent to a
laboratory to be tested for the
presence of various pathogens.
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63. • PneumoniaCheck uses fluid
mechanics to isolate lung
pathogens onto the filter.
• Fluid mechanics is the branch of
physics that studies fluids (liquids,
gases, and plasmas) and the forces
on them.
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67. • The air from the upper respiratory is
collected in a reservoir, and aerosols
from the lower respiratory are
captured on a microbial filter.
• PneumoniaCheck is then sent to a
laboratory to be tested for the
presence of various pathogens.
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