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.
Antibiotic stewardship explained in one presentation, which can be helpful to the medical field beginners and students as well as thorough information can be obtained regarding the subject matter.
Objectives:
1. To understand the purpose of implementing an antimicrobial stewardship program (ASP)
2.To recall the core elements of hospital and outpatient antibiotic stewardship programs as defined by the CDC
3. To recognize key interventions that an antimicrobial stewardship program can implement in both the hospital and community settings
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.
Antibiotic stewardship explained in one presentation, which can be helpful to the medical field beginners and students as well as thorough information can be obtained regarding the subject matter.
Objectives:
1. To understand the purpose of implementing an antimicrobial stewardship program (ASP)
2.To recall the core elements of hospital and outpatient antibiotic stewardship programs as defined by the CDC
3. To recognize key interventions that an antimicrobial stewardship program can implement in both the hospital and community settings
Antibiotic policy and trends in antibiotic policy,
References
Infection control: Basic concepts and practices, 2nd edn.
www.cdc.org
Antibiotics guide: choices for common infections
Chennai Declaration
Antibiotic policy and trends in antibiotic policy,
References
Infection control: Basic concepts and practices, 2nd edn.
www.cdc.org
Antibiotics guide: choices for common infections
Chennai Declaration
Antimicrobial stewardship programs (ASP) are an essential practice to prevent increasing
resistance against antibiotics. A successful ASP monitors not only prescribing patterns and
practices but also contributes in minimizing the toxic effects of antibiotics. Moreover, ASP
also facilitates the selection of disease specific antibiotics and enforces rules and regulations to rationalize the use of antibiotics. The aim of the study is to highlight the core
elements of Hospital Antibiotic Stewardship Programs in Karachi. The key elements proposed by center of disease control (CDC) such as; leadership, accountability, drug
expertise, actions to support optimal antibiotic use, tracking (monitoring antibiotic prescribing, use and resistance), reporting information to staff on improving antibiotic use
and resistance and education were evaluated on Yes/No scale. The data was collected
from 44 hospitals of different categories in Karachi and all the major elements were
studied. It was observed that all the hospitals in one setting failed to comply with all the
guidelines. It has been concluded that efforts should be made to design ASP at each
hospital and implemented through suitable policies and procedures.
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
For decades microbes, in particular bacteria, have become increasingly resistant to various antimicrobials.
The World Health Assembly’s endorsement of the Global Action Plan on Antimicrobial Resistance (AMR) in May 2015, and the Political Declaration of the High-Level Meeting of the General Assembly on AMR in September 2017, both recognize AMR as a global threat to public health.
These policy initiatives acknowledge overuse and misuse of antimicrobials as a main driver for development of resistance, as well as a need to optimize the use of antimicrobials.
The Global Action Plan on AMR sets out five strategic objectives as a blueprint for countries in developing national action plans (NAPs) on AMR:
Objective 1: Improve awareness and understanding of AMR through effective communication, education and training.
Objective 2: Strengthen the knowledge and evidence base through surveillance and research.
Objective 3: Reduce the incidence of infection through effective sanitation, hygiene and infection prevention measures.
Objective 4: Optimize the use of antimicrobial medicines in human and animal health.
Objective 5: Develop the economic case for sustainable investment that takes account of the needs of all countries, and increase investment in new medicines, diagnostic tools, vaccines and other interventions.
Antimicrobial stewardship programmes optimize the use of antimicrobials, improve patient outcomes, reduce AMR and health-care-associated infections, and save health-care costs amongst others.
Today, AMS is one of three “pillars” of an integrated approach to health systems strengthening. The other two are infection prevention and control (IPC) and medicine and patient safety.
Linking all three pillars to other key components of infection management and health systems strengthening, such as AMR surveillance and adequate supply of quality assured medicines, promotes equitable and quality health care towards the goal of achieving universal health coverage
CDC has defined “Antimicrobial stewardship” as-
The right antibiotic
for the right patient,
at the right time,
with the right dose, and
the right route, causing
the least harm to the patient and future patients
Why AMSP is needed?
Antimicrobial Resistance (AMR)
Misuse and Over-use of Antimicrobials
Widespread Use of Antimicrobials in Other Sectors
Poor Antimicrobial Research
IMPLEMENTATION OF ANTIMICROBIAL STEWARDSHIP PROGRAM
Administrative Support (Leadership)
Formulating AMS Team
Infrastructure Support
Framing Antimicrobial Policy
Implementing AMS strategies
Education and Training
Should be publicly committed to the program.
Provide necessary funding and infrastructure support.
Multidisciplinary committee - responsible for framing, implementing and monitoring the compliance to antimicrobial policy of the hospital.
Led by the antimicrobial steward - infectious disease physician or infection control officer or clinical microbiologist.
Other members of AMS team - stewardship nurses
In today’s healthcare environment, there is an increasing emphasis on antimicrobial stewardship programs (ASP) and their impact on patient and community health and hospital financials. There are now new regulatory standards from The Joint Commission (TJC) that require hospitals to implement ASPs, and the Centers for Medicare and Medicaid Services (CMS) has proposed making it mandatory that hospitals implement an ASP in order to participate in Medicare and Medicaid. Regardless, a solid ASP is critically important to patient wellbeing, public health, and a hospital’s bottom line. This webinar will focus on how to bring a successful ASP to life in your hospital with a business plan and buy in from key stakeholders across the organization.
Dr.sherin elsherbiny
Senior registrar clinical microbiology
AMR coordinator
Infection control auditor
Riyadh region
Meeqat General Hospital ,Madina,KSA
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
Tackling the U.S. Healthcare System’s Infectious Disease Management ProblemViewics
The United States healthcare system has a serious infectious disease management problem. The antibiotic resistance crisis is widespread, serious, costly, and deadly. Delays in pathogen identification lead to poor clinical outcomes, including increased mortality risk. And, optimally managing outbreaks is critical to health systems whose reimbursement is tied to the health of a population, such as ACOs.
Eleanor Herriman, MD, MBA, Chief Medical Informatics Officer at Viewics led an informative panel discussion with industry leaders on the issues surrounding the infectious disease management crisis. Margret Oethinger, MD, Ph.D., Medical Director of Providence Health & Services, and Susan E. Sharp, Ph.D., DABMM, FAAM, Regional Director of Microbiology and the Molecular Infectious Disease Laboratories, Department of Pathology, Kaiser Permanente and President-Elect, American Society for Microbiology cover the current state of infectious disease management in the U.S., and what can be done to improve it.
You’ll learn about:
• The magnitude of the U.S. health system’s infectious disease management problem
• The most serious concerns and trends for healthcare institutions and communities across the nation
• The most promising solutions to health systems’ most urgent infectious disease management challenges
Dr. Arjun Srinivasan - In-Patient Antimicrobial Resistance (AMR) IssuesJohn Blue
In-Patient Antimicrobial Resistance (AMR) Issues - Dr. Arjun Srinivasan, Associate Director for Healthcare-Associated Infection Prevention Programs, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (CDC), 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
Dr. Julie Lyn Hall, WHO Country Representative for the Philippines, discusses the strategies of the WPRO in handling and preventing EIDs like Ebola and MERS-CoV in our region
In the age of internet and social media, Dr. Carl Abelardo Antonio teaches us how to evaluate online health resources so we can tell which of them is gold and which of them is junk.
Dr. Mary Ann Lansang teaches us how to use the concepts of evidence-based medicine in our daily lives as infection prevention and control practitioners
This comprehensive lecture by Dr. Anthony Perez discusses the epidemiology, presentation, management and preventive strategies against surgical site infections
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Antimicrobial stewardship to prevent antimicrobial resistanceGovindRankawat1
India is among the nations with the highest burden of bacterial infections.
India is one of the largest consumers of antibiotics worldwide.
India carries one of the largest burdens of drug‑resistant pathogens worldwide.
Highest burden of multidrug‑resistant tuberculosis,
Alarmingly high resistance among Gram‑negative and Gram‑positive bacteria even to newer antimicrobials such as carbapenems.
NDM‑1 ( New Delhi Metallo Beta lactamase 1, an enzyme which inactivates majority of Beta lactam antibiotics including carbapenems) was reported in 2008
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
2. Outline
Context: global and local actions; the infection control unit and the
antimicrobial stewardship program of an institution
Why: the need for an institutional antibiotic policy
How: evidence-guided recommendations, best practices, and
experiences in the formulation of antibiotic policies in an
institution
Who: stewards of rational antibiotic use and stakeholders
3.
4. The Development of Antimicrobial Resistance
From: Faces of Antimicrobial Resistance, IDSA, 2017
5. 2020 Targets of the Action Plan
(5-year time frame)
- Reduce by 30% carbapenem-resistant
Enterobacteriaceae infections acquired during
hospitalization
-Maintain the prevalence of ceftriaxone-resistant N.
gonorrhoeae to zero
-Reduce by at least 30% MRSA bloodstream infections
compared to 2014 rates
-Reduce by 30% MDR Pseudomonas spp. Infections
acquired during hospitalization compared to 2014 rates
- Reduce by 25% ciprofloxacin-resistant non-typhoidal
Salmonella infections compared to 2014
8. WHO Global Priority Pathogens List
for R&D of New Antibiotics
(released 27 Feb 2017)
# Mycobacteria not included – already established as a global priority.
15. “… the concerted implementation of systematic,
multi-disciplinary, multi-pronged interventions
in both public and private hospitals in the
Philippines to improve appropriate use of
antimicrobials…”
16. Strategies for controlling AMR:
inter-related approaches
Antibiotic
stewardship
• Surveillance
• Antibiotic policies &
guidelines
• Antibiotic manage-
ment programs
Prevention of spread
• Infection prevention &
control in healthcare settings
• Isolation when needed
• Hand hygiene
• Environmental hygiene
Reduction
• Usage control
• Appropriate use
• Human
• Animal
• Environmental
18. Strategies for controlling AMR:
inter-related approaches
Antibiotic
stewardship
• Surveillance
• Antibiotic policies
& guidelines
• Antibiotic manage-
ment programs
Prevention of spread
• Infection prevention &
control in healthcare settings
• Isolation when needed
• Hand hygiene
• Environmental hygiene
Reduction
• Usage control
• Appropriate use
• Human
• Animal
• Environmental
19. Outline
Context: global and local actions; the infection control unit and the
antimicrobial stewardship program of an institution
Why: the need for an institutional antibiotic policy
How: evidence-guided recommendations, best practices, and
experiences in the formulation of antibiotic policies in an
institution
Who: stewards of rational antibiotic use and stakeholders
20. Why do we need a hospital
antibiotic policy? (1)
• High level of antibiotic use in hospitals. CDC report (MMWR, 7Mar2017):
• 56% of patients discharged from 323 US hospitals received antibiotics
• 37% of antibiotic prescribing could be improved
• Patients with multiple pathogens are concentrated in hospitals
• Close proximity of patients with multiple healthcare worker contacts
• Sicker, more vulnerable patients in the hospitals
• Transfer of patients with MDR organisms into the hospital from the
community, another facility, or another country
21. From: Paterson DL. The Role of Antimicrobial Management Programs in Optimizing Antibiotic Prescribing within Hospitals
Clin Infect Dis. 2006;42(Supplement_2):S90-S95. doi:10.1086/499407
22. Why do we need a hospital
antibiotic policy? (2)
• To improve patient outcomes through appropriate
antibiotic use: the RIGHT indication, choice, dose,
route of administration, timing, duration
• To minimize harm to the patients (and future patients)
• To reduce health care-related costs: shorter hospital
stay, use of less costly antibiotics, less ADRs
• To prevent or control the emergence of AMR
23. Outline
Context: global and local actions; the infection control unit
and the
antimicrobial stewardship program of an institution
Why: the need for an institutional antibiotic policy
How: evidence-guided recommendations, best
practices, and experiences in the formulation of
antibiotic policies in an institution
Who: stewards of rational antibiotic use and stakeholders
35. From:
All hospitals should adopt or adapt to their local
context the National Antibiotic Guidelines to
guide clinicians in the management of infectious
diseases and in the selection of the most
appropriate antimicrobial agent.
36.
37.
38.
39. From:
Simple and clear clinical pathways
should be created to guide and
standardize treatment for timely
and appropriate management of
infections.
41. Summary of strategies to improve antibiotic use (1)
Pulcini & Gryssens. Virulence 2013; 4:192-202
Passive educational measures Developing/updating local antibiotic guidelines
Educational sessions, workshops, local conferences
Clinical rounds discussing cases
Active interventions Prospective audit with intervention & feedback
Reassessment of abtic prescriptions, with streamlining &
de-escalation of therapy
Academic detailing, educational outreach visits
Restrictive measures Limiting no. of abtics on the hosp. formulary
Antibiotic order form (compulsory)
Automatic stop order
Formulary restriction & pre-authorization
Limiting reporting of susceptibilities by the micro lab
Regulating contacts with the pharma industry
42. Summary of strategies to improve antibiotic use (2)
Pulcini & Gryssens. Virulence 2013; 4:192-202
Supportive/supplemental measures Multidisciplinary AMS team
Consultancy service (infectious diseases, pharmacy,
microbiology)
Computer-assisted management program
Parenteral to oral conversion
Therapeutic drug monitoring service
46. Outline
Context: global and local actions; the infection control unit and the
antimicrobial stewardship program of an institution
Why: the need for an institutional antibiotic policy
How: evidence-guided recommendations, best
practices, and experiences in the formulation of
antibiotic policies in an institution
Who: stewards of rational antibiotic use and
stakeholders
50. 2015 WHO WPRO and Philippines partnership:
Pilot AMS Program implementation in Hospitals
TRAINING OF TRAINORS
WORKSHOP ON THE
ANTIMICROBIAL STEWARDSHIP
ADVOCACY PACKAGE
(March and September 2015)
Baguio General Hospital and Medical
Center
CAR
Jose B. Lingad Memorial Regional
Hospital
Region III
Rizal Medical Center NCR
Research Institute for Tropical Medicine NCR
Corazon Locsin Montelibano Memorial
Regional Hospital
Region VI
Vicente Sotto Memorial Medical Center Region VII
Northern Mindanao Medical Center Region X
Southern Philippines Medical Center Region XI