Antimicrobial stewardship & healthcare epidemiology : ASHE最新文献

{"title":"Women in ASHE.","authors":"Louise-Marie Dembry","doi":"10.1017/ash.2025.34","DOIUrl":"https://doi.org/10.1017/ash.2025.34","url":null,"abstract":"","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e58"},"PeriodicalIF":0.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A review of implementation aspects and sustainability in the prevention of hospital onset bacteremia.","authors":"Robert Garcia, Edward J Septimus, Jack LeDonne, Lisa K Sturm, Nancy Moureau, Michelle DeVries, Barbara DeBaun","doi":"10.1017/ash.2025.1","DOIUrl":"https://doi.org/10.1017/ash.2025.1","url":null,"abstract":"<p><p>The emerging perspectives and implementation aspects presented in this review article outline infection prevention core components supported by recent research relevant to the mitigation of Hospital Onset Bacteremia and Fungemia in a surveillance setting that includes expanded efforts to all vascular access devices.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e62"},"PeriodicalIF":0.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the impact of treatment guidelines on outpatient antibiotic prescription trends at a cancer center in Pakistan.","authors":"Salma Abbas, Seemal Aslam, Sara Batool, Mahnoor Zafar, Sadia Khaliq, Momal Fatima, Iraj Shehzad, Muhammad Arslan, Iqra Attiq, Muhammad Shehbaz, Anum Khan, Muhammad Ali Raza, Hamza Zulfiqar, Ahsan Mahmood, Faisal Sultan","doi":"10.1017/ash.2025.2","DOIUrl":"https://doi.org/10.1017/ash.2025.2","url":null,"abstract":"<p><strong>Objective: </strong>To assess the impact of treatment guidelines on the trends of outpatient antibiotic prescription among pediatric and adult patients at a cancer center in Pakistan.</p><p><strong>Design: </strong>Retrospective observational study conducted between July 1^st 2018 and July 31^st 2023.</p><p><strong>Methods: </strong>We determined the indication for antibiotics and the frequency of guideline-discordant prescriptions for upper respiratory tract infection (URTI), lower respiratory tract infection (LRTI), urinary tract infection (UTI), and diarrhea. The χ² test was used to assess the impact of treatment guidelines on antibiotics prescribed for these indications.</p><p><strong>Results: </strong>The top indications for antibiotic prescription were skin and skin structure infection (SSSI) (n = 5159; 21.5%), URTI (n = 2760; 11.5%) and UTI (n = 2686; 11.2%). Amoxicillin-clavulanate (n = 7964; 33.3%), was the most frequently prescribed antibiotic. A large proportion of antibiotic prescriptions for URTI, diarrhea, UTI, and LRTI were either inappropriate (n = 6695; 86.5%) or unnecessary (n = 5534; 71.5%). Results revealed a statistically significant decline in the proportion of inappropriate antibiotics for UTI (91.3% vs 84.0%; <i>P</i> ≤ .001) and diarrhea (92.6% vs 87.0%; <i>P</i> = .031) and unnecessary antibiotics for diarrhea (90.2% vs 83.2%; <i>P</i> = .016) with the introduction of treatment guidelines. We noted a higher proportion of unnecessary prescriptions for LRTI (41.7% vs 31.7%; <i>P</i> = .003) and inappropriate antibiotics for UTI (95.1% vs 87.4%; <i>P</i> = .011) for pediatric patients.</p><p><strong>Conclusion: </strong>Misuse of outpatient antibiotics is common. Diarrhea, URTI, UTI, and LRTI are high-priority conditions for outpatient oncology-focused prescriber education and stewardship interventions.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e51"},"PeriodicalIF":0.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An inpatient antimicrobial stewardship team driven penicillin allergy delabeling protocol for minimal and low-risk penicillin allergic patients.","authors":"Shivanjali Shankaran, Emily Adochio, Robert Petrak, Benjamin Goldenberg, Fischer Herald, Christy Lunn, Hayley Hodgson, Sarah Won","doi":"10.1017/ash.2025.7","DOIUrl":"https://doi.org/10.1017/ash.2025.7","url":null,"abstract":"<p><p>Inappropriate penicillin allergy labeling results in suboptimal or excessive broad spectrum antibiotic use. In this multidisciplinary project, the antimicrobial stewardship team safely delabeled 71.4% of hospitalized patients approached. Similar programs may also be able to delabel minimal or low-risk penicillin allergic patients without formal allergy consultation.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e54"},"PeriodicalIF":0.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stewarding the inappropriate diagnosis and treatment of urinary tract infection: leveraging the urinalysis to understand true antibiotic overuse.","authors":"Whitney Hartlage, Alyssa Y Castillo, Zahra Kassamali Escobar, Maria Bajenov, Natalia Martinez-Paz, John B Lynch, Chloe Bryson-Cahn, Jeannie D Chan","doi":"10.1017/ash.2025.26","DOIUrl":"https://doi.org/10.1017/ash.2025.26","url":null,"abstract":"<p><p>We evaluated 249 asymptomatic patients receiving antibiotics for urinary infection: 222 had asymptomatic pyuria and/or nitrituria (ASPN) and 133 had asymptomatic bacteriuria (ASB, growth ≥10⁵ colony forming units/ml). ASPN identified 40% more cases of unnecessary antibiotics compared to ASB and may be a more comprehensive measure of unnecessary antibiotic use.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e49"},"PeriodicalIF":0.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stewarding beyond the 9-5: Implementation of overnight review of rapid blood culture identification panel results by intensive care unit pharmacists.","authors":"Sarah M Arduser Sindelar, Jonathan H Ryder, Jeremy Tigh, Theodore Blum, Jessica Prucha, Paul Fey, Scott J Bergman, Trevor C Van Schooneveld, Shawnalyn W Sunagawa","doi":"10.1017/ash.2025.28","DOIUrl":"https://doi.org/10.1017/ash.2025.28","url":null,"abstract":"<p><p>Rapid blood culture identification is most effective with antimicrobial stewardship feedback, which is limited during non-business hours. We implemented overnight review of Blood Culture Identification 2 panel results by intensive care unit pharmacists and demonstrated reduced time to evaluation (3.6 vs 9.3 hours, <i>P</i> < .01).</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e52"},"PeriodicalIF":0.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Curbing inappropriate <i>C. difficile</i> treatment in patients receiving concomitant laxatives.","authors":"Paige Fields, Christopher David, Anish Choksi, Natasha N Pettit, Alison K Lew, Jennifer Pisano, Cynthia T Nguyen","doi":"10.1017/ash.2025.25","DOIUrl":"https://doi.org/10.1017/ash.2025.25","url":null,"abstract":"<p><p>In the setting of universal <i>Clostridioides difficile</i> screening, we implemented an alert that triggered when <i>C. difficile</i> treatment was ordered in patients who recently received laxatives. This resulted in <i>C. difficile</i> treatment avoidance in 37% of patients and was associated with drug cost savings of $143,905 over a 10-month period.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e50"},"PeriodicalIF":0.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential role of report nudging on diagnosis and treatment of ventilator-associated pneumonia: a quantitative survey.","authors":"Kimberly C Claeys, Blaine Kenaa, Ravi K Tripathi, Kristen Rayner, Michelle Newman, Surbhi Leekha","doi":"10.1017/ash.2025.43","DOIUrl":"https://doi.org/10.1017/ash.2025.43","url":null,"abstract":"<p><p>Diagnosis of ventilator-associated pneumonia (VAP) is challenging and relies heavily on respiratory culture results. The results of this survey underscore the potential for a diagnostic stewardship nudge limiting culture reports to \"potential colonization or contamination\" in those without clinical findings of VAP to decrease unnecessary antibiotic prescribing.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e55"},"PeriodicalIF":0.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short versus long treatment duration for streptococcal bloodstream infection.","authors":"Julie Gray, Chong Zhang, Ali Earl, Emily S Spivak","doi":"10.1017/ash.2025.29","DOIUrl":"10.1017/ash.2025.29","url":null,"abstract":"<p><strong>Background: </strong>Emerging data surrounding the rise in antimicrobial resistance have prompted a shift towards shorter antibiotic durations. Studies show similar clinical outcomes comparing shorter antibiotic courses to longer ones for uncomplicated Gram-negative bloodstream infections (BSI). However, there is a lack of data to inform durations of therapy for Streptococcal BSI.</p><p><strong>Methods: </strong>This was a retrospective cohort study of patients admitted to University of Utah Health with uncomplicated Streptococcal BSI. Inverse probability of treatment weighting (IPTW) was used to estimate the average treatment effects (ATE) of antibiotics administered for 10 days or fewer (short duration) versus more than 10 days (long duration). The primary outcome was a composite of recurrent BSI, all-cause mortality, and readmissions at 30 days from end of therapy.</p><p><strong>Results: </strong>Five hundred patients were screened and 196 were included in the final analysis. The most common sources were skin and soft tissue infections. The median duration in the short and long groups were 8 (IQR, 7-10) and 15 days (IQR, 14-17), respectively. The ATE of short versus long duration of antibiotics was not significant for the composite primary outcome (18% vs 18%; OR = 1.42 [95% CI: 0.57 to 3.53]).</p><p><strong>Conclusions: </strong>We found no appreciable difference in outcomes between patients treated with short versus long antibiotic durations for uncomplicated Streptococcal BSI. Given low absolute rates of mortality and recurrent BSI, along with the lack of evidence indicating a significant difference related to treatment duration, it is reasonable to consider shorter durations. Future research is needed to confirm our findings.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e47"},"PeriodicalIF":0.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-center observational analysis of a pharmacist-driven antibiotic time-out targeting antipseudomonal drugs.","authors":"Carina Diaz, Alice Margulis Landayan, Lorenzo Porras, Sonia Samsundar, Jorge Murillo, Timothy P Gauthier","doi":"10.1017/ash.2025.6","DOIUrl":"https://doi.org/10.1017/ash.2025.6","url":null,"abstract":"<p><p>This study found that implementation of a pharmacist-driven antipseudomonal antibiotic time-out at a 450-bed community hospital led to a 5% reduction in the use of targeted antipseudomonal antibiotics (<i>P</i> = .12), which may be clinically meaningful as it extrapolates to approximately 1,800 avoided days of therapy annually.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e48"},"PeriodicalIF":0.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}