Antimicrobial stewardship & healthcare epidemiology : ASHE最新文献

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Implementation and evaluation of a complex outpatient oral antimicrobial therapy program (COpAT) in Canada. 加拿大复杂门诊口服抗菌药物治疗方案(COpAT)的实施和评估。
Antimicrobial stewardship & healthcare epidemiology : ASHE Pub Date : 2025-02-12 eCollection Date: 2025-01-01 DOI: 10.1017/ash.2025.19
Maggie Wong, Davie Wong
{"title":"Implementation and evaluation of a complex outpatient oral antimicrobial therapy program (COpAT) in Canada.","authors":"Maggie Wong, Davie Wong","doi":"10.1017/ash.2025.19","DOIUrl":"10.1017/ash.2025.19","url":null,"abstract":"<p><strong>Objective: </strong>We describe the implementation, outcomes, and challenges of a complex outpatient oral antimicrobial therapy program (COpAT) in Canada to provide a framework for those interested in establishing such a program.</p><p><strong>Setting: </strong>Outpatient ambulatory clinic led by infectious diseases physicians, serving patients from a tertiary hospital and a small community hospital.</p><p><strong>Design: </strong>Retrospective observational study that evaluated the efficacy, safety, and cost savings of patients enrolled in the program from August 2023 to June 2024.</p><p><strong>Results: </strong>One hundred three patients were included, of which 84.4% achieved successful clinical outcomes. Mean age of the patients was 62 years and 30% had diabetes. The top three sources of infections were bone and joint, intra-abdominal, and skin-and-soft tissue. Mean duration of COpAT was 37 days. Seventy-five percent of patients required only a single agent, and amoxicillin/clavulanic acid was most commonly used. Twenty-two patients developed an adverse reaction, of which three required a change in therapy and one resolved with antibiotic dose reduction. No C. difficile infections or mortality were reported 30-days post COpAT discharge. Twelve patients were re-admitted to the hospital; 50% of the cases were unrelated to infections. Compared to outpatient intravenous therapy, the total cost savings from COpAT were estimated to be $255,000 Canadian dollars (CAD), which translated to an average cost savings of $2500 CAD per patient per year.</p><p><strong>Conclusion: </strong>We demonstrated favorable clinical and safety outcomes with our COpAT program and substantial cost savings using existing infrastructure. COpAT allows efficient use of healthcare resources including decongestion of hospitals.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e39"},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416410","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}
引用次数: 0
Implementing with intention: advantages, challenges, and tactics to optimally utilize the AXR metric. 有意实现:优势、挑战和最佳利用AXR指标的策略。
Antimicrobial stewardship & healthcare epidemiology : ASHE Pub Date : 2025-02-12 eCollection Date: 2025-01-01 DOI: 10.1017/ash.2024.495
Alyssa Y Castillo, Holly M Frost, Nicole M Poole, Timothy C Jenkins, Allan M Seibert, Edward Stenehjem
{"title":"Implementing with intention: advantages, challenges, and tactics to optimally utilize the AXR metric.","authors":"Alyssa Y Castillo, Holly M Frost, Nicole M Poole, Timothy C Jenkins, Allan M Seibert, Edward Stenehjem","doi":"10.1017/ash.2024.495","DOIUrl":"10.1017/ash.2024.495","url":null,"abstract":"<p><p>Antibiotic utilization for respiratory conditions (AXR) is a new Healthcare Effectiveness Data & Information Set <sup>®</sup> (HEDIS<sup>®</sup>) measure designed to complement disease-specific metrics to improve outpatient antibiotic prescribing. Unique challenges include ensuring clinicians understand the metric and establishing appropriate goals within different health systems and service lines. Successful implementation requires awareness of the metric's limitations and may be enhanced by co-reporting with condition-specific antibiotic use metrics to prioritize local interventions.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e42"},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416411","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}
引用次数: 0
Use of standardized nasal and skin decolonization to reduce rates of bacteremia in patients undergoing extracorporeal membrane oxygenation. 使用标准化的鼻腔和皮肤去菌落以降低体外膜氧合患者的菌血症率。
Antimicrobial stewardship & healthcare epidemiology : ASHE Pub Date : 2025-02-12 eCollection Date: 2025-01-01 DOI: 10.1017/ash.2025.9
Madyson Taylor, Russell L Griffin, Jeremey Walker, Catina James, Angela Akinsanya, Mary Duncan, Rachael A Lee
{"title":"Use of standardized nasal and skin decolonization to reduce rates of bacteremia in patients undergoing extracorporeal membrane oxygenation.","authors":"Madyson Taylor, Russell L Griffin, Jeremey Walker, Catina James, Angela Akinsanya, Mary Duncan, Rachael A Lee","doi":"10.1017/ash.2025.9","DOIUrl":"10.1017/ash.2025.9","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to determine if implementation of universal nasal decolonization with daily chlorhexidine bathing will decrease blood stream infections (BSI) in patients undergoing extracorporeal membrane oxygenation (ECMO).</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Tertiary care facility.</p><p><strong>Patients: </strong>Patients placed on ECMO from January 1, 2017 to December 31, 2023.</p><p><strong>Intervention: </strong>Daily bathing with 4% chlorhexidine soap and universal mupirocin nasal decolonization were initiated for all ECMO patients May 2021. The primary outcome was rate of ECMO-attributable positive blood cultures. Zero-inflated Poisson regression analysis was performed to estimate rate ratios (RRs) for the association between decolonization with BSI rates.</p><p><strong>Results: </strong>A total of 776 patients met inclusion criteria during the study period, 425 (55%) preimplementation and 351 (45%) post-implementation. Following implementation of decolonization, the overall incidence rate of BSI increased nonsignificantly from 10.7 to 14.0 infections per 1000 ECMO days (aRR 1.09, 95% CI 0.74-1.59). For gram-positive cocci (GPC) pathogens, a nonsignificant 40% increased rate was observed in the post-implementation period (RR 1.40, 95% CI 0.89-2.21), due mostly to a significant increase in the crude rate of <i>Enterococcus</i> BSI (RR 1.89, 95% CI 1.01-3.55). Excluding <i>Enterococcus</i> resulted in a nonsignificant 28% decreased rate (aRR 0.72, 95% CI 0.39-1.36) due to a nonsignificant 55% decreased rate of MRSA (aRR 0.45, 95% CI 0.18-3.58).</p><p><strong>Conclusions: </strong>Implementation of a universal decolonization protocol did not significantly reduce rates of certain BSIs, including MRSA and other gram-positive pathogens. Although nonsignificant, reduction in BSI rates in this patient population has important implications on surveillance metrics, such as MRSA, and in the future, hospital-onset bacteremia.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e41"},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416419","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}
引用次数: 0
Handshake antimicrobial stewardship for adult surgical patients. 成人外科病人握手抗菌药物管理。
Antimicrobial stewardship & healthcare epidemiology : ASHE Pub Date : 2025-02-12 eCollection Date: 2025-01-01 DOI: 10.1017/ash.2024.498
Abby Kosharek, Elizabeth Neuner, Emily Welch, Spenser January, Alice Bewley, Kevin Hsueh, Sena Sayood
{"title":"Handshake antimicrobial stewardship for adult surgical patients.","authors":"Abby Kosharek, Elizabeth Neuner, Emily Welch, Spenser January, Alice Bewley, Kevin Hsueh, Sena Sayood","doi":"10.1017/ash.2024.498","DOIUrl":"10.1017/ash.2024.498","url":null,"abstract":"<p><strong>Objective: </strong>Evaluate the effects of handshake stewardship on adult general surgical units.</p><p><strong>Design: </strong>Retrospective quasi-experimental pre- and post-intervention study.</p><p><strong>Setting: </strong>A total of 1,278 bed academic medical center with a level 1 trauma center in St. Louis, Missouri.</p><p><strong>Patients: </strong>Adults admitted to general surgery units.</p><p><strong>Intervention: </strong>Once weekly handshake antimicrobial stewardship rounds were initiated in January 2022 on adult general surgery units. The handshake stewardship team consisted of an infectious diseases (ID) physician and pharmacist who reviewed charts of patients receiving systemic antimicrobials without a formal ID consult. Antimicrobial recommendations were delivered in person to general surgery teams including trauma, geriatric trauma, and emergency/general surgery.</p><p><strong>Results: </strong>A total of 1,241 charts were reviewed during the post-implementation period with 391 interventions. Seventy-two percent of those interventions were accepted and the acceptance rate improved over the 18-month post-implementation period. Total antimicrobial usage significantly decreased between the pre- and post-implementation period (608 vs 542 d of therapy/1,000 d present, <i>P</i> = 0.004). An interrupted time series found that there was an immediate (<i>P</i> < 0.001) and sustained (<i>P</i> < 0.001) decrease in antibiotic spectrum index during the post-implementation period. No difference was found for in-hospital mortality between the pre- and post-implementation periods [28 (1%) vs 29 (1%), <i>P</i> = 0.791].</p><p><strong>Conclusion: </strong>A once-weekly handshake antimicrobial stewardship program was successfully implemented in general surgery units. Antimicrobial use significantly decreased without negatively impacting hospital mortality.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e46"},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416435","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}
引用次数: 0
Development of a multi-year pediatric antibiogram in Georgia identifies antibiotic resistance changes over the past ten years. 格鲁吉亚多年儿童抗生素谱的发展确定了过去十年抗生素耐药性的变化。
Antimicrobial stewardship & healthcare epidemiology : ASHE Pub Date : 2025-02-12 eCollection Date: 2025-01-01 DOI: 10.1017/ash.2025.32
Matthew Linam, Madeleine Goldstein, Tracy Huang, Adrianna Westbrook, Robert C Jerris, Mark D Gonzalez
{"title":"Development of a multi-year pediatric antibiogram in Georgia identifies antibiotic resistance changes over the past ten years.","authors":"Matthew Linam, Madeleine Goldstein, Tracy Huang, Adrianna Westbrook, Robert C Jerris, Mark D Gonzalez","doi":"10.1017/ash.2025.32","DOIUrl":"10.1017/ash.2025.32","url":null,"abstract":"<p><strong>Background: </strong>Antibiograms monitor antibiotic resistance trends and help guide empiric antibiotic treatment. A statewide pediatric antibiogram can help inform stewardship efforts.</p><p><strong>Methods: </strong>Annual pediatric antibiograms for the five children's hospitals in Georgia from 2014-2023 were collected. All sites used the Clinical and Laboratory Standards Institute guidelines for antibiogram development. Antibiogram data were combined, and the most common bacteria were included: Staphylococcus aureus, Streptococcus pneumoniae, Enterococcus faecalis, Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae complex and Pseudomonas aeruginosa. Interhospital differences were compared for methicillin-susceptible S. aureus (MSSA), methicillin-resistant S. aureus (MRSA), E. coli and K. pneumoniae. The combined data from 2014 and 2023 were compared to demonstrate antibiotic susceptibility changes over time.</p><p><strong>Results: </strong>Data in 2023 for MSSA and MRSA showed clindamycin susceptibility was 78% and 82%, respectively. S. pneumoniae susceptibility to amoxicillin/clavulanate was 96%. E. faecalis resistance to ampicillin and vancomycin was rare. For all included gram-negative bacteria, susceptibility remained high to 3<sup>rd</sup> generation cephalosporins (90%-92%) and meropenem (95%-99%). From 2014 to 2023, the rate of MRSA decreased from 49% to 33.5%. S. pneumoniae susceptibility to amoxicillin/clavulanate and clindamycin significantly increased. For E. coli, there was a significant decrease in susceptibility for cefazolin (90% to 84%), ceftriaxone (95% to 92%), and meropenem (100% to 99%). There were nonsignificant decreases in susceptibility for K. pneumoniae.</p><p><strong>Conclusion: </strong>Over the past 10 years, MRSA rates decreased, S. pneumoniae antibiotic susceptibility increased, and gram-negative bacilli susceptibility was stable to slightly decreased. Georgia antibiogram data support the recommended antibiotic treatment for common pediatric infections.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e37"},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416432","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}
引用次数: 0
Electronic tools to improve procalcitonin utilization. 提高降钙素原利用的电子工具。
Antimicrobial stewardship & healthcare epidemiology : ASHE Pub Date : 2025-02-11 eCollection Date: 2025-01-01 DOI: 10.1017/ash.2024.501
Julia A Hisey, Grace K Mahowald, Nicole V Tolan, Phillip Kang, Ramy H Elshaboury, Anand S Dighe, Kent B Lewandrowski, Christiana A Demetriou, Stacy E F Melanson, Alyssa R Letourneau
{"title":"Electronic tools to improve procalcitonin utilization.","authors":"Julia A Hisey, Grace K Mahowald, Nicole V Tolan, Phillip Kang, Ramy H Elshaboury, Anand S Dighe, Kent B Lewandrowski, Christiana A Demetriou, Stacy E F Melanson, Alyssa R Letourneau","doi":"10.1017/ash.2024.501","DOIUrl":"10.1017/ash.2024.501","url":null,"abstract":"","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e33"},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416433","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}
引用次数: 0
Impact of a cerebrospinal fluid diagnostic stewardship intervention on quantity of tests, length of stay, antibiotic prescriptions, and cost. 脑脊液诊断管理干预对检测数量、住院时间、抗生素处方和费用的影响。
Antimicrobial stewardship & healthcare epidemiology : ASHE Pub Date : 2025-02-11 eCollection Date: 2025-01-01 DOI: 10.1017/ash.2025.17
Aaron Pathak, Sabra Shay, Todd Lasco, Mayar Al Mohajer
{"title":"Impact of a cerebrospinal fluid diagnostic stewardship intervention on quantity of tests, length of stay, antibiotic prescriptions, and cost.","authors":"Aaron Pathak, Sabra Shay, Todd Lasco, Mayar Al Mohajer","doi":"10.1017/ash.2025.17","DOIUrl":"10.1017/ash.2025.17","url":null,"abstract":"<p><p>Redundant and low-value cerebrospinal fluid analysis for suspected meningitis can increase costs and antimicrobial use. Our diagnostic stewardship intervention limited available infectious disease cerebrospinal fluid assays to seven common tests, including a multiplex polymerase chain reaction panel. There was no significant difference in the cost of testing or clinical outcomes.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e35"},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416436","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}
引用次数: 0
Delayed recognition of mpox on an inpatient psychiatric unit: a case report and investigation. 精神科住院病人mpox的延迟识别:一个病例报告和调查。
Antimicrobial stewardship & healthcare epidemiology : ASHE Pub Date : 2025-02-11 eCollection Date: 2025-01-01 DOI: 10.1017/ash.2025.3
Waleed Malik, Simon Dosovitz, Jonathan Whitehouse, Nafisa Reza, Sharmin Khan, Justin Chan
{"title":"Delayed recognition of mpox on an inpatient psychiatric unit: a case report and investigation.","authors":"Waleed Malik, Simon Dosovitz, Jonathan Whitehouse, Nafisa Reza, Sharmin Khan, Justin Chan","doi":"10.1017/ash.2025.3","DOIUrl":"10.1017/ash.2025.3","url":null,"abstract":"<p><p>This report describes a delayed recognition of mpox in a patient admitted to an inpatient psychiatry unit, resulting in potential exposures to staff and patients. We detail the investigation and risk mitigation efforts and emphasize the importance of prompt identification and isolation in congregate healthcare settings to prevent transmission.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e36"},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416431","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}
引用次数: 0
An ultraviolet-C (UV-C) light device is effective for low-level disinfection of surgical site marking pens with UV-C transmissible caps. 紫外线- c (UV-C)光装置是有效的低水平消毒手术部位标记笔与紫外线- c传播帽。
Antimicrobial stewardship & healthcare epidemiology : ASHE Pub Date : 2025-02-10 eCollection Date: 2025-01-01 DOI: 10.1017/ash.2025.13
Amelia L Milner, Jennifer L Cadnum, Jennifer M Hailes, Curtis J Donskey
{"title":"An ultraviolet-C (UV-C) light device is effective for low-level disinfection of surgical site marking pens with UV-C transmissible caps.","authors":"Amelia L Milner, Jennifer L Cadnum, Jennifer M Hailes, Curtis J Donskey","doi":"10.1017/ash.2025.13","DOIUrl":"10.1017/ash.2025.13","url":null,"abstract":"<p><p>Single-use plastic pens are commonly used to mark surgical sites on the skin of patients. In laboratory testing, an ultraviolet-C (UV-C) light device was effective for decontamination of marking pens with plastic caps designed to allow transmission of UV-C. Decontamination of marking pens could reduce plastic and carbon footprints.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e34"},"PeriodicalIF":0.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416429","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}
引用次数: 0
Opportunities for collaboration: the synergy between antimicrobial and diagnostic stewardship in pediatrics. 合作机会:儿科抗菌剂和诊断管理之间的协同作用。
Antimicrobial stewardship & healthcare epidemiology : ASHE Pub Date : 2025-02-07 eCollection Date: 2025-01-01 DOI: 10.1017/ash.2024.464
Brandy M Hoyt, Kevin Messacar, Anna C Sick-Samuels, Preeti Jaggi, Stacey L Hamilton, Sarah Janelle, Sarah K Parker
{"title":"Opportunities for collaboration: the synergy between antimicrobial and diagnostic stewardship in pediatrics.","authors":"Brandy M Hoyt, Kevin Messacar, Anna C Sick-Samuels, Preeti Jaggi, Stacey L Hamilton, Sarah Janelle, Sarah K Parker","doi":"10.1017/ash.2024.464","DOIUrl":"10.1017/ash.2024.464","url":null,"abstract":"<p><p>Advancement of antimicrobial stewardship (AS) programs requires partnership with clinicians, quality assurance teams, and laboratorians. Inevitably, AS programs also practice diagnostic stewardship (DS), as stewards are aptly placed to connect key stakeholders and help steer processes toward higher value care for pediatric patients. In this review, we illustrate five moments of collaboration between stakeholders in the interplay between AS and DS in pediatrics. These moments include (1) Observation, (2) Reflection, (3) Exploration, (4) Enactment and (5) Evaluation. We offer a targeted narrative of examples in current literature using common relatable scenarios (ie, endotracheal aspirates, blood cultures, gastrointestinal samples, and urine testing) including impact on financial and environmental waste.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e32"},"PeriodicalIF":0.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416412","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}
引用次数: 0
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