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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/ambulatory-care/pharyngitis-guide.docx
September 01, 2022 - Antibiotic Use
1
The “Sometimes Antibiotics” Diagnoses: Pharyngitis
Ambulatory Care
Slide Title … Does my patient have an infection that requires antibiotics?
2. … an infection that requires antibiotics? … Does this patient require antibiotics? … Slide 12
The Four Moments of Antibiotic Decision Making
SAY:
Moment Three is: If antibiotics are
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/safety/changes-slides.pptx
November 01, 2019 - Decision Making
Does my patient have an infection that requires antibiotics? … Have I ordered appropriate cultures before starting antibiotics? … Can I stop antibiotics? Can I narrow therapy or change from IV to oral therapy? … Decision Making
Defect Issue Moment
Patient remained on IV antibiotics for duration of hospitalization … Antibiotics could have been changed from IV to PO once clinical improvement and ability to tolerate
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/best-practices/gastro-slides.pptx
November 01, 2019 - 4
The Four Moments of Antibiotic Decision Making
Does my patient have an infection that requires antibiotics … antibiotics? … 18
The Four Moments of Antibiotic Decision Making
Does my patient have an infection that requires antibiotics … courses into
practice
Order sets with preset antibiotic durations
Evaluation of need for oral antibiotics … cultures are obtained and source control followed by a short course of antibiotics
Avoid prolonged antibiotic
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/ambulatory-care/sinusitis-guide.docx
September 01, 2022 - Antibiotic Use
1
The “Sometimes Antibiotics” Diagnoses:
Sinusitis
Ambulatory Care
Slide Title and … and
· Describe the non-antibiotic management of sinusitis
Slide 2
The Four Moments of Antibiotic … Does my patient have an infection that requires antibiotics?
2. … infection that requires antibiotics? … Slide 11
The Four Moments of Antibiotic Decision-Making
SAY:
Moment Three is: If antibiotics are
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/ambulatory-care/allergies-slides.pptx
September 01, 2022 - antibiotics
Recognize types of reactions to antibiotics commonly prescribed in the outpatient setting … reports an allergy to penicillin
95% of people who report a penicillin allergy can tolerate beta-lactam antibiotics … antibiotics are more likely to receive an alternative, broader spectrum antibiotic that:
Is less effective … Palpable purpura
Joint pain
Urticaria
Lymphadenopathy
Fevers
Most commonly occur after several days of antibiotics … DRESS syndrome
Nonsevere reactions
Maculopapular/morbilliform rash
Generally occur days to weeks after antibiotics
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/best-practices/sepsis-slides.pptx
November 01, 2019 - infection that requires antibiotics? … for Improving Antibiotic Use – Acute Care
Sepsis
Sepsis: Antibiotic Timing
Antibiotics should be … infection that requires antibiotics? … .
21
AHRQ Safety Program for Improving Antibiotic Use – Acute Care
Sepsis
Narrowing Antibiotics … have an infection that requires antibiotics?
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/nhguide/3_TK2_T3-Sample_Monthly_Summary_Reports_Final.pdf
October 01, 2016 - Summary Report of Infections and Antibiotic Use
(This example focuses on data for evaluating antibiotic … of
Antibiotic
Rx Divided
by Number
of Resident
Days
Number of
Residents
Receiving
Antibiotics … Agents in Use
(This example focuses on tracking use of specific antibiotics of concern in the nursing … home)
Month
[Antibiotic
Name]
[Antibiotic
Name]
[Antibiotic
Name]
[Antibiotic
Name]
[ … Antibiotic
Name]
[Antibiotic
Name]
[Antibiotic
Name]
Jan In each cell,
enter the
number of
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/nhguide/6_TK1_T2-Talking_with_Residents_Family_Members_Final.docx
October 01, 2016 - is effectively treated.
· Unneeded antibiotics can do more harm than good.
· Before taking an antibiotic … But, side effects vary a lot from person to person, and from antibiotic to antibiotic.
1. … In other words, the more often you use an antibiotic, the greater the chance that the antibiotic won’ … Second, we have an antibiotic stewardship program to—
Make sure that antibiotics are used only when absolutely … When Taking an Antibiotic
· When taking an antibiotic, your family member may experience several side
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/nhguide/6_TK1_T1-Talking_with_Residents_Final.pdf
October 01, 2016 - • Before taking an antibiotic, it is important to understand how antibiotics could harm or
hurt you … But, side effects vary a lot from person to person, and
from antibiotic to antibiotic.
3. … This is called antibiotic resistance. … In other words, the more often
you use an antibiotic, the greater the chance that the antibiotic won … When Taking an Antibiotic
• When you take an antibiotic, you may experience several side effects such
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/ambulatory-care/four-moments-poster-1.pdf
September 01, 2022 - Poster_Four Moments of Antibiotic Decision Making
AHRQ Pub. No. 17(22)-0030
September 2022
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ce.effectivehealthcare.ahrq.gov/nhguide/toolkits/determine-whether-to-treat/antibiotic-tool.html
September 01, 2017 - SHARE:
Minimum Criteria for Antibiotics … Green check mark: minimum criteria for antibiotics are met. … Urine cultures should be used to identify the most appropriate antibiotic. … residents
with acute dysuria, it may be appropriate to initiate empirical antibiotic … https://www.ahrq.gov/nhguide/toolkits/determine-whether-to-treat/antibiotic-tool.html
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/improve/program-part2-slides.pptx
November 01, 2019 - antibiotics
Optimizes empiric antibiotic choices
Gives opportunity to advise about sending appropriate … antibiotics
Optimizes empiric antibiotic choices
Gives opportunity to advise about sending appropriate … antibiotics
Optimizes empiric antibiotic choices
Gives opportunity to advise about sending appropriate … Con
Providers or clinical teams review their patients who are receiving antibiotics to determine if … the antibiotics are truly needed or if they could be modified Engages frontline clinicians/teams to
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/nhguide/5_TK1_T1-Background_final.docx
October 01, 2016 - · Antibiograms are important tools for health care professionals involved in prescribing empiric antibiotics … · Antibiograms encourage responsible use of antibiotics throughout facilities. … They do not provide the prevalence resistance to multiple antibiotics.
· Antibiograms provide guidance … It may be helpful to examine the antibiogram and identify the one two antibiotics that are not working … Please avoid that antibiotic.
AHRQ Pub.
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ce.effectivehealthcare.ahrq.gov/antibiotic-use/long-term-care/four-moments/posters.html
June 01, 2021 - The Four Moments of Antibiotic Decision Making Explained (PDF, 170.3 KB)
The Four Moments of Antibiotic … Making Poster for workstations (small) (PDF, 122.2 KB)
The Four Moments of Antibiotic Decision Making … Poster as a pocket card (PDF, 137.5 KB)
Four Moments of Antibiotic Decision Making With Associated … Four Questions To Ask Your Doctor or Nurse About Antibiotics (PDF, 194 KB) … https://www.ahrq.gov/antibiotic-use/long-term-care/four-moments/posters.html
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/nhguide/3_TK2_T3-Sample_Monthly_Summary_Reports_Final.docx
October 01, 2016 - Summary Report of Infections and Antibiotic Use
(This example focuses on data for evaluating antibiotic … use for suspected UTIs)
Month
Number of Resident Days
Number of Antibiotic Rx
Number of Antibiotic … Rx Divided by Number of Resident Days
Number of Residents Receiving Antibiotics for UTI (incl. … tracking use of specific antibiotics of concern in the nursing home)
Month
[Antibiotic Name]
[Antibiotic … Name]
[Antibiotic Name]
[Antibiotic Name]
[Antibiotic Name]
[Antibiotic Name]
[Antibiotic Name]
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/nhguide/6_TK1_T2-Talking_with_Residents_Family_Members_Final.pdf
October 01, 2016 - But, side effects vary a lot from person
to person, and from antibiotic to antibiotic.
3. … This is called antibiotic resistance. … In other words, the
more often you use an antibiotic, the greater the chance that the antibiotic won’ … – Second, we have an antibiotic stewardship program to—
Make sure that antibiotics are used only … When Taking an Antibiotic
• When taking an antibiotic, your family member may experience several side
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/nhguide/5_TK1_T1-Background_final.pdf
October 01, 2016 - • Antibiograms are important tools for health care professionals involved in prescribing empiric
antibiotics … • Antibiograms encourage responsible use of antibiotics throughout facilities. … They do not provide the prevalence resistance to
multiple antibiotics. … It may be helpful to
examine the antibiogram and identify the one two antibiotics that are not working … Please avoid that antibiotic.
Tool 1.
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/sustainability-plan.pdf
June 01, 2021 - for all residents receiving antibiotics to ensure that a
discussion happens for the ongoing need for … antibiotics. … antibiotics should become familiar with the educational toolkit. … The
Antibiotic Stewardship Team should monitor the use of antibiotics and Clostridioides difficile rates … readmission rates or the number of residents given antibiotics for asymptomatic bacteriuria.
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/ambulatory-care/common-cold-guide.docx
September 01, 2022 - Guide
AHRQ Safety Program for Improving
Antibiotic Use
The “Never Antibiotics” Diagnosis: Acute Viral … Harm associated with antibiotics includes adverse drug events, microbiome disruption, and antibiotic … About 10 percent of people who receive an antibiotic develop diarrhea. … Second, patients may expect an antibiotic because in previous medical encounters an antibiotic has been … Slide 16
The Four Moment of Antibiotic Decision Making
SAY:
Returning to the Four Moments of Antibiotic
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/tracking-measuring-data-facilitator-guide.docx
June 01, 2021 - AHRQ Safety Program for Improving Antibiotic Use
Tracking and Measuring Antibiotic Use Data
Long-Term … It is useful to look at individual antibiotics as well as the combined total of all antibiotics. … This is the number of new prescriptions for each antibiotic and for all antibiotics. … Note that new admissions already on antibiotics should be counted as an antibiotic start. … If a resident receives two different antibiotics, count each as a start.