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www.ahrq.gov/sites/default/files/wysiwyg/nhguide/5_TK2_P2T8-Sample_Antibiogram_Phase_2.doc
May 01, 2014 - Laboratory Name
Antibiogram for dd/mm/yyyy to dd/mm/yyyy
Gram Negative
Gram Positive
Antibiotic … The antibiograms will be most applicable when selecting antibiotics to treat urine infections and systemic … One antibiotic from each class is usually tested. … Antibiotics from the same class are likely to have similar resistance patterns, for example with cephalosporins … · Significant resistance to commonly used antibiotics is seen among the gram-negative organisms that
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www.ahrq.gov/sites/default/files/wysiwyg/nhguide/5_TK2_P2T8-Sample_Antibiogram_Phase_2.pdf
May 01, 2014 - Name/Clinical Laboratory Name
Antibiogram for dd/mm/yyyy to dd/mm/yyyy
Gram Negative Gram Positive
Antibiotic … The antibiograms will be
most applicable when selecting antibiotics to treat urine infections and systemic … One antibiotic from each class is usually tested. … Antibiotics from the same
class are likely to have similar resistance patterns, for example with cephalosporins … • Significant resistance to commonly used antibiotics is seen among the gram-negative organisms that
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www.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.
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www.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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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/surgery/modules/onboarding/onboarding_build_ssibundle.pptx
December 01, 2017 - to help prevent infection 98% 98%
Surgery patients whose preventive antibiotics were stopped at the … Johns Hopkins also does quite well at discontinuing antibiotics. … The front line said, we’re not always giving the antibiotics at the right time. … (n=972) 552 (56.8%)
Was antibiotic redosed? … So, even though there’s excellent level-one evidence to support the role of antibiotics in preventing
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/best-practices/ASB-UTI-facilitator-guide.pdf
November 01, 2019 - As a reminder, the Four Moments include:
Moment 1: Does my patient have an infection that
requires antibiotics … Moment 2: Have I ordered appropriate cultures
before starting antibiotics? … Can I stop
antibiotics? Can I narrow therapy or change from
intravenous to oral therapy? … Lower cutoffs may be considered if the patient has
received antibiotics before the culture was sent, … In addition to antibiotics, management of the
underlying associated process must also occur
whenever
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www.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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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/ambulatory-care/aom-discussion-guide.docx
September 01, 2022 - Also, remind staff how they can access the AHRQ Toolkit To Improve Antibiotic Use in Ambulatory Care … How is the practice currently deciding which children with acute otitis media to treat with antibiotics … What guidelines/educational tools is the practice currently using to address the length of antibiotic … What measures will the practice use to guide decision making for observation without antibiotic therapy … What anticipatory guidance will the practice use for patients who will not be started on antibiotics
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www.ahrq.gov/sites/default/files/wysiwyg/nhguide/3_TK2_T4-Quarterly_or_Monthly_Prescribing_Profile_Final.docx
October 01, 2016 - clinician]
This [quarterly / monthly] report is provided for your reference as we continue to monitor antibiotic … Between 25 percent and 75 percent of antibiotics are prescribed unnecessarily for nursing home residents … Infections and antibiotic resistance in nursing homes. Clin Microbiol Rev. 1996 Jan;9(1):1-17. … This report provides information regarding your prescriptions for antibiotics for residents over the … Resident Name
Infection Type/ Diagnosis
Last Treated
Organism Identified
Rx Date
Rx Duration
Antibiotic
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www.ahrq.gov/sites/default/files/wysiwyg/nhguide/3_TK2_T4-Quarterly_or_Monthly_Prescribing_Profile_Final.pdf
October 01, 2016 - clinician]
This [quarterly / monthly] report is provided for your reference as we continue to monitor
antibiotic … Between 25 percent and 75 percent of antibiotics are prescribed unnecessarily for nursing home
residents … This report provides information regarding your prescriptions for antibiotics for residents over
the … for your information only and is meant to help you
maintain an awareness of trends in infections and antibiotic … Infections and antibiotic resistance in nursing homes. Clin Microbiol
Rev. 1996 Jan;9(1):1-17.
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/improve/behavior-change-slides.pptx
November 01, 2019 - Around Antibiotic Prescribing
Acute Care
AHRQ Safety Program for Improving
Antibiotic Use
AHRQ Pub. … antibiotics. … – Antibiotic Prescribing
7
Drivers of Suboptimal Antibiotic Prescribing
Fear of inadequate antibiotic … Behavior Changes – Antibiotic Prescribing
11
Antibiotics Are Our Parrot
St. … broad empiric coverage
Are worried about stopping MRSA or Pseudomonas coverage
Want to keep antibiotics
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/best-practices/asp-pneumonitis-one-page.pdf
November 01, 2019 - cultures should be considered when the diagnosis is unclear, if
purulent sputum is being produced, or if antibiotic … Treatment
• Hemodynamically stable patients with aspiration events
o Antibiotics are not warranted … o Prophylactic antibiotics have not been shown to be helpful in preventing the development
of pneumonia … If clincial symptoms resolve, antibiotics can be discontinued. … no improvement or there is clinical worsening within the first 48–72 hours,
consider a course of antibiotic
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/manage-resident-UTI-slides.PPT
June 01, 2021 - affects around 50% of residents
It is not associated with increased morbidity or mortality
Unnecessary antibiotics … choices, review the resident’s chart to determine if there are any contraindications to specific antibiotics … dependent on the local epidemiology (review the local antibiogram).
10
UTI Management
10
Common Antibiotics … No known allergies to antibiotics
>100,000 µg/mL E. coli
MIC INT
Ampicillin >16 R
Ampicillin-sulbactum … treat UTIs
Fluoroquinolones should be avoided as an empiric choice due to resistance and side effects
Antibiotics
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/one-pager-bacterial-pneumonia.pdf
June 01, 2021 - are generally in reasonable health and who have not been hospitalized or exposed to
broad-spectrum antibiotics … • Residents with risk factors for resistant Gram-negative bacteria (hospitalized or broad-spectrum
antibiotics … Care
AHRQ Safety Program for Improving Antibiotic … Development of minimum criteria for the initiation
of antibiotics in residents of long-term-care
facilities … Comparison
of 8 vs 15 days of antibiotic therapy for ventilator-
associated pneumonia in adults: a
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/best-practices/cellulitis-one-page.docx
November 01, 2019 - cellulitis
· Incision and drainage of abscess is essential
· For skin abscess with minimal cellulitis, antibiotics … are of modest benefit once abscess is drained in uncomplicated cases
· Antibiotics are recommended … severely immunocompromised or with suspected necrotizing fasciitis should receive empiric broad-spectrum antibiotics … bites, and cellulitis associated with long-standing diabetic foot ulcers may also require alternative antibiotics … Discuss these cases with the antibiotic stewardship program and/or infectious diseases consultant.
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www.ahrq.gov/research/findings/final-reports/stpra/stpraexh9.html
April 01, 2018 - BMI <40)
Event 642 (0.2)
Fail to protect patient effectively (failure related to skin prep, antibiotics … Event 182 (0.2)
Fail to administer indicated antibiotics
Event 543 (0.0325)
SSI risk for … BMI <40)
Event 642 (0.2)
Fail to protect patient effectively (failure related to skin prep, antibiotics … Event 182 (0.2)
Fail to administer indicated antibiotics
Event 659 (0.18)
Glove puncture … Event 182 (0.2)
Fail to administer indicated antibiotics
Event 138 (0.15)
Fail to remove
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www.ahrq.gov/hai/cauti-tools/archived-webinars/infectious-complications-slides.html
December 01, 2017 - (choose one)
Patient developing symptomatic CAUTI
Patient being given inappropriate antibiotics … Slide 7
Polling Question 2: Multidrug Resistant Organisms (choose one)
Antibiotic resistance … is associated with $20 billion direct healthcare cost per year
Antibiotic resistance is associated … with about $1 billion direct healthcare cost per year
Developing new antibiotics is more important … It is s bar chart showing percentage of CAUTI isolates testing resistant to multiple antibiotics.
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/cauti-tools/archived-webinars/infectious-complications-090914.pptx
January 01, 2014 - (choose one)
3
Patient developing symptomatic CAUTI
Patient being given inappropriate antibiotics for … with about $1 billion direct healthcare cost per year
Developing new antibiotics is more important than … Promoting the development of new antibiotics and developing new diagnostic tests for resistant bacteria … Example: Carbapenem Resistant Enterobacteriaceae…
Very resistant organisms to many antibiotics … In 93 (73.8%) episodes, at least 1 preceding course of antibiotics was inappropriate.
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www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/mrsa/035-importance-mrsa-prevention-notes.docx
October 01, 2024 - Slide 6
Antibiotic Resistance
SAY:
MRSA infections increase the use of antibiotics, which puts further … Antibiotic pressure, caused by treating patients with courses of antibiotics with activity against S. … This antibiotic pressure can also induce the expression of antibiotic resistance genes in S. aureus, … Antibiotic stewardship aims to optimize the use of antibiotics by ensuring antibiotics are prescribed … Overuse and misuse of antibiotics are primary contributors to the emergence of resistance.
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/ambulatory-care/improving-communication-guide.docx
September 01, 2022 - To temper expectations and ensure patients understand why the decision to not prescribe antibiotics might … If one clinician tends to always prescribe antibiotics for acute bronchitis, and a patient has had a … reaction to antibiotics, perhaps a reasonable comment is, "I am concerned that the patient had a reaction … How do you think we can ensure that our patients get antibiotics only when appropriate to make things … and think of conditions for which alternative antibiotics could be considered?