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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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meps.ahrq.gov/data_files/publications/st137/stat137.pdf
August 01, 2006 - In particular, inappropriate use can have a negative impact
on the effectiveness of antibiotics and … immediately, but if a throat culture is obtained and the result is
negative the antibiotics should … Antibiotics should not be prescribed for children whose symptoms
indicate a low probability of streptococcus … Of these children, over
two-thirds (69.7 percent) were
prescribed antibiotics to treat
their sore … Of these children, over two-thirds (69.7 percent) were prescribed antibiotics to treat their sore throat
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psnet.ahrq.gov/issue/antibiotic-prescribing-ambulatory-pediatrics-united-states
May 25, 2016 - Study
Antibiotic prescribing in ambulatory pediatrics in the United States. … Antibiotic prescribing in ambulatory pediatrics in the United States. … Prescribing of antibiotics for non-bacterial illnesses remains very common in outpatient pediatrics. … Antibiotic prescribing in ambulatory pediatrics in the United States. … March 1, 2023
Antibiotic shortages in pediatrics.
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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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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.347_slideshow.ppt
May 01, 2015 - blood cultures grew methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin was added to her antibiotic … Despite the antibiotics and additional intravenous fluids, she continued to deteriorate. … N Engl J Med. 2001;345:1368-1377. http://www.ncbi.nlm.nih.gov/pubmed/11794169
14
Antibiotics
Early, … )
The pharmacist facilitates rapid antibiotic administration
19
19
UCSF Sepsis Team (2)
Since the … place
Had a protocol or formal process been in place, the patient might have received the appropriate antibiotic
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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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effectivehealthcare.ahrq.gov/sites/default/files/pdf/TND-0768-141211.pdf
October 23, 2014 - least 3
episodes per year for 3 years)
Intervention(s): Tonsillectomy
Comparator(s): Prophylactic antibiotic … PICO
Population(s): Children, ages 1 to 18, who undergo tonsillectomy
Intervention(s): Perioperative antibiotic … Should clinicians administer or prescribe perioperative antibiotics to children
undergoing tonsillectomy … effectiveness of tonsillectomy in SDB and
the comparative effectiveness of prescribing perioperative antibiotics … some reduction in morbidities associated with tonsillectomy through the use of
perioperative topical antibiotics
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psnet.ahrq.gov/node/44937/psn-pdf
September 29, 2017 - Effect of behavioral interventions on inappropriate
antibiotic prescribing among primary care practices … Effect of Behavioral Interventions on Inappropriate Antibiotic
Prescribing Among Primary Care Practices … trial among 47 primary care practices, prompting clinicians to enter justifications
for prescribing antibiotics … mean antibiotic prescribing rates compared to controls. … Antibiotics are a
significant source of medical care overuse and inappropriate prescriptions can lead
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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?
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www.ahrq.gov/funding/grantee-profiles/grtprofile-gonzales.html
October 01, 2024 - When antibiotics are prescribed inappropriately or not taken correctly, the bacteria that antibiotics … Gonzales received a 5-year AHRQ grant to reduce the overuse of antibiotics to treat acute respiratory … His project, Minimizing Antibiotic Resistance in Colorado (MARC) , evaluated the impact of educational … The MARC project did help reduce antibiotic use in the community. … Gonzales received another 5-year AHRQ grant that allowed him to expand on his antibiotic stewardship
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/best-practices/biliary-tract-one-page.docx
November 01, 2019 - signs and symptoms of infection, patients with jaundice or non-obstructing gallstones do not require antibiotics … infection, patients with biliary colic (i.e., RUQ pain lasting 1–3 hours that resolves) do not require antibiotics … 5-10 days based on clinical response*
Uncomplicated acute cholecystitis, surgical management
No antibiotics … Fever-based antibiotic therapy for acute cholangitis following successful endoscopic biliary drainage … Effect of postoperative antibiotic administration on postoperative infection following cholecystectomy
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/best-practices/COPD-one-page.pdf
November 01, 2019 - • Antibiotics are recommended for moderate to severe COPD exacerbations. … o Patients admitted for COPD exacerbations usually meet criteria for antibiotic treatment. … alternative agents for a 5-day course depending on risk factors for Pseudomonas
• Prophylactic antibiotics … Comparison of first-line with second-line antibiotics
for acute exacerbations of chronic bronchitis: … Reduced risk
of next exacerbation and mortality associated with
antibiotic use in COPD.
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psnet.ahrq.gov/issue/prompting-physicians-address-daily-checklist-antibiotics-do-we-need-co-pilot-icu
September 23, 2020 - Review
Prompting physicians to address a daily checklist for antibiotics: do we need … Prompting physicians to address a daily checklist for antibiotics: do we need a co-pilot in the ICU? … coupled with forcing functions in the intensive care unit as a strategy to enhance appropriate antibiotic … Prompting physicians to address a daily checklist for antibiotics: do we need a co-pilot in the ICU?
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www.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/chipra-1416-p007-2-ef.pdf
November 01, 2015 - Transcranial Doppler (TCD) Ultrasonography Screening for Children with SCD; and Appropriate Antibiotic … who were continuously enrolled in
Medicaid and during the
measurement year received
preventive antibiotics … children with SCA
receive yearly TCD screenings from ages 2 through 15.2
Prompt and consistent use of antibiotics … infants with SCA be started on twice-daily penicillin as early as possible and remain on
preventive antibiotics … ● Between States, the rates of prescriptions for antibiotics varied from 5 percent to 33 percent
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digital.ahrq.gov/ahrq-funded-projects/improving-guideline-development-and-implementation/citation/improving
January 01, 2023 - Improving diagnostic testing and reducing overuse of antibiotics for children with pharyngitis: a useful … Improving diagnostic testing and reducing overuse of antibiotics for children with pharyngitis: a useful
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www.ahrq.gov/sites/default/files/wysiwyg/nhguide/5_TK2_T6-Using_Nursing_Home_Antibiograms_to_Choose_the_Right_Antibiotic_Data_Entry_Form.xlsx
May 01, 2014 - No. 14-0012-6-EF
Helpful Hints
Using Nursing Home Antibiograms to Choose the Right Antibiotic
Tool … AHRQ 14-0012-6-EF 1/2014
Some Helpful Hints for using the spreadsheet template:
-Add or delete antibiotics … If your laboratory does not test against a certain antibiotic, delete that column. … Add in antibiotics that are missing. Also change abbreviations to match what your laboratory uses. … The first diagnostic isolate for each antibiotic per organism is collected.