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CIDRAP- Stewardship / Resistance Scan for Sep 02, 2022- Antibiotic stewardship accreditation;  Improper antibiotic Rx in PICUs

Lance

MPH, CSP & CIT Retired, CHMM Emeritus
https://www.cidrap.umn.edu/news-perspective/2022/09/stewardship-resistance-scan-sep-02-2022

Stewardship / Resistance Scan for Sep 02, 2022


Antibiotic stewardship accreditation;
Improper antibiotic Rx in PICUs

Filed Under:
Antimicrobial Stewardship

BSAC launches global plan to accredit antimicrobial stewardship efforts


Yesterday, the British Society for Antimicrobial Chemotherapy (BSAC) launched the Global Antimicrobial Stewardship Accreditation Scheme (GAMSAS), which aims to support healthcare organizations globally by recognizing good practices to combat antimicrobial resistance, identifying areas for improvement, and supporting education and training.

BSAC said GAMSAS plans to establish centers of excellence around the world to support the spread of effective antimicrobial stewardship (AMS) programs, according to a BSAC news release.

BSAC President David Jenkins MBBS, said, "AMS is a collection of evidence-based tools that helps keep antimicrobial resistance at bay. AMS ensures best treatment for infected patients now and keeps antibiotics working for future patients. Accreditation is another evidence-based discipline that measures and drives up quality of healthcare.

"The BSAC GAMSAS is the first global scheme to combine these two methodologies to focus on antimicrobial prescribing," BSAC said in the release.
Sep 1 BSAC news release
GAMSAS website



Study finds antibiotic use high in kids' ICUs, with a third deemed improper


A point-prevalence study in 10 medical centers across the United States reveals that almost 60% of pediatric intensive care unit (PICU) patients receive antibiotics, and researchers estimate that a third of antibiotic orders in PICUs are inappropriate, according to a study yesterday in Clinical Infectious Diseases.

The group of scientists, led by researchers with the Children's Hospital of Philadelphia, conducted the study over 4 days in 2019. They call it the largest such study to date focused on PICU patients.

The researchers note that, of 1,462 PICU patients, 843 (58%) had at least one order for antibiotics. They reviewed 1,277 antibiotic orders and note that 260 orders (21%) were empiric therapy for suspected bacterial infections without sepsis or septic shock and 164 (13%) were for non-operative prophylaxis, followed by empiric therapy for sepsis or septic shock (155 orders; 12%), community acquired pneumonia (CAP; 118; 9%), and post-operative prophylaxis (94; 8%).

Of 985 orders assessed for appropriate prescribing, the investigators classified 331 (34%) as inappropriate. The most common of those were empiric therapy for suspected bacterial infection without sepsis or septic shock (78 orders; 24%), sepsis or septic shock (55; 17%), CAP (51; 15%), ventilator-associated infections (47; 14%), and post-operative prophylaxis (44; 14%). The proportion of antibiotics classified as inappropriate varied across PICUs, from 19% to 43%.

The authors conclude, "Tailoring empiric antibiotic choices, de-escalating antibiotics when no bacterial infection has been identified, limiting the duration of post-operative antibiotics, and ensuring antibiotic durations are aligned with national guidelines represent actionable stewardship targets in this population."
Sep 1 Clin Infect Dis abstract
 
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