Tag Archives: Antibiotic awareness

CDC Provides Best Practices for Appropriate Antibiotic Use in Dentistry 2016

MalePhysician

07/26/2016

In an article published  in The Journal of the American Dental Association (JADA), experts from the Centers for Disease Control and Prevention (CDC) and the Organization for Safety, Asepsis and Prevention (OSAP) provide best practices for responsible antibiotic use in dentistry.

 

Dentists write nearly 26 million prescriptions for antibiotics each year, which amounts to 10 percent of all antibiotic prescriptions filled in outpatient pharmacies.

While the extent is unknown, experts are concerned that unnecessary antibiotic prescribing occurs in dental settings. To assist throughout the entire antibiotic prescribing process, CDC and OSAP have developed a checklist to guide dentists through pre-treatment, prescribing, and patient and staff education.

Patients are encouraged to use the following Do’s and Don’ts for ensuring patient safety when they or their loved ones are prescribed antibiotics at the dentist.

 

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U.S. Food and Drug Administration Advises Serious Side Effects Associated With Fluoroquinolone Antibacterial Medication

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The Division of Drug Information (DDI)- serving the public by providing information on human drug products and drug product regulation by FDA.


The U.S. Food and Drug Administration is advising that the serious side effects associated with fluoroquinolone antibacterial drugs generally outweigh the benefits for patients with sinusitis, bronchitis, and uncomplicated urinary tract infections who have other treatment options.  For patients with these conditions, fluoroquinolone should be reserved for those who do not have alternative treatment options. 

The new FDA ruling calling for restricted use of fluoroquinolones affects five prescription antibiotics: ciprofloxacin (Cipro), levofloxacin (Levaquin), moxifloxacin (Avelox), ofloxacin (Floxin), and gemifloxacin (Factive). All are also available as generics.

https://cdifffoundation.org/2016/05/05/a-study-provides-data-that-between-2010-and-2011-throughout-u-s-at-least-30-percent-of-antibiotics-unnecessarily-prescribed/

 

ANTIBIOTIC STEWARDSHIP PROGRAM UPDATES:

https://cdifffoundation.org/2016/04/29/antibiotic-stewardship-program-and-updates-from-sources-cdc-pew-charitable-trusts-with-idsa-and-shea-guidelines/

 

For Additional Information Regarding This Topic – Please Visit The Following Consumer Article:

http://www.consumerreports.org/drugs/fluoroquinolones-are-too-risky-for-common-infections/

An FDA safety review has shown that fluoroquinolones when used systemically (i.e. tablets, capsules, and injectable) are associated with disabling and potentially permanent serious side effects that can occur together.  These side effects can involve the tendons, muscles, joints, nerves, and central nervous system. 

As a result, we are requiring the drug labels and Medication Guides for all fluoroquinolone antibacterial drugs to be updated to reflect this new safety information.  We are continuing to investigate safety issues with fluoroquinolones and will update the public with additional information if it becomes available.

Patients should contact your health care professional immediately if you experience any serious side effects while taking your fluoroquinolone medicine.   Some signs and symptoms of serious side effects include tendon, joint and muscle pain, a “pins and needles” tingling or pricking sensation, confusion, and hallucinations.  Patients should talk with your health care professional if you have any questions or concerns.

Health care professionals should stop systemic fluoroquinolone treatment immediately if a patient reports serious side effects, and switch to a non-fluoroquinolone antibacterial drug to complete the patient’s treatment course.  

Fluoroquinolone drugs work by killing or stopping the growth of bacteria that can cause illness.

We previously communicated safety information associated with systemic fluoroquinolone antibacterial drugs in August 2013 and July 2008.  The safety issues described in this Drug Safety Communication were also discussed at an FDA Advisory Committee meeting in November 2015. 

We urge patients and health care professionals to report side effects involving fluoroquinolone antibacterial drugs and other drugs to the FDA MedWatch program, using the information in the “Contact FDA” box at the bottom of the page.

For more information, please visit: Fluoroquinolone.

 

IDSA and SHEA Release New Antibiotic Stewardship Guidelines

In The News

April 2016

Preauthorization of broad-spectrum antibiotics and prospective review after two or three days of treatment should form the cornerstone of antibiotic stewardship programs to ensure the right drug is prescribed at the right time for the right diagnosis. These are among the numerous recommendations included in new guidelines released by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) and published in the journal Clinical Infectious Diseases.

“Initially, antibiotic stewardship was more focused on cost savings, and physicians responded negatively to that, because they often felt it was best to give patients the newest, most expensive drug,” said Tamar Barlam, MD, lead co-author of the guidelines, director of the antibiotic stewardship program at Boston Medical Center and associate professor of medicine at Boston University Medical School. “While these programs do save hospitals money, their most important benefit is that they improve patient outcomes and reduce the emergence of antibiotic resistance. When we say stewardship, we really mean stewardship, and increasingly, doctors are realizing it’s important and necessary.”

The White House has called for hospitals and healthcare systems to implement antibiotic stewardship programs by 2020 to ensure appropriate use of these vital drugs and reduce resistance, an escalating problem that threatens the ability to effectively treat often life-threatening infections.

The new guidelines replace those originally created to help with the development of programs when antibiotic stewardship was in its infancy, and instead focus on specific strategies that the evidence suggests are most beneficial to ensure the program will be effective and sustainable. They also note it is key that these programs tailor interventions based on local issues, resources and expertise. To ensure that, the guidelines recommend the programs be led by physicians and pharmacists and rely on the expertise of infectious diseases specialists.

“We want hospital administrators to understand the importance of giving antibiotic stewardship their full support to ensure its success,” said Sara Cosgrove, MD, MS, lead co-author of the guidelines, president-elect of SHEA and associate professor of medicine and epidemiology at Johns Hopkins University, and director of the antimicrobial stewardship program and associate hospital epidemiologist at The Johns Hopkins Hospital, Baltimore. “Distributing a few brochures or holding grand rounds won’t do it. It’s vital that antibiotic stewardship be integrated into the hospital’s culture and that infectious disease specialists guide strategies that have been shown to work.”

The guidelines note that more research needs to be done to determine how to ensure antibiotic stewardship is most effective. However, the best evidence to date suggests a number of components, including the following, will help ensure the implementation of an effective antibiotic stewardship program.

  • Preauthorization or prospective audit and feedback – Targeted antibiotics, such as those that treat emerging drug-resistant bacterial infections, should require preauthorization. This means providers need to get approval to use antibiotics before they are prescribed. Prospective audit and feedback can be an alternate strategy or combined with preauthorization. Prospective audit allows antibiotic stewards to engage the prescribing clinician after the antibiotic has been used, typically after two or three days, to optimize antibiotic treatments. Both methods can reduce antibiotic misuse and decrease the development of resistance. Hospitals should choose one or both of these methods as part of their program based on their local resources and expertise.
  • Syndrome-specific interventions – The guidelines recommend focused multifaceted interventions for the treatment of specific syndromes, rather than trying to improve treatment of all infections at once. For example, Dr. Barlam said those leading a hospital’s antibiotic stewardship program might take a close look at management of pneumonia during winter, including making recommendations to shorten the amount of time people are treated and switching to an oral agent more quickly, and then measuring the results of those interventions. In the fall, the program might focus on urinary tract infections and then several months later, switch to skin and soft tissue infections. “This method makes stewardship more manageable and provides a targeted and clear treatment message rather than trying to disseminate 100 different lessons at the same time,” she said.
  • Rapid diagnostic testing – The guidelines note that rapid diagnostic testing of respiratory specimens can help determine if the cause is viral and therefore reduce the inappropriate use of antibiotics. They also note that the rapid testing of blood cultures in addition to conventional culture is helpful, but should be guided by the antibiotic stewardship team for maximum benefit to the patient.

Other recommendations include reducing the use of antibiotics associated with Clostridium difficile infection, implementing antibiotic time-outs and other strategies to encourage prescribers to perform routine reviews of regimens and using computerized clinical decision support if possible.

The guidelines do not recommend relying solely on passive educational materials to implement antibiotic stewardship because any improvement likely will not be sustained. Lectures and brochures should be used to supplement strategies such as antibiotic preauthorization and prospective audit and feedback, the authors note.

AT A GLANCE

  • Preauthorization and prospective review of antibiotics are among the many recommendations to ensure antibiotic stewardship programs are most effective, suggest new guidelines from IDSA/SHEA.
  • Antibiotic stewardship programs should be led by physicians and pharmacists, including ID specialists, who have the expertise and education to ensure the right drug is being prescribed at the right time for the right diagnosis.
  • Antibiotic stewardship programs must be based on the specific problems identified by the healthcare facility and a realistic examination of available resources to ensure interventions are performed with consistency.
  • These programs have been shown to improve patient outcomes, reduce antibiotic resistance and save money.

In addition to Drs. Barlam and Cosgrove, the antibiotic stewardship program guidelines panel includes: Lilian Abbo, Conan MacDougall, Audrey N. Schuetz, Ed Septimus, Arjun Srinivasan, Timothy Dellit, Yngve T. Falck-Ytter, Neil Fishman, Cindy W. Hamilton, Timothy C. Jenkins, Pamela A. Lipsett, Preeti N. Malani, Larissa S. May, Gregory J. Moran, Melinda M. Neuhauser, Jason Newland, Christopher A. Ohl, Matthew Samore, Susan Seo and Kavita K. Trivedi.

IDSA and SHEA individually have published myriad treatment guidelines and together have published several, including the prevention of healthcare-associated infections and antimicrobial prophylaxis in surgery.

As with other IDSA and SHEA guidelines, the antibiotic stewardship guidelines will be available in a smartphone format and a pocket-sized quick-reference edition.

The full guidelines are available free on the

IDSA website at http://www.idsociety.org

 

SHEA website at http://www.shea-online.org.

 

To read this article in its entirety click  on the following link:

http://www.eurekalert.org/pub_releases/2016-04/idso-nas041216.php

 

Blood Test Developed By N.C. Researchers Is Able To Distinguish Between Viral and Bacterial Infections

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In the news *

 

 

A new blood test developed by researchers in North Carolina has been shown to distinguish between viral and bacterial infections.

The blood test has been designed to measure the gene expression of certain components of the immune system, which should allow doctors to identify whether the infection a patient is suffering from is bacterial or viral.

This distinction is crucial, as bacterial infections can be treated with antibiotics, whereas viral infections cannot, and prescribing antibiotics for viral infections only adds to the growing problem of antibiotic resistance.

‘Antibiotic resistance has been described as ‘one of the biggest health threats of our time’…’

Antibiotic resistance has been described as ‘one of the biggest health threats of our time’, and bold warnings have been issued explaining that if we do not refine our use of the drugs, in the future we may no longer be able to perform routine operations or use chemotherapy, and many could end up dying from illnesses commonly treatable today.Antibiotics work by targeting properties of bacteria that are unique and fundamental to them, such as blocking their ability to synthesize proteins or damaging their cell wall. The reason antibiotics can work so well is because the properties we target have no counterparts in human cells and therefore treatment can be given with minimal side effects on ourselves.

The problem of resistance arises as bacteria mutate, and there are a number of ways in which bacteria can do this. One way bacteria can counter the effects of antibiotics is by altering the drug’s target, such as the cell wall, so it is no longer vulnerable to the antibiotic. Bacteria can also create enzymes which inactivate the antibiotic or can create a ‘pump’ to remove the drug from their cells.

It only takes a single bacterium to acquire one of these changes to result in an antibiotic resistant infection. Bacteria multiply at a very fast rate and thus if even one bacterium mutates, and the antibiotic clears every other normal bacterial cell involved in the infection, that single mutated bacterium can rapidly divide, increase in numbers resulting in an antibiotic resistant infection.

‘The overuse of antibiotics makes it far more likely that bacteria will acquire mutations that make them resistant…’

An astounding 50% of antibiotics prescribed are given to patients in unnecessary circumstances, such as in viral infection. The properties of viruses are very different to bacteria and therefore antibiotics are ineffective against infections caused by viruses. The overuse of antibiotics makes it far more likely that bacteria will acquire mutations that make them resistant, meaning our antibiotics are slowly but surely becoming ineffective.

The new blood test developed by scientists at Duke University in North Carolina managed to distinguish between bacterial and viral infection with an accuracy of 87% in a study on 317 patient blood samples.

Here in the UK, the Longitude Prize, a £10 million grant, was chosen by the public to be invested in antibiotic research with the aim to design a test that will conclusively distinguish between bacterial and viral infection.

The new blood test in question could provide a good foundation for further research to be done, allowing conclusive and accurate diagnosis of bacterial infection. Unfortunately, the blood test requires ten hours of analysis and so would be of minimal use in a GP environment where most over-prescription takes place. However, with the Longitude Prize pushing for new research into a quick and easy test to confirm bacterial infection, this new blood test has the potential to do big things for such a topical issue.

 

To read the article in its entirety click on the link below:

 

http://www.redbrick.me/tech/new-blood-test-distinguishes-viral-bacterial-infections/

Using Antibiotics Wisely, How Everyone Can Help In the Fight Against Antibiotic Resistance Worldwide

Did you have the opportunity to listen  to the live broadcast on “C. diff. Spores and More Global Broadcasting Network”  on Tuesday, February 9th, 2016 with guests Dr. Lori Hicks and Dr. Arjun Srinivasan from  the Centers of Disease Control and Prevention (CDC) ?

Dr. Hicks and Dr. Srinivasan discussed how to use antibiotics wisely and how everyone can help in the fight against antibiotic-resistance.

This important  information  is now available to you on demand by clicking directly on the logo below

 

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For additional information on Inpatient Antibiotic Stewardship please click on the following link:

http://www.cdc.gov/getsmart/healthcare/inpatient-stewardship.html

 

To access the CDC Get Smart Program, please click on the following link to be redirected:

http://www.cdc.gov/getsmart/index.html

 

 

C. diff. Spores and More” programming is brought to you by VoiceAmerica  and sponsored by Clorox Healthcare

For more information please visit the C. diff. Spores and More program page:

https://cdifffoundation.org/c-diff-radio/

C diff Spores and More Global Broadcasting Network and Guests Dr. Srinivasan and Dr. Hicks of the CDC Discuss Antibiotic Resistance

cdiffRadioLogoMarch2015

C. diff. Spores and More , Global Broadcasting Network – innovative and educational interactive healthcare talk radio show discuss antibiotic resistance and what everyone can do to join in the fight against it with guests Dr. Arjun Srinivasan and
Dr. Lauri Hicks on Tuesday, February 9th at 10 AM Pacific Time on VoiceAmerica Health and Wellness Channel

Bringing guests together, such as Dr. Arjun Srinivasan, MD and Dr. Lauri Hicks, DO from the Center of Disease Control and Prevention (CDC), one of the leading government healthcare organizations in the U.S., and internationally recognized experts on antibiotic resistance has built a loyal listenership and continue to inform and educate listeners’ worldwide.

C.diff. Spores and More” is broadcast live every Tuesday at 10 AM Pacific Time on the VoiceAmerica Health and Wellness channel, officially sponsored by Clorox Healthcare. Archived C. diff. Spores and More shows can be found Here.

“I am so proud to be the Senior Executive Producer of the “C. diff. Spores and More,” program as it continues to raise awareness, on a global level, of the overuse of antibiotics. Having guests; Dr. Arjun Srinivasan, MD and Dr. Lauri Hicks, DO truly affect change in both the leadership and education guiding the public and raising awareness in many areas of health care,” stated Robert Ciolino, Senior Executive Producer VoiceAmerica.

About The C diff Foundation Executive Director
Nancy C Caralla, hosts “C. diff. Spores and More” Global Broadcasting Network with a team focus on educating, and advocating for C. diff. infection prevention, treatments, and environmental safety – and more — worldwide.

For information please visit www.cdifffoundation.org

Listen in on Tuesday, February 9th at 10:00 Pacific Time–

https://cdifffoundation.org/c-diff-radio/

Acute Respiratory Tract Symptoms? American College of Physicians and the CDC Publish Recommendations On the Use Of Antibiotics To Treat

Antibiotics are NOT always the answer………….

The American College of Physicians and the CDC have published a set of recommendations on the appropriate use of antibiotics for acute respiratory tract infection.

The recommendations, published in the Annals of Internal Medicine, include the following:

  • Bronchitis: Clinicians shouldn’t order tests or start antibiotics unless they suspect pneumonia.

  • Group A streptococcal pharyngitis: Clinicians should conduct a rapid antigen detection test and/or culture for group A Streptococcus in symptomatic patients. Only patients with confirmed streptococcal pharyngitis should receive antibiotics.

  • Acute rhinosinusitis: Clinicians should prescribe antibiotics only in patients with symptoms that have lasted over 10 days; with severe symptom onset or high fever and purulent nasal discharge or facial pain that has lasted for 3 days or more; or with worsening symptoms after a viral illness that was improving.

  • Common cold: Antibiotics shouldn’t be prescribed.

 

The groups also provide a set of talking points for clinicians when discussing antibiotic use with patients who have an acute respiratory tract infection.

http://www.jwatch.org/fw111074/2016/01/19/acp-cdc-offer-advice-use-antibiotics-acute-respiratory?query=pfwTOC&jwd=000020001882&jspc=EM#sthash.ap0ILqds.dpuf

To read the article in its entirety click on the following link: