Tag Archives: Antibiotic Therapy

Over prescribing of antibiotics in pediatric patients

* In The News *

An estimated 17,000 children aged  1 through 17 years get C. difficile infections every year, according to preliminary data from the Center of Disease Control and Infection. The Pediatrics study found that there was no difference in the incidence of C. difficile infection among boys and girls, and that the highest numbers were seen in white children and those between the ages of 12 and 23 months.

Clostridium difficile is a spore forming bacteria which can be part of the normal intestinal flora in as many as 50% of children under age two, and less frequently in individuals over two years of age. C. difficile (C. diff.) is the major cause of pseudomembranous colitis and antibiotic associated diarrhea.

Many parents continue to insist on physicians prescribing an antibiotic, i.e.,  amoxicillin or zithromax, each time their child has a sore throat, bronchitis, or mild ear infection which are usually caused by a virus and not bacteria.  Antibiotics are not effective treating viruses.

A new CDC study published earlier last week in the Journal Pediatrics found that 71 percent of C. difficile infections that occurred in children were not associated with a hospital stay and usually followed a course of antibiotics prescribed by a pediatrician. Previous research suggests that at least half of antibiotics prescribed to children are for respiratory infections, most of which don’t require antibiotics.

The CDC Director, Dr. Tom Frieden stated,  “When antibiotics are prescribed incorrectly, our children are needlessly put at risk for health problems including C. difficile infection and dangerous antibiotic resistant infections.” “Improved antibiotic prescribing is critical to protect the health of our nation’s children,”

Physicians are more cautious about prescribing antibiotics, and parents need to become more understanding that antibiotics are not recommended for viruses and the symptoms noted.  However; if the symptoms are not relieved with over-the-counter medications, or fever persists, the Physician should be notified/seen and symptoms assessed.  Antibiotics should only be considered and prescribed by physicians for symptoms that do not resolve on their own or linger past a week or two.

 

 

Pediatric C. diff. infections linked with antibiotic use

According to the latest report published by the Center of Disease Control and Prevention, it  urges Physicians to improve on prescribing antibiotics, in an outpatient setting, to reduce harm in the pediatric population.

In a new study it showed that 71 percent of the cases of C. difficile infection identified among children aged 1 through 17 years were community-associated—that is, not associated with an overnight stay in a healthcare facility.  By contrast, two-thirds of C. difficile infections in adults are associated with hospital stays.

“Among the community-associated pediatric cases whose parents were interviewed, 73 percent were prescribed antibiotics during the 12 weeks prior to their illness, usually in an outpatient setting such as a doctor’s office.  Most of the children who received antibiotics were being treated for ear, sinus, or upper respiratory infections. Previous studies show that at least 50 percent of antibiotics prescribed in doctor’s offices for children are for respiratory infections, most of which do not require antibiotics.”

A statement from the CDC Director; Dr. Tom Frieden, M.D., M.P.H.,  “Improved antibiotic prescribing is critical to protect the health of our nation’s children,”  “When antibiotics are prescribed incorrectly, our children are needlessly put at risk for health problems including C. difficile infection and dangerous antibiotic resistant infections.”

To read the report in its’ entirety please click on the following link:

http://www.cdc.gov/media/releases/2014/p0307-severe-diarrheal-illness.html

Also the published January 2014 study in Pediatrics – Journal of the Academy of Pediatrics

http://pediatrics.aappublications.org/content/early/2014/02/25/peds.2013-3049

Antibiotic checklist to improve Antibiotic Prescribing

Through the Centers for Disease Control and Prevention and their new Vital Signs report, the main focus remains on the use of antibiotics and raising awareness of antibiotic therapy.

A statement from CDC Director, Dr. Tom Frieden, MD, MPH, “Improving antibiotic prescribing can save today’s patients from deadly infections and protect lifesaving antibiotics for tomorrow’s patients.”   “Healthcare facilities are an important part of the solution to drug resistance and every hospital in the country should have a strong antibiotic stewardship program.”

Through the National Healthcare Safety Network, healthcare – associated infection (HAI) tracking system the CDC provides facilities, states, regions, and the nation data needed to identify problem areas, the measurable progress of prevention efforts being made with constant interventions and goal to eliminate HAI’s across the board.

The CDC recommends every hospital implement a Stewardship program that includes the following seven key elements:

Accountability: Appoint a single leader responsible for program outcome. Physicians have proven successful in this role.

Act: Take at least one prescribing improvement action, such as requiring reassessment of prescriptions within 48 hours to check drug choice, dose, and duration.

Drug Expertise: Appoint a single Pharmacist leader to support improved prescribing.

Educate: Offer education about antibiotic resistance and improve prescribing practices.

Leadership Commitment: Dedicate the necessary human, financial, and IT resources.

Report: Regularly report prescribing and resistance information to clinicians.

Track: Monitor prescribing and antibiotic resistance patterns.

The CDC stresses the importance of communicating and working with other health care facilities in the area to prevent infection transmission, and resistance from occurring.

To read the Vital Signs report in its’ entirety please click on the following link:

http://www.prnewswire.com/news-releases/improving-antibiotic-prescribing-in-hospitals-can-make-health-care-safer-248400031.html

 

The CDC Antibiotic Stewardship Program:  Save money with antibiotic stewardship

 

Antibiotic stewardship programs and interventions help ensure that patients get the right antibiotics at the right time for the right duration. Numerous studies have shown that implementing an antibiotic stewardship program can not only save lives, but can save significant healthcare dollars.   Inpatient antibiotic stewardship programs have consistently demonstrated annual savings to hospitals and other healthcare facilities of $200,000 to $400,000.

A University of Maryland study showed one antibiotic stewardship program saved a total of $17 million over 8 years.   Antibiotic stewardship helps improve patient care and shorten hospital stays, thus benefiting patients as well as hospitals.

According to a University of Maryland study, implementation of one antibiotic stewardship program saved a total of $17 million over 8 years at one institution.  * After the program was discontinued, antibiotic costs increased over $1 million in the first year (an increase of 23 percent) and continued to increase the following year.

  • In a study conducted at The Johns Hopkins Hospital, it was demonstrated that guidelines for management of community-acquired pneumonia could promote the use of shorter courses of therapy, saving money and promoting patient safety.
  • Targeting certain infections may decrease antibiotic use. For example, determining when and how to treat patients for urinary tract infections, the second most common bacterial infection leading to hospitalization, can lead to improved patient outcomes and cost savings.
  • Why we must act now: The way we use antibiotics today or in one patient directly impacts how effective they will be tomorrow or in another patient; they are a shared resource.  Antibiotic resistance is not just a problem for the person with the infection. Some resistant bacteria have the potential to spread to others — promoting antibiotic-resistant infections. Since it will be many years before new antibiotics are available to treat some resistant infections, we need to improve the use of antibiotics that are currently available.
  • Healthcare facility administrators and payers can – Make appropriate antibiotic use a quality improvement and patient safety priority.  Focus on reducing unnecessary antibiotic use, which can reduce antibiotic-resistant infections, Clostridium difficile infections, and costs, while improving patient outcomes.   Emphasize and implement antibiotic stewardship programs and interventions for every facility – regardless of facility setting and size.  Monitor Healthcare Effectiveness Data and Information Set (HEDIS®) performance measures on pharyngitis, upper respiratory infections, acute bronchitis, and antibiotic utilization.

For more information regarding the CDC Antibiotic Stewardship information please click on the following link:

http://www.cdc.gov/getsmart/healthcare/learn-from-others/factsheets/antibiotic-use.html

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Antibiotic Therapy: New method for rapidily measuring the level of antibiotic drug molecules in human blood serum

The news of new methods being discovered by researchers to measure the levels of  antibiotic  drug molecules in human blood serum opens new doors with antibiotic treatment.  Antibiotic therapy will be closely monitored and tailored to each person’s needs.

“Existing biosensors on the market do not measure cellular stress, however, the nanomechanical sensor exploited by a group of researchers from the London Centre for Nanotechnology (LCN) at UCL, the University of Cambridge, the University of Queensland and Jomo Kenyatta University of Agriculture and Technology, can accurately measure this important information even when antibiotic drug molecules are only present at very low concentrations.”

“The researchers coated the surface of a nanomechanical cantilever array with a model bacterial membrane and used this as a surface stress sensor. The sensor is extremely sensitive to tiny bending signals caused by its interactions with the antibiotics, in this case, the FDA-approved vancomycin and the yet to be approved oritavancin, which appears to deal with certain vancomycin-resistant bacteria, in the blood serum.”

“This investigation has yielded the first experimental evidence that drug-serum complexes (the antibiotics bound to the competing serum proteins) do not induce stress on the bacteria and so could provide realistic in-vitro susceptibility tests for drugs and to define effective doses which are effective enough but less toxic to patients.”

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

http://www.news-medical.net/news/20140303/New-methodology-for-rapidly-detecting-antibiotics-in-blood-paves-way-to-drug-development-personalized-treatment.aspx