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.
Join us for live broadcasting on Tuesday January 19th, 2016 at 10 a.m. Pacific Time,
11 a.m. Mountain Time, 12 p.m. Central Time, 1 p.m. Eastern Time.
Programming for Tuesday, January 19th: “C. difficile Infections; The What, Where and How.”
This episode of “C. diff. Spores and More” is focused on
“C. difficile Infections; The What, Where and How.”
What is it, What can be done to prevent acquiring it,
Where is it acquired, Where can clinicians and patients
learn more about this infection, How is it being prevented at home
and in the hospitals, How CDI’s are being treated, and How to learn more about the
prevention, treatments, and environmental safety products available With our special guests:
Dr. Caterina Oneto,, MD
and Dr. Paul Feuerstadt, MD,
Both professors and physicians specializing in Gastroenterology with
a wealth of knowledge and experience treating patients
with a CDI and through ongoing scientific/medical research.
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We are pleased to share “C. diff. Spores and More ” with you because, as advocates
of C. diff., we know the importance of this cutting-edge new weekly radio show
and what it means for our Foundation’s community worldwide.
Hard Facts: Deaths and illnesses are much higher than reports have shown Nearly half a million Americans suffered from Clostridium difficile (C. diff.) infections in a single year according to a study released today, February 25, 2015, by the Centers for Disease Control and Prevention (CDC).
Previous studies indicate that C. diff. has become the most common
microbial cause of Healthcare-Associated Infections found in U.S. hospitals
driving up costs to $4.8 billion each year in excess health care costs in acute
care facilities alone. Approximately two-thirds of C. diff. infections
were found to be associated with an inpatient stay in a health care facility,
only 24% of the total cases occurred in patients while they were hospitalized.
The study also revealed that almost as many cases occurred in nursing homes as
in hospitals and the remainder of individuals acquired the
Healthcare-Associated infection, C. diff., recently discharged from
a health care facility.
This new study finds that 1 out of every 5 patients with the
Healthcare-Associated Infection (HAI), C. diff., experience
a recurrence of the infection and 1 out of every 9 patients over the
age of 65 diagnosed with a HAI – C. diff. infection died
within 30 days of being diagnosed. Older Americans are quite vulnerable
to this life-threatening diarrhea infection. The CDC study also found
that women and Caucasian individuals are at an increased risk of
acquiring a C. diff. infection.
The CDC Director, Dr. Tom Frieden, MD, MPH said, “C. difficile
infections cause immense suffering and death for thousands of Americans
each year.” “These infections can be prevented by improving antibiotic
prescribing and by improving infection control in the health care system.
CDC hopes to ramp up prevention of this deadly infection by supporting
State Antibiotic Resistance Prevention Programs in all 50 states.”
“This does not include the number of C. diff. infections taking place
and being treated in other countries.” “The C Diff Foundation supports hundreds
of communities by sharing the Foundation’s mission and
Raising C. diff. awareness to healthcare professionals,patients,
families, and communities working towards a shared goal ~ witnessing a
reduction of newly diagnosed C. diff. cases by 2020 .”
” The C Diff Foundation volunteer Advocates are truly appreciated and stand
with the Foundation members creating positive changes through
time and dedication in “Raising C. diff. awareness ” worldwide.
“C. diff. Spores and More “ spotlights world
renowned topic experts, research scientists, healthcare professionals,
organization representatives, C. diff. survivors, board members,
and C Diff Foundation volunteer advocates – all working together to
create positive changes in the C. diff. community and more.
Through their interviews, the C Diff Foundation mission will
connect, educate, and empower our worldwide listeners.
Do you have Questions? Email them to the C Diff Foundation at
firstname.lastname@example.org or through the show page portal.
Questions will be addressed by the show’s Medical Correspondent, Dr. Fred Zar, MD, FACP,
Dr. Fred Zar is a Professor of Clinical Medicine,
Vice Head for Education in the Department of Medicine, and Program Director of the Internal Medicine Residency
at the University of Illinois at Chicago. Over the last two decades he has
been a pioneer in the study of the treatment of Clostridium difficile disease
and the need to stratify patients by disease severity.
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Through the “Get Smart” campaign and programs offered everyone can gain valuable knowledge about Antibiotics. The Centers For Disease Control and Prevention (CDC) provides the Get Smart: Know When Antibiotics Work educational programs for the general public, for farming, and healthcare.
Take a moment and review the CDC’s “Get Smart” information provided on their website and diligently advocate for the safety and the proper use of antibiotics worldwide.
(An excerpt from Dr. Stone’s article)
At last week’s C. diff Foundation conference, Dr. Hudson Garrett suggested that physicians employ a slightly different tactic. Rather than give in to demands for an unnecessary and harmful antibiotic prescription, he suggested that the patients receive a written prescription for specific symptomatic relief products, to provide this sense of validation and to boost satisfaction. It would be nice to see if this can be verified through studies.
Patients seem to have a love-hate relationship with antibiotics, both wanting them, and yet feeling they are a “harsh” and “necessary evil.” This in turn leads many to stop taking them early, not wanting their body to “grow immune”—and not understanding that it is the bacteria that become resistant to antibiotics. This was a widespread belief that appears difficult to overcome.
As the incidence of Clostridium difficile (C. diff) infection spirals, physicians should emphasize the importance of antibiotic stewardship.
A study published in the journal affiliated with the National Foundation for Infectious Diseases (NFID) summarized a recent NFID webinar by Carolyn V. Gould, MD, and L. Clifford McDonald, MD, Centers for Disease Control and Prevention (CDC) and Thomas M. File, Jr., MD, Editor-in-Chief, Infectious Diseases in Clinical Practice.
While C. diff is mainly a significant hospital-acquired infection, recently approximately 5% of C. diff cases are diagnosed outside hospitals.
Since prior antibiotic treatment is the primary risk factor for C. diff, antibiotic stewardship is considered a key factor in controlling significant spikes in incidences.
Antibiotics are capable of disrupting intestinal balance, thereby creating the opportunity for C. diff spores to produce diarrhea-causing toxins.
According to the CDC, there are six essential methods to consider for C. diff prevention:
· Careful prescribing and use of antibiotics
· Early and reliable diagnosis
· Immediate isolation of infected patients
· Contact precautions – wearing gloves and gowns for all contact with the patient and patient-care environment
· Adequately cleaning patient care environments; using an EPA-registered C. diff sporicidal disinfectant
· Effective communication about C. diff status when patients are transferred between healthcare facilities
To review article in its entirety click on the following link:
In the case of C diff and CRE a multipronged intervention approach is necessary. The federal government needs to track outbreaks and monitor antibiotic use. The state and local health departments need to coordinate infection control activities. Hospitals and nursing homes need to implement infection control plans and collaborate in sharing data. Doctors need to avoid excessive antibiotic use and practice hand hygiene.
As for the patients, they need to demand action: ask their health care providers what they and the facility are doing to protect the patient from C difficile and CRE infection. Also, patients need to wash their hands and insist that all health care worker wash their hands before touching them.
To read the article in its entirety click on link below: