Infectious disease clinics of North America
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Infect. Dis. Clin. North Am. · Jun 2014
ReviewTransformation of antimicrobial stewardship programs through technology and informatics.
The successful integration of technology in antimicrobial stewardship programs has made it possible for clinicians to function more efficiently. With government endorsement of electronic health records (EHRs), EHRs and clinical decision support systems (CDSSs) are being used as decision support tools to aid clinicians in efforts to improve antibiotic use. Likewise, medical applications (apps) have provided educational tools easily accessible to clinicians through their mobile devices. In this article, the impact that informatics and technology have had on promoting antibiotic stewardship is described, focusing on EHRs and CDSSs, apps, electronic resources, and social media.
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Infect. Dis. Clin. North Am. · Jun 2014
ReviewAntimicrobial stewardship interventions: thinking inside and outside the box.
At present, less than half of all acute health care facilities have antimicrobial stewardship programs. By targeting areas that are vulnerable to inappropriate antimicrobial use and by using novel strategies to increase the reach of stewardship interventions, providers can make antimicrobial stewardship a universal practice in all health care settings. This review discusses how stewardship can make large impacts in areas where it has traditionally been absent in facilities both with and without formal antimicrobial stewardship programs.
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Infect. Dis. Clin. North Am. · Jun 2014
ReviewHealth care provider education as a tool to enhance antibiotic stewardship practices.
Antibiotic stewardship education for health care providers provides a foundation of knowledge and an environment that facilitates and supports optimal antibiotic prescribing. There is a need to extend this education to medical students and health care trainees. ⋯ Such education has been shown to enhance other antibiotic stewardship interventions. In this review, the need and suggested audience for antibiotic stewardship education are highlighted, and effective education techniques are recommended for increasing knowledge of antibiotics and improving their use.
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Infect. Dis. Clin. North Am. · Jun 2014
ReviewHospital antimicrobial stewardship in the nonuniversity setting.
Inappropriate antimicrobial use and antimicrobial resistance persist across the healthcare continuum. Antimicrobial stewardship guidelines assist healthcare institutions in establishing antimicrobial stewardship programs but rely on infectious diseases expertise and leadership, which are not available in all settings. Despite this, many institutions have found ways to use available resources to perform stewardship activities, with improvements in antimicrobial use and reductions in resistance and cost. This article highlights success stories in nonuniversity hospital settings and proposes antimicrobial stewardship strategies that may be more feasible in settings with limited infectious diseases expertise, information technology, or financial resources.
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Infect. Dis. Clin. North Am. · Jun 2014
ReviewAntimicrobial stewardship in immunocompromised hosts.
The global spread of antimicrobial resistance has limited the availability of antimicrobial agents to treat infections that affect immunocompromised hosts. Efforts to optimize the selection, dosing, and duration of antimicrobial therapy to improve patient outcomes and minimize selective pressure on antimicrobial resistance are relevant to immunocompromised patients. Collaborative efforts between health care providers with expertise in the diagnosis and treatment of patients with various degrees of immunosuppression are pivotal for the success of antimicrobial stewardship programs in immunocompromised patients.