Antimicrobial Resistance: Factors and Outcomes

Fish, Douglas N.; Ohlinger, Martin J.

doi:10.1016/j.ccc.2006.02.006

Cited by 47 publications

(27 citation statements)

References 96 publications

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“…Such strategies should include reducing unnecessary hospital stay, avoiding or shortening the use of invasive devices, adhering to hand hygiene guidelines, and applying antimicrobial cycling and combination strategies [38][39][40]. The participants of our study showed a significant awareness of the above approaches.…”

Section: Discussionmentioning

confidence: 84%

“…The strategies for limiting bacterial resistance are consistently discussed in literature. The adoption of certain guidelines, practice parameters, clinical pathways, or protocols, is associated with more appropriate antibiotic use, improved patient outcomes, fewer adverse events and errors, and more importantly, minimized resistance emergence [25,39]. Since nosocomial infections highly contribute to poor outcomes and increased rates of bacterial resistance, hospitals should play a major role in limiting bacterial resistance.…”

Section: Discussionmentioning

confidence: 99%

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Awareness and Beliefs of Antimicrobial Resistance among Health Professionals Working at Tikur Anbessa Specialized Hospital, Addis Ababa: Ethiopia

Berha¹,

Amin²,

Alebachew³

2017

J Bioanal Biomed

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Introduction: Antimicrobial Resistance (AMR) threatens the effective prevention and treatment of an everincreasing range of infections caused by bacteria, parasites, viruses and fungi. In recent years, since the rate at which resistance occurs has outpaced the development of new drug replacements, it has become necessary to use the currently available agents, optimally and appropriately. The aim of this study was to assess the medical staff awareness towards the most common resistant bacteria species, the factors contributing to the lack of awareness, and the possible measures to address the awareness gap. Methods:A structured questionnaire was administered to 205 health care professionals including physicians, pharmacists, and nurses at Tikur Anbessa Specialized Hospitals, Addis Ababa-Ethiopia. Results:The study identified that most of the responding physicians and pharmacists considered Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus (MRSA) as the most frequently encountered resistant bacterial species. However, nurses recognized both MRSA and extended-spectrum β-lactamase producing Gramnegative bacilli (ESBL) as the most prevalent resistant species. Majority of physicians (79.2%) and pharmacists (79.9%) reported prolonged hospitalization as a factor likely to contribute to the increased incidence of bacterial resistance. About 66.0% of pharmacists indicated that the use of antibiotics without prescription as a significant reason for the development of bacterial resistance. Most of the physicians (71.4%) reported that appropriate infection control is the most important measure to reduce bacterial resistance. Conclusion:The findings of this study revealed that there was good awareness of the most common AMR etiologies and their risk factors among the different discipline health professionals. Even though there was a varying level of awareness among the health care professionals. Continuous medical education programs would be desirable to keep the health care professionals updated and diminish the future risk of excessive bacterial resistance.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Awareness and Beliefs of Antimicrobial Resistance among Health Professionals Working at Tikur Anbessa Specialized Hospital, Addis Ababa: Ethiopia

Berha¹,

Amin²,

Alebachew³

2017

J Bioanal Biomed

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“…Better infection control strategies in hospitals and regular efficiency checks on these strategies must be put to practice. Such strategies should include reducing unnecessary hospital stay, avoiding or shortening the use of invasive devices, adhering to hand hygiene guidelines, and applying antimicrobial cycling and combination strategies [9,31,32]. The participants of our study showed a significant awareness of the above approaches.…”

Section: Medical Staff Awareness Of Bacterial O R I G I N a L P A P Ementioning

confidence: 84%

“…Acinetobacter is frequently resistant to aminoglycosides, flouroqiunolones, ureidopenicilliuns, and third-generation cephalosporins as well as carbapenems [20,21]. 9,31]. Since nosocomial infections highly contribute to poor outcomes and increased rates of bacterial resistance, hospitals should play a major role in limiting bacterial resistance.…”

Section: Medical Staff Awareness Of Bacterial O R I G I N a L P A P Ementioning

confidence: 99%

Awareness of bacterial resistance among physicians, pharmacists and nurses

Alzoubi

Ayoub²,

Al-Sakaji³

et al. 2009

International Journal of Occupational Medicine and Environmental Health

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Objective:To assess the level of medical staff awareness of bacterial resistance and characterize the most common resistant bacterial species, the factors contributing to the development of such resistance, and the possible measures to limit the increasing rate of resistance to current antibacterial therapies. Method: A questionnaire was administered to 352 health care professionals including physicians, pharmacists and nurses at four central university hospitals in Jordan. Results: Our results indicate that most of the responding physicians and pharmacists considered Pseudomonas aeruginosa and methicilinresistant Staphylococcus aureus the most frequently encountered resistant bacterial species. However, nurses recognized both methicilin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococci (VRE) as the most prevalent resistant species. Physicians and nurses (50.0% and 61.6%, respectively) reported prolonged hospitalization as a factor likely to contribute to the increased incidence of bacterial resistance. About 58% of pharmacists indicated the use of antibiotics without prescription as a significant reason for the development of bacterial resistance. Most of physicians (61.2%) reported that appropriate infection control is the most important measure to reduce bacterial resistance. Pharmacists (58.1%) recognized better adherence to the infection control guidelines as the most important factor that could reduce the risk of bacterial resistance. Conclusion: The findings of this study indicate a varying level of awareness of bacterial resistance among the health care professionals. Thus, serious efforts are still needed to develop and implement strategies to decrease the future risk of bacterial resistance to antibiotics.

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“…Therefore, health system policymakers should consider implementing reasonable administration guidelines for AMAs through appropriate drug policies [19]. Antimicrobial protocol and guidelines; formulary-based antimicrobial restriction [20] can be used to improve rational usage of antimicrobials. In future, pharmacists have a greater responsibility to take prominent roles in antimicrobial stewardship and infection prevention and control programs in health-care systems.…”

Section: Pattern Of Culture In Micu and Sicumentioning

confidence: 99%

A Comparative Study on Drug Use of Antimicrobial Agents in Medical and Surgical Intensive Care Units of a Tertiary Care Hospital.

Paul

Kumar

2018

Asian J Pharm Clin Res

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Objective: To identify the pattern of drug utilization of antimicrobials in prescriptions of patients admitted at medical intensive care unit (MICU) and surgical intensive care unit (SICU) department and to analyze the utilization of different classes of drugs.Methods: A prospective observational study was carried out in 10 bedded medical and surgical intensive care unit (ICU) of tertiary care hospital, Adayar, from October 1 st 2016 to March 1 st 2016. The study was performed in 100 prescriptions. The relevant data on drug prescription of each patient were collected from in-patient records. The demographic data, disease data, and the utilization of different classes of antimicrobial agents (AMAs) were analyzed. Results:In MICU, a total of 648 drugs were prescribed during the period of stay and AMAs accounted for 15% of total drug. The average length of stay was found to be 8 (±8.73). The mean number of drugs received by patients is 11.6 ± 2 drugs. The most frequently prescribed AMAs were ceftriaxone followed by meropenem and clindamycin. Cephalosporin is commonly prescribed due to their relatively lower toxicity and broader spectrum activity. The generally prescribed AMA combination was amoxicillin + clavulanic acid (32.50%) and piperacillin + tazobactam (27.50%). The laboratory reported positive cultures for 30 patients. The most prevailing organisms were Escherichia coli (50%). In SICU, a total of 780 drugs were prescribed during the period of stay and AMAs accounted for 18% of total drug. An average of 5 (±2.0) drugs was prescribed for each patient and each prescription contains an average of 2 (±0.9) AMAs. The results indicated that ceftriaxone was the most commonly prescribed AMAs (22%), followed by meropenem (18%), ciprofloxacin (18%), and colistin (8%). A total of five AMA combination therapies were used in SICU. Among them, piperacillin+clavulanic acid (36.84%) was the most commonly prescribed combination. In the study, 30 (60 %) cases had microbial growth and have performed sensitivity test. Conclusion:A wide class and percentage of AMAs were prescribed in ICUs. There is a need of antimicrobial agent's usage guidelines and restriction policies for the rational prescribing of antimicrobials in critically ill patients.

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Antimicrobial Resistance: Factors and Outcomes

Cited by 47 publications

References 96 publications

Awareness and Beliefs of Antimicrobial Resistance among Health Professionals Working at Tikur Anbessa Specialized Hospital, Addis Ababa: Ethiopia

Awareness and Beliefs of Antimicrobial Resistance among Health Professionals Working at Tikur Anbessa Specialized Hospital, Addis Ababa: Ethiopia

Awareness of bacterial resistance among physicians, pharmacists and nurses

A Comparative Study on Drug Use of Antimicrobial Agents in Medical and Surgical Intensive Care Units of a Tertiary Care Hospital.

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