Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-2 (of 2 Records) |
Query Trace: McDonald CL[original query] |
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Human colonization with multidrug-resistant organisms: Getting to the bottom of antibiotic resistance
Smith RM , Lautenbach E , Omulo S , Araos R , Call DR , Kumar GCP , Chowdhury F , McDonald CL , Park BJ . Open Forum Infect Dis 2021 8 (11) ofab531 The spread of antimicrobial resistance (AR) is a public health threat in both high-income countries (HICs) and low- and middle-income countries (LMICs). Multidrug-resistant organisms (MDROs), particularly gram-negative bacteria, are of critical concern with several having been identified by the United States Centers for Disease Control and Prevention and the World Health Organization (WHO) as priority pathogens for control and research [1, 2]. Essential to the task of mitigating the spread of AR is the development and use of robust surveillance systems to measure and track the incidence, prevalence, and spread of AR as policies and interventions for its prevention and control are introduced and evaluated. |
Vital signs: improving antibiotic use among hospitalized patients
Fridkin S , Baggs J , Fagan R , Magill S , Pollack LA , Malpiedi P , Slayton R , Khader K , Rubin MA , Jones M , Samore MH , Dumyati G , Dodds-Ashley E , Meek J , Yousey-Hindes K , Jernigan J , Shehab N , Herrera R , McDonald CL , Schneider A , Srinivasan A . MMWR Morb Mortal Wkly Rep 2014 63 (9) 194-200 BACKGROUND: Antibiotics are essential to effectively treat many hospitalized patients. However, when antibiotics are prescribed incorrectly, they offer little benefit to patients and potentially expose them to risks for complications, including Clostridium difficile infection (CDI) and antibiotic-resistant infections. Information is needed on the frequency of incorrect prescribing in hospitals and how improved prescribing will benefit patients. METHODS: A national administrative database (MarketScan Hospital Drug Database) and CDC's Emerging Infections Program (EIP) data were analyzed to assess the potential for improvement of inpatient antibiotic prescribing. Variability in days of therapy for selected antibiotics reported to the National Healthcare Safety Network (NHSN) antimicrobial use option was computed. The impact of reducing inpatient antibiotic exposure on incidence of CDI was modeled using data from two U.S. hospitals. RESULTS: In 2010, 55.7% of patients discharged from 323 hospitals received antibiotics during their hospitalization. EIP reviewed patients' records from 183 hospitals to describe inpatient antibiotic use; antibiotic prescribing potentially could be improved in 37.2% of the most common prescription scenarios reviewed. There were threefold differences in usage rates among 26 medical/surgical wards reporting to NHSN. Models estimate that the total direct and indirect effects from a 30% reduction in use of broad-spectrum antibiotics will result in a 26% reduction in CDI. CONCLUSIONS: Antibiotic prescribing for inpatients is common, and there is ample opportunity to improve use and patient safety by reducing incorrect antibiotic prescribing. Implications for Public Health: Hospital administrators and health-care providers can reduce potential harm and risk for antibiotic resistance by implementing formal programs to improve antibiotic prescribing in hospitals. |
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