Combating Antimicrobial Resistance and Protecting the Miracle of Modern Medicine


Book Description

The National Strategy for Combating Antibiotic Resistant Bacteria, published in 2014, sets out a plan for government work to mitigate the emergence and spread of resistant bacteria. Direction on the implementation of this strategy is provided in five-year national action plans, the first covering 2015 to 2020, and the second covering 2020 to 2025. Combating Antimicrobial Resistance and Protecting the Miracle of Modern Medicine evaluates progress made against the national strategy. This report discusses ways to improve detection of resistant infections and estimate the risk to human health from environmental sources of resistance. In addition, the report considers the effect of agricultural practices on human and animal health and animal welfare and ways these practices could be improved, and advises on key drugs and diseases for which animal-specific test breakpoints are needed.




Antimicrobial Stewardship


Book Description

In an age where antimicrobial resistance amongst pathogens grows more prevalent, particularly in the hospital setting, antimicrobial stewardship is an evidence-based, proven measure in the battle against resistance and infection. This single comprehensive, definitive reference work is written by an international team of acknowledged experts in the field. The authors explore the effective use of coordinated antimicrobial interventions to change prescribing practice and help slow the emergence of antimicrobial resistance, ensuring that antimicrobials remain an effective treatment for infection. Amongst the first of its kind, this book provides infectious disease physicians, administrators, laboratory, pharmacy, nursing and medical staff with practical guidance in setting up antimicrobial stewardship programs in their institutions with the aim of selecting the optimal antimicrobial drug regimen, dose, duration of therapy, and route of administration.




Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine


Book Description

Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine 4E has been fully updated and revised. The clinical diagnostic approach to common infectious disease problems in the CCU is the underlying theme in the book. Emphasized throughout is the importance of formulating an accurate early presumptive clinical syndromic diagnosis which is the basis for selecting optimal initial antimicrobial therapy in the CCU. Without an accurate presumptive clinical diagnosis, effective therapy is unlikely at best. Based on the most probable clinical diagnosis, optimal antibiotic empiric therapy, based on antimicrobial stewardship principles, minimizes resistance and antibiotic complications in the CCU. This new edition features chapters that explain the tenets of differential diagnostic reasoning, differential diagnostic characteristics of fever patterns in the CCU. The proper interpretation of rapid diagnostic tests, in the appropriate clinical context, is included. The diagnostic importance of cardinal clinical findings, particularly when combined, in the appropriate clinical context is emphasized and remains the basis for clinical problem solving in the CCU. Uniquely, critical diagnostic physical findings in the CCU, including color atlas of diagnostic eye findings, are included as important diagnostic determinants in the CCU. Written by infectious disease clinicians for CCU consultants, Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine 4E remains a useful evidence based and experience tempered key clinical resource for infectious disease problems in the CCU. Key Features Essentials of the tenets of clinical diagnostic reasoning is explained as it relates to formulating a rapid and accurate clinical syndromic diagnosis in the CCU The diagnostic significance of fever patterns and their relationship to the pulse rate in the proper clinical context is explained in depth as related to the CCU setting Formulating an accurate early clinical syndromic diagnosis is presented as essential since it is the basis of effective empiric antibiotic therapy in the CCU How to combine key non-specific laboratory and imaging findings to increase diagnostic specificity and diagnostic probability in the CCU is presented Clinical perspective on the proper interpretation of the clinical significance of rapid diagnostic test results in the CCU is included A clinical approach to apparent "antibiotic failure" in the CCU is presented either due to actual antibiotic failure or seeming but unrelated non-antibiotic failure Section focuses on the practical aspects of antimicrobial stewardship particularly as related to optimizing dosing effectiveness while minimizing resistance and adverse effects in the CCU




Antibiotic Optimization


Book Description

This book focuses on topics ranging from the economics of drug-resistant infections and the management of antimicrobial use to new information on methods to optimize the selection, route of administration, dosing, and duration of antimicrobial therapies for common infections. In addition to offering ideas on studied programmatic approaches for judi




Infectious Diseases in Critical Care


Book Description

Critical care practitioners are often the initial providers of care to seriously ill patients with infections. This book provides clinicians practicing in the intensive care unit with a reference to help guide their care of infected patients. It brings together a group of international authors to address important topics related to infectious diseases for the critical care practitioner.




The Pharmacist's Guide to Antimicrobial Therapy and Stewardship


Book Description

When a patient comes in with a suspected infectious disease, knowledge is power. Now this knowledge is simplified, comprehensive and easy to find. The Pharmacist's Guide to Antimicrobial Therapy and Stewardship puts all the necessary information in one place, including: Evaluating potentially infected patients Identifying the infection's suspected source and related organisms Comparing the range of anti-infectives Knowing the factors that impact treatment Developing an antimicrobial stewardship program A step-wise approach walks logically from overall key concepts to disease- and drug-specific information. Disease states are summarized for easy reference. Tables make it easy to evaluate recommended treatment options. In infectious disease management, when answers are seldom black and white, this guide helps pharmacists make confident decisions.




Practical Implementation of an Antibiotic Stewardship Program


Book Description

This practical reference guide from experts in the field details why and how to establish successful antibiotic stewardship programs.




Antibiotic Pharmacokinetic/Pharmacodynamic Considerations in the Critically Ill


Book Description

This book provides unique insights into the issues that drive modified dosing regimens for antibiotics in the critically ill. Leading international authors provide their commentary alongside a summary of existing evidence on how to effectively dose antibiotics. Severe infection frequently necessitates admission to the intensive care unit (ICU). Equally, nosocomial sepsis often complicates the clinical course in ICU. Early, appropriate application of antibiotic therapy remains a cornerstone of effective management. However, this is challenging in the critical care environment, given the significant changes in patient physiology and organ function frequently encountered. Being cognisant of these factors, prescribers need to consider modified dosing regimens, not only to ensure adequate drug exposure, and therefore the greatest chance of clinical cure, but also to avoid encouraging drug resistance.




Sepsis Management in Resource-limited Settings


Book Description

This book is open access under a CC BY 4.0 license. It constitutes a unique source of knowledge and guidance for all healthcare workers who care for patients with sepsis and septic shock in resource-limited settings. More than eighty percent of the worldwide deaths related to sepsis occur in resource-limited settings in low and middle-income countries. Current international sepsis guidelines cannot be implemented without adaptations towards these settings, mainly because of the difference in local resources and a different spectrum of infectious diseases causing sepsis. This prompted members of the Global Intensive Care working group of the European Society of Intensive Care Medicine (ESICM) and the Mahidol-Oxford Tropical Medicine Research Unit (MORU, Bangkok, Thailand) - among which the Editors – to develop with an international group of experts a comprehensive set of recommendations for the management of sepsis in resource-limited settings. Recommendations are based on both current scientific evidence and clinical experience of clinicians working in resource-limited settings. The book includes an overview chapter outlining the current challenges and future directions of sepsis management as well as general recommendations on the structure and organization of intensive care services in resource-limited settings. Specific recommendations on the recognition and management of patients with sepsis and septic shock in these settings are grouped into seven chapters. The book provides evidence-based practical guidance for doctors in low and middle income countries treating patients with sepsis, and highlights areas for further research and discussion.




Improving Diagnosis in Health Care


Book Description

Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.