Le présent document de travail a été conçu pour offrir des conseils pratiqueset des suggestions sur la manièred’établir et de maintenir la collaboration multisectorielle nécessaire pour élaborer et mettre en œuvre les plans d’action nationaux (PAN) de lutte contre la RAM. Il s’adresse... à tous ceux qui ont pourresponsabilité de combattre la RAM au niveau national. S’appuyant à la fois sur la littérature publiée et sur l’expérience pratique de quatre «pays focaux» (Éthiopie, Kenya, Philippines et Thaïlande), ce documentrésume les enseignements tirés et les derniers points de vuesur la collaboration multisectorielle en vue d’une action efficace contre la RAM.
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This document updates the 2014 Core Elements for Hospital Antibiotic Stewardship Programs and incorporates new evidence and lessons learned from experience with the Core Elements. The Core Elements are applicable in all hospitals, regardless of size. There are suggestions specific to small and criti...cal access hospitals in Implementation of Antibiotic Stewardship Core Elements at Small and Critical Access Hospitals (12).There is no single template for a program to optimize antibiotic prescribing in hospitals. Implementation of antibiotic stewardship programs requires flexibility due to the complexity of medical decision-making surrounding antibiotic use and the variability in the size and types of care among U.S. hospitals. In some sections, CDC has identified priorities for implementation, based on the experiences of successful stewardship programs and published data. The Core Elements are intended to be an adaptable framework that hospitals can use to guide efforts to improve antibiotic prescribing. The assessment tool that accompanies this document can help hospitals identify gaps to address.
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Intensive Care Med (2009) 35:9–29DOI 10.1007/s00134-008-1336-9
Although thousands of papers have been devoted tohospital-acquired pneumonia (HAP), many controversiesremain, and management of HAP is probably often sub-optimal. Several reviews or guidelines have been pub-lished rec...ently, mostly by North American initiatives(CDC, ATS). Three European Societies (ERS, ESCMID andESICM) were interested in producing a document thatcould complement in some way the last IDSA/ATS guidelines published 3 years ago. In addition, the Helics
working group supported this initiative.
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The international community sits at the tipping pointof a post-‐antibiotic era, where common bacterial infections are no longer treatable with the antibiotic armamentarium that exists. In South Africa, t...he identification of the first case of pan-‐resistant Klebsiella pneumoniae(Brink et al, J Clin Microbiol. 2013;51(1):369-‐72) marks a watershed moment and highlights ourtip of the antibiotic resistance ‘iceberg’ in this country. Multi-‐drug resistant (MDR)-‐bacterial infections, predominantly in Gram-‐negative bacteria such as Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosaand Acinetobacter baumanniiare now commonplace in South African hospitals. Whilst a number of expensive new antibiotics for Gram-‐positive bacterial infections have been manufactured recently (some of which are licenced for usein South Africa), no new antibiotics active against Gram-‐negative infections are expected in the next 10-‐15years. Hence what we have now, needs conserving
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The guidelines are to be used to guide the management of adults with lower respiratory tract infection (LRTI). As will be seen in the following text, this diagnosis, and the other clinical syndromes within this grouping, can be difficult to make accurately. In the absence of agreed definitions of th...ese syndromes these guidelines are to be used when, in the opinion of a clinician, an LRTI syndrome is present. The following are put forward as def-initions to guide the clinician, but it will be seen in the ensuingtext that some of these labels will always be inaccurate. These definitions are pragmatic and based on a synthesis of available studies. They are primarily meant to be simple to apply in clinical practice, and this might be at the expense of scientific accuracy. These definitions are not mutually exclusive, with lower respiratory tract infection being an umbrella term that includes all others, which can also be used for cases that cannot be classified into one of the other groups. No new evidence has been identified that would lead to a change in the clinical definitions,which are therefore unchanged from the 2005 publication.
Clin Microbiol Infect 2011;17(Suppl. 6): 1–24 The full version of these guidelines can be found on Wiley Online Library.
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The product of all this work is the Standard Treatment Guideline and Essential Medicines List of Common Medical Conditions in the Kingdom of Swaziland. These systematically developed statements are designed to assist practitioners in making decisions about appropriate treatment for specific clinical... conditions. They are meant to reflect expert consensus based on a review of current and published scientific evidence of acceptable approaches to diagnosis, man-agement, or prevention of specific conditions.It is enlightening to note that section A of the document contains the STG, and effort has been made to have the conditions commonly encountered in Swaziland classified according to systems. Written in simple, clear language, each section consists of a short definition followed by common symptoms and signs of the disease or condition and then management (pharmacological and nonpharmacological)
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The method, entitled “elicit-provide-elicit”, is a patient centred method which is adaptable to a range of clinical situations. Recent clinical trials show that the introduction of advanced communication skills based on this method in general practice allows primary care physicians to prescribe... significantly less antibiotics while maintaining a high degree of patient satisfac-tion, without impacting patient recovery time and consultation times.
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A short movie about the history and the current status of antibiotics from the four week online course: Antibiotic Resistance: the silent tsunami, produced by ReAct and Uppsala University, Sweden.
The infectious disease burden in India is among the highest in the world. A large amount of antibiot-ics are consumed in fighting infections, some of them saving lives, but every use adding to antibiotic resistance in bacteria. Antibiotic use is increasing steadily (table 1), particularly ... certain antibiotic classes (beta-lactam antibacterials), most notably in the more prosperous states. Resistance follows in lock-step.
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Stenotrophomonas maltophiliais a nonfermenting Gram-negative rod that is ubiquitous in nature (predominantly occurring in aquatic environments and on plants). Biochemically, it iscatalase positive and oxidase negative, and it produces acid frommaltose (hence the name“maltophilia”). Due to it...s chargedcell wall surface and biofilm production, it may attach to and survive on abiotic surfaces in clinical settings (eg, central venouscatheters, disinfectant and hand-washing solutions, solutions for hemodialysis, endoscopes, inspiration/expiration circuits of ventilators, nebulizers, tap water, and showerheads).
Health Services Research and Managerial Epidemiology Volume 6: 1-9ªThe Author(s) 2019
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Nosocomial infections, or hospital-acquired infec-tions (HAI), are among the most significant causesof morbidity and mortality in healthcare settingsthroughout the world.Prevention of HAIs iscentral to providing high quality and safe health-care, even in settings with limited resources.Transmi...ssion of infectious agents between patientsby health workers and irrational use of antibioticsare two important preventable factors involved inmany HAIs.
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Des milliers de personnes meurent chaque jour des suites d’infections acquises au cours des procédures de soins.
Antibiotic resistance has been recognized as a major global health threat and optimizing prescribing is one of the most effective measures to preserve the effectiveness of antibiotics. The quality of prescribing depends mostly on those prescribers belonging to clinical medical specialties... having direct contact with patients. These doctors, who comprise the majority of antibiotic prescribers,undergo long-term undergraduate and postgraduate training that shapes their professional knowledge and behaviour
J Antimicrob Chemother2019;74: 3611–3618doi:10.1093/jac/dkz375 Advance Access publication 3 September 2019
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Antibiotic stewardship refers to coordinated efforts and activities that seek to measure and improve use of antibiotics. Implementation of ASPs has demonstrated positive public health and clinical impacts including reducing costs, lengths of hospital stays, and the burden of antibiotic resistance wh...ile maintaining or improving patient outcomes. The U.S. Centers for Disease Control and Prevention (CDC) released the Core Elements of Hospital Antibiotic Stewardship Programs in 2014, which outlines essential components for ASPs in hospitals and provides practical guidance for implementing a robust ASPin an acute care facility. Variations to the Core Elements have been developed to deal with the particular challenges in small, rural or critical access hospitals in the United States and in outpatient facilities and nursing homes.
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The Global Antibiotic Resistance Partnership (GARP) aims to address the challenge of antibiotic resistance by developing actionable Policy Proposals in Vietnam and four other low- and middle-income countries: China, India, Kenya and South Africa. GARP will develop the evidence base for Policy action... on antibiotic resistance and identify policy opportunities where research, advocacy and information have the best chance of slowing the development and spread of resistance.
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