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1 – 10 of over 2000
Article
Publication date: 1 December 2004

Fiona J. Cooke, Bryony Dean Franklin, Wendy Lawson, Ann Jacklin and Alison Holmes

Antibiotic resistance presents a major public health challenge at local, national and international levels. At a local level, the challenge is to tackle the antibiotic

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Abstract

Antibiotic resistance presents a major public health challenge at local, national and international levels. At a local level, the challenge is to tackle the antibiotic stewardship agenda, within the clinical governance framework, across all professional groups and specialities. This paper presents the response to this challenge in a large multi‐site NHS trust. The approach focuses around a multi‐disciplinary antibiotic steering group, in which a dedicated infectious diseases pharmacist plays a key role. Proposes seven key elements for a successful antibiotic stewardship programme and discuss examples of local action. These elements are: strong leadership; dedicated individuals with responsibility for leading on antibiotic use; integration into pre‐existing trust structures; harnessing existing resources to deliver change; obtaining local data on prescribing patterns and resistance; communication; and education and training. All pillars of clinical governance are supported by the multi‐disciplinary approach described.

Details

Clinical Governance: An International Journal, vol. 9 no. 4
Type: Research Article
ISSN: 1477-7274

Keywords

Article
Publication date: 12 April 2022

Rima Alkirawan, Ramin Kawous, Evert Bloemen, Maria van den Muijsenbergh, Simone Goosen, Jeanine Suurmond and Fijgje de Boer

This study is oriented towards getting insight into the perspectives, knowledge and practices among Syrian refugees regarding antibiotic use and prescribing in Dutch primary care.

Abstract

Purpose

This study is oriented towards getting insight into the perspectives, knowledge and practices among Syrian refugees regarding antibiotic use and prescribing in Dutch primary care.

Design/methodology/approach

A thematic qualitative study was carried out using semi-structured interviews with 12 Syrian refugees living in the Netherlands. Data analysis consisted of three steps and was oriented towards the development of themes.

Findings

Participants were confronted with restricted access to antibiotics in the Netherlands which was contrary to their experiences in Syria. Some of them continued to self-prescribe antibiotics, while others adhered to the Dutch General Practitioner (GP)’s advice. Especially mothers with young children took up the Dutch GP’s advice. Syrian refugees expressed health beliefs about the healing effects of antibiotics which are related to their past experiences of use and which influenced their current use. Respondents complained about the Dutch health-care system and expressed a preference for the one in Syria.

Research limitations/implications

Syrian refugees vary in their way of dealing with restricted access to antibiotics in Dutch primary care. More in-depth knowledge is required to improve refugee patient–doctor communication about antibiotic use.

Practical implications

The message that antibiotics are not needed may be challenging. Additional communication seems to be necessary to persuade Syrian refugees from self-prescribing antibiotics. Therefore, identifying refugee patient concerns and carefully counseling and communicating it with them is substantial. Developing educational toolkits consisting of various experiences of antibiotic use and ways of dealing with it can equip doctors to more adequately react to migrants’ needs for care.

Social implications

Primary care professionals seem insufficiently equipped to tackle issues related to antibiotic use amongst newly arrived migrants. Therefore, it is important to support professionals in their communication with this patient group about the proper use of antibiotics.

Originality/value

This study shows that more in-depth knowledge is needed about the strategies of newly arrived migrants and their complex reactions to treatment prescriptions with which they are not familiar.

Details

International Journal of Migration, Health and Social Care, vol. 18 no. 2
Type: Research Article
ISSN: 1747-9894

Keywords

Article
Publication date: 5 September 2016

Marisa Anne D'Angeli, Joe B. Baker, Douglas R. Call, Margaret A. Davis, Kelly J. Kauber, Uma Malhotra, Gregory T. Matsuura, Dale A. Moore, Chris Porter, Paul Pottinger, Virginia Stockwell, Carol Wagner, Ron Wohrle, Jonathan Yoder, Leah Hampson Yoke and Peter Rabinowitz

Antibiotic resistance (AR) is a global health crisis that is attracting focussed attention from healthcare, public health, governmental agencies, the public, and food…

Abstract

Purpose

Antibiotic resistance (AR) is a global health crisis that is attracting focussed attention from healthcare, public health, governmental agencies, the public, and food producers. The purpose of this paper is to describe the work in Washington State to combat resistance and promote antimicrobial stewardship from a one health perspective.

Design/methodology/approach

In 2014, the Washington State Department of Health convened a One Health Steering Committee and two workgroups to focus on AR, the One Health Antimicrobial Stewardship work group and the One Health Antimicrobial Resistance Surveillance work group. The group organized educational sessions to establish a basic understanding of epidemiological factors that contribute to resistance, including antibiotic use, transmission of resistant bacteria, and environmental contamination with resistant bacteria and antibiotic residues.

Findings

The authors describe the varied uses of antibiotics; efforts to promote stewardship in human, and animal health, including examples from the USA and Europe; economic factors that promote use of antibiotics in animal agriculture; and efforts, products and next steps of the workgroups.

Originality/value

In Washington, human, animal and environmental health experts are working collaboratively to address resistance from a one health perspective. The authors are establishing a multi-species resistance database that will allow tracking resistance trends in the region. Gaps include measurement of antibiotic use in humans and animals; integrated resistance surveillance information; and funding for AR and animal health research.

Details

International Journal of Health Governance, vol. 21 no. 3
Type: Research Article
ISSN: 2059-4631

Keywords

Article
Publication date: 19 June 2007

Mohammad Reza Shariatzadeh and Thomas J. Marrie

Timely administration of antimicrobials in patients with community‐acquired pneumonia is now a standard of care. The purpose of this paper is to present a large…

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Abstract

Purpose

Timely administration of antimicrobials in patients with community‐acquired pneumonia is now a standard of care. The purpose of this paper is to present a large observational study to understand the issues that result in a delay in the administration of antibiotics to patients with community‐acquired pneumonia

Design/methodology/approach

This prospective study involved all six hospitals in the Edmonton area: patients were enrolled at the time of hospitalization if they were adults aged ≥17 years with a clinical presentation consistent with community‐acquired pneumonia. A retrospective chart review was performed to determine the reasons why it took more than eight hours to administer the first dose of antibiotics.

Findings

The paper finds that of all 3,394 hospitalized patients, 646 (19.0 percent) received antibiotics over four hours after admission to the emergency department and in most instances the delay was more than 12 hours. A total of 30 percent of the delays were justifiable – 17 percent due to diagnostic indecision and 13 percent due to recent receipt of an antibiotic at home or at another institution prior to transfer. All the other delays were unnecessary and easily correctable. In this paper the data indicate that only 5.6 percent of 3,394 patients had an adequate reason for delay in antibiotic administration. Thus a reasonable target for timely administration of antibiotics is at least 90 percent of the patient population.

Originality/value

The strengths of this study lie in its large number of patients, inclusiveness and real world context.

Details

International Journal of Health Care Quality Assurance, vol. 20 no. 4
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 7 November 2018

Jan Michael Alexandre Cortez Bernadas

Drawing insights from the culture-centered approach (Dutta-Bergman, 2004; Dutta, 2007), the purpose of this paper is to explore the meanings of, experiences with, and…

Abstract

Purpose

Drawing insights from the culture-centered approach (Dutta-Bergman, 2004; Dutta, 2007), the purpose of this paper is to explore the meanings of, experiences with, and information sources for antibiotics among at-risk yet understudied populations in urban and economic margins in the Global South.

Design/methodology/approach

Given the exploratory purpose of this paper, it used qualitative approach specifically focus group discussions with mothers, guardians and female senior citizens from Manila, Philippines.

Findings

Antibiotics had multiple meanings – from purposes and modes of acquisition to side-effects. Experiences with antibiotics were not only tied to financial difficulties, but also in administering antibiotics to children or wards and managing side-effects. Furthermore, medical doctors were the most accessed and preferred sources of antibiotics-related information.

Originality/value

To date, this paper is one of the few to argue that knowing the conditions into which antibiotics are situated in the Global South is critical for strengthening global public health campaigns and policies against antimicrobial resistance a and reducing global health inequity.

Details

International Journal of Human Rights in Healthcare, vol. 12 no. 1
Type: Research Article
ISSN: 2056-4902

Keywords

Article
Publication date: 2 January 2007

Cliodna A.M. McNulty, Jo Bowen, David Gelb and Andre Charlett

The aim of this study is to measure the effectiveness of the “Bug Investigators” pack in improving children's knowledge about micro‐organisms, hygiene and antibiotics when…

Abstract

Purpose

The aim of this study is to measure the effectiveness of the “Bug Investigators” pack in improving children's knowledge about micro‐organisms, hygiene and antibiotics when it is used within the National Curriculum in junior schools.

Design/methodology/approach

Teaching, using the “Bug Investigators” pack, was given by Gloucestershire primary school teachers. Children's general knowledge about hygiene, micro‐organisms and antibiotics was measured by questionnaire before and after lessons using the pack. A sample of 198 children aged 10 and 11 years in eight primary schools completed the questionnaires before and after teaching. A focus group was held with teachers to explore their views after using the pack.

Findings

Children's knowledge improved in all topic areas. Improved knowledge was most significant for what antibiotics do and how to use them and the value of our own good bugs (27, 31 and 16 percent improvement respectively). Knowledge about how bugs spread and hand hygiene was excellent (88 and 90 percent) before the education, but there was still 4 percent improvement in these topics. An exploratory discussion with teachers disclosed that some worksheets on viruses and resistant bacteria were too advanced for junior schools.

Research limitations/implications

The study in this paper was undertaken in schools with relatively high‐level four‐science attainment, which could affect generalisability of findings.

Originality/value

The “Bug Investigators” teaching pack was effective at improving knowledge about micro‐organisms, hygiene and antibiotic use; it should be used more widely by junior schools. It is now a recognised teaching resource. Increased awareness of hygiene and prudent use of antibiotics should lower school absenteeism and improve antibiotic use in this generation of future adults.

Details

Health Education, vol. 107 no. 1
Type: Research Article
ISSN: 0965-4283

Keywords

Open Access
Article
Publication date: 25 March 2021

Santhosh J. Thattil and T.A. Ajith

Severe bacterial infection is a major cause of neonatal morbidity and mortality worldwide. Geographical-based demographic laboratory and clinical data are required to get…

Abstract

Purpose

Severe bacterial infection is a major cause of neonatal morbidity and mortality worldwide. Geographical-based demographic laboratory and clinical data are required to get a conclusion about the bacterial infection and their antibiotic susceptibility for the empiric antibiotic treatment in infants who presented with suspected infection. This study was aimed to find the most prevalent bacterial infection and antibiotic sensitivity among infants in the post-neonatal period presented at a tertiary care centre in South India.

Design/methodology/approach

A cross-sectional study was designed among infants (29 days to 1 year old) presented with suspected infection in the paediatric department. Infants with positive culture report were analysed for the bacteriological and antibiotic profile from the medical records. Antibiotic sensitivity was determined for the isolated bacteria according to standard procedure and data statically analysed.

Findings

Total of 218 samples (138 male and 80 female) were analysed. Most of the samples (171/218, 78.4%) were throat swab (p = 0.0247). Only one sample was cerebrospinal fluid from case of meningitis. Sample from upper RTI was major (162/218, 74.3%) with male dominance followed by stool samples from cases of diarrhoea (22/218, 10.0%). Staphylococcus aureus was the major organism identified in 46/171 (26.9 %) throat swabs. The most sensitive antibiotic against bacteria isolated from throat swab and CSF was gentamicin and cloxacillin. Netilmicin and piperacillin plus tazobactam were the sensitive antibiotics against bacteria isolated from stool, ear secretion and urine samples.

Originality/value

Upper RTI was the prevalent bacterial infection followed by diarrhoea in infants in the post-neonatal period. Klebsiella pneumoniae was the common organism identified in the overall report followed by E. coli and S. aureus. Community-based awareness should be provided to follow good hygiene regularly in child care. Furthermore, avoid delay in seeking treatment and provide the medicine prescribed at the right time and in the right dose to limit the morbidity and bacterial resistance.

Details

Journal of Health Research, vol. 36 no. 2
Type: Research Article
ISSN: 0857-4421

Keywords

Article
Publication date: 1 October 2001

Cliodna A.M. McNulty, Anthony V. Swan and David Boland

The recent Standing Medical Advisory Committee’s report The Path of Least Resistance advised a National Advice to the Public campaign aimed at minimising the development…

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Abstract

The recent Standing Medical Advisory Committee’s report The Path of Least Resistance advised a National Advice to the Public campaign aimed at minimising the development of antimicrobial resistance. Describes two 90 minute interactive workshops entitled “Antibiotics and your good bugs” for Year 5 children (nine‐to‐ten years old). Before the workshops, 45 per cent of the children correctly answered all the questions describing antibiotics but, after the workshops, 73 per cent answered correctly. Before the workshops only 23 per cent, 43 per cent, 28 per cent and 26 per cent of the children respectively knew that antibiotics do not kill viruses, do not help colds, do not help hay fever, but do kill our good bacteria, compared with 47 per cent, 76 per cent, 77 per cent and 69 per cent afterwards. These workshops greatly improved the children’s knowledge and understanding of antibiotics and our normal flora. They will prove useful for parties involved in planning the National Advice to the Public campaign on antibiotic resistance in schools.

Details

Health Education, vol. 101 no. 5
Type: Research Article
ISSN: 0965-4283

Keywords

Article
Publication date: 11 March 2019

Kunal Karamchandani, Kyle Barden and Jansie Prozesky

The purpose of this paper is to review surgical antimicrobial prophylaxis administration practices in a small cohort and assess compliance with national guidelines.

Abstract

Purpose

The purpose of this paper is to review surgical antimicrobial prophylaxis administration practices in a small cohort and assess compliance with national guidelines.

Design/methodology/approach

Patients that developed surgical site infections (SSI) in a tertiary care academic medical center over a two-year period were identified. Their electronic medical records were reviewed for compliance with national guidelines with respect to surgical antibiotic prophylaxis.

Findings

Over a two-year period, 283 SSI patients were identified. An appropriate antibiotic was chosen in 80 percent, an appropriate dose was administered in 45 percent and timing complied in 89 percent. The antibiotics were appropriately re-dosed in only 9.2 percent in whom the requirement was met. The prescribing guidelines were adhered to in entirety in only 54 patients (23.8 percent).

Practical implications

Timely and appropriate antibiotic administration prior to surgery is essential to prevent SSI. Proper diligence is required to accomplish this task effectively.

Originality/value

Based on the findings, it appears that merely, “checking a box” for antibiotic administration during surgery is not enough, and a multidisciplinary approach should be followed to ensure “appropriate” antibiotic administration.

Details

International Journal of Health Care Quality Assurance, vol. 32 no. 2
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 1 August 1999

Quintin A. McKellar

Antibiotics are used in animals to cure disease and prevent suffering. Bacterial populations in animals which are exposed to these antibiotics may be selected for…

651

Abstract

Antibiotics are used in animals to cure disease and prevent suffering. Bacterial populations in animals which are exposed to these antibiotics may be selected for resistance. There is a concern that spread of these bacteria in the food chain to humans may result in the establishment of antibiotic resistant bacteria in people which will prove difficult or impossible to treat with conventional drugs. It is clear that antibiotics must be used carefully to reduce the development of resistance and that steps should be taken to reduce the transfer of bacteria from animals to man.

Details

Nutrition & Food Science, vol. 99 no. 4
Type: Research Article
ISSN: 0034-6659

Keywords

1 – 10 of over 2000