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Adjustment of antibiotic treatment according to the results of blood cultures leads to decreased antibiotic use and costs.

https://arctichealth.org/en/permalink/ahliterature171349
Source
J Antimicrob Chemother. 2006 Feb;57(2):326-30
Publication Type
Article
Date
Feb-2006
Author
Dag Berild
Atefeh Mohseni
Lien My Diep
Mogens Jensenius
Signe Holta Ringertz
Author Affiliation
Department of Internal Medicine, Aker University Hospital, N-0514 Oslo, Norway. dag.berild@medisin.uio.no
Source
J Antimicrob Chemother. 2006 Feb;57(2):326-30
Date
Feb-2006
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Anti-Bacterial Agents - administration & dosage - economics - therapeutic use
Bacteremia - blood - drug therapy - economics
Drug Costs
Escherichia coli - drug effects
Female
Gram-Negative Bacteria - drug effects
Gram-Positive Bacteria - drug effects
Guidelines as Topic
Hospitals, University - economics
Humans
Male
Middle Aged
Norway
Retrospective Studies
Treatment Outcome
Abstract
To avoid the use of unnecessary broad-spectrum antibiotics, empirical therapy of bacteraemia should be adjusted according to the results of blood cultures.
To investigate whether the results of blood cultures led to changes in antibiotic use and costs in a tertiary-care university hospital in Norway.
Medical records from all patients with positive blood cultures in 2001 were analysed retrospectively. Factors predisposing to infections, results of blood cultures, antibiotic use and outcome were recorded. The influence of blood culture results on antibiotic treatment and costs were analysed.
The antibiotic use in 226 episodes of bacteraemia in 214 patients was analysed. According to the guidelines empirical antibiotic treatment should be adjusted in 166 episodes. Antibiotic use was adjusted in 146 (88%) of these 166 episodes, which led to a narrowing of therapy in 118 (80%) episodes. Compared with empirical therapy there was a 22% reduction in the number of antibiotics. Adjustment of therapy was more often performed in Gram-negative bacteraemia and polymicrobial cultures than in Gram-positive bacteraemia. In bacteraemia caused by ampicillin-resistant Escherichia coli, ampicillin was mostly replaced by ciprofloxacin. The cost for 7 days adjusted therapy in 146 episodes was euro19,800 (23%) less than for 7 days of empirical therapy.
Adjustment of antibiotic therapy according to the results of blood cultures led to a reduction in the number of antibiotics and a narrowing of antibiotic therapy. The costs for antibiotics decreased.
PubMed ID
16387751 View in PubMed
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Antibiotic prescribing in nursing homes in an area with low prevalence of antibiotic resistance: compliance with national guidelines.

https://arctichealth.org/en/permalink/ahliterature128584
Source
Scand J Prim Health Care. 2012 Mar;30(1):10-5
Publication Type
Article
Date
Mar-2012
Author
Mark Fagan
Marthe Mæhlen
Morten Lindbæk
Dag Berild
Author Affiliation
Department of General Practice and Community Medicine, University of Oslo, Oslo, Norway. markfagannor@gmail.com
Source
Scand J Prim Health Care. 2012 Mar;30(1):10-5
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Aged, 80 and over
Anti-Bacterial Agents - therapeutic use
Drug Resistance, Microbial
Female
Guideline Adherence - statistics & numerical data
Humans
Infection - drug therapy
Male
Norway
Nursing Homes - statistics & numerical data
Physician's Practice Patterns - standards
Practice Guidelines as Topic
Retrospective Studies
Abstract
To examine antibiotic prescribing in nursing homes and determine to what degree the prescribing was in accordance with the national guidelines for antibiotic prescribing.
Retrospective examination of patients' records who were prescribed antibiotics in the period 1 March 2007 to 28 February 2008.
Patients residing in the nursing homes of Arendal, Norway.
Choice of antibiotic in respect of the recommendations in the national guidelines for antibiotic prescribing.
A total of 714 antibiotic courses were prescribed to 327 patients yielding a prevalence of 6.6%. Compliant prescribing was 77% for urinary tract infections (UTI), 79% for respiratory tract infections (RTI), and 76% for skin and soft tissue infections (SSTI). Ciprofloxacin was responsible for 63% of non-compliant prescribing. On the respite wards there was a higher rate of total prescribing, non-compliant prescribing, and prescribing by physicians employed at the local hospital.
Guidelines for antibiotic use must be implemented actively and efforts to improve antibiotic prescribing in nursing homes must be aimed at both nursing home and hospital physicians.
Notes
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Comment In: J Urol. 2013 Jan;189(1):15623235224
PubMed ID
22188479 View in PubMed
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Antibiotic resistance in hospitals: a ward-specific random effect model in a low antibiotic consumption environment.

https://arctichealth.org/en/permalink/ahliterature120238
Source
Stat Med. 2013 Apr 15;32(8):1407-18
Publication Type
Article
Date
Apr-15-2013
Author
Magne Aldrin
Ragnhild Raastad
Ingunn Fride Tvete
Dag Berild
Arnoldo Frigessi
Truls Leegaard
Dominique L Monnet
Mette Walberg
Fredrik Müller
Author Affiliation
The Norwegian Computing Center, 0314 Oslo, Norway. Magne.Aldrin@nr.no
Source
Stat Med. 2013 Apr 15;32(8):1407-18
Date
Apr-15-2013
Language
English
Publication Type
Article
Keywords
Anti-Bacterial Agents - administration & dosage
Computer simulation
Drug Resistance, Bacterial
Hospitals
Humans
Models, Statistical
Norway - epidemiology
Pseudomonas Infections - drug therapy - epidemiology - microbiology
Pseudomonas aeruginosa - drug effects - isolation & purification
Retrospective Studies
Abstract
Association between previous antibiotic use and emergence of antibiotic resistance has been reported for several microorganisms. The relationship has been extensively studied, and although the causes of antibiotic resistance are multi-factorial, clear evidence of antibiotic use as a major risk factor exists. Most studies are carried out in countries with high consumption of antibiotics and corresponding high levels of antibiotic resistance, and currently, little is known whether and at what level the associations are detectable in a low antibiotic consumption environment. We conduct an ecological, retrospective study aimed at determining the impact of antibiotic consumption on antibiotic-resistant Pseudomonas aeruginosa in three hospitals in Norway, a country with low levels of antibiotic use. We construct a sophisticated statistical model to capture such low signals. To reduce noise, we conduct our study at hospital ward level. We propose a random effect Poisson or binomial regression model, with a reparametrisation that allows us to reduce the number of parameters. Inference is likelihood based. Through scenario simulation, we study the potential effects of reduced or increased antibiotic use. Results clearly indicate that the effects of consumption on resistance are present under conditions with relatively low use of antibiotic agents. This strengthens the recommendation on prudent use of antibiotics, even when consumption is relatively low.
PubMed ID
23027651 View in PubMed
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Antibiotic resistance patterns of bacteria causing urinary tract infections in the elderly living in nursing homes versus the elderly living at home: an observational study.

https://arctichealth.org/en/permalink/ahliterature269775
Source
BMC Geriatr. 2015;15:98
Publication Type
Article
Date
2015
Author
Mark Fagan
Morten Lindbæk
Nils Grude
Harald Reiso
Maria Romøren
Dagfinn Skaare
Dag Berild
Source
BMC Geriatr. 2015;15:98
Date
2015
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Anti-Infective Agents, Urinary - classification - pharmacology
Cross-Sectional Studies
Drug Resistance, Bacterial
Escherichia coli - drug effects
Escherichia coli Infections - diagnosis - drug therapy - epidemiology
Female
Homes for the Aged - statistics & numerical data
Humans
Independent Living - statistics & numerical data
Male
Norway - epidemiology
Nursing Homes - statistics & numerical data
Practice Guidelines as Topic
Proteus Infections - diagnosis - drug therapy - epidemiology
Proteus mirabilis - drug effects
Sex Factors
Urinalysis - methods
Urinary Tract Infections - diagnosis - drug therapy - epidemiology - microbiology
Abstract
Antibiotic resistance is a problem in nursing homes. Presumed urinary tract infections (UTI) are the most common infection. This study examines urine culture results from elderly patients to see if specific guidelines based on gender or whether the patient resides in a nursing home (NH) are warranted.
This is a cross sectional observation study comparing urine cultures from NH patients with urine cultures from patients in the same age group living in the community.
There were 232 positive urine cultures in the NH group and 3554 in the community group. Escherichia coli was isolated in 145 urines in the NH group (64%) and 2275 (64%) in the community group. There were no clinically significant differences in resistance. Combined, there were 3016 positive urine cultures from females and 770 from males. Escherichia coli was significantly more common in females 2120 (70%) than in males 303 (39%) (p?
Notes
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PubMed ID
26238248 View in PubMed
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Source
Tidsskr Nor Laegeforen. 2016 Aug;136(14-15):1182
Publication Type
Article
Date
Aug-2016
Author
Dag Berild
Source
Tidsskr Nor Laegeforen. 2016 Aug;136(14-15):1182
Date
Aug-2016
Language
English
Norwegian
Publication Type
Article
Keywords
Cause of Death
Drug Resistance, Bacterial
Drug Utilization
Humans
Norway
PubMed ID
27554541 View in PubMed
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Appropriate antibiotic use according to diagnoses and bacteriological findings: report of 12 point-prevalence studies on antibiotic use in a university hospital.

https://arctichealth.org/en/permalink/ahliterature191216
Source
Scand J Infect Dis. 2002;34(1):56-60
Publication Type
Article
Date
2002
Author
Dag Berild
Signe Holta Ringertz
Michaela Lelek
Author Affiliation
Department of Medicine and Microbiology, Aker University Hospital, Oslo, Norway.
Source
Scand J Infect Dis. 2002;34(1):56-60
Date
2002
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Anti-Bacterial Agents - administration & dosage - classification - therapeutic use
Bacterial Infections - diagnosis - drug therapy - microbiology
Drug Utilization
Female
Guideline Adherence
Hospitals, University
Humans
Male
Middle Aged
Norway
Practice Guidelines as Topic
Abstract
The objective of this study was to evaluate antibiotic use in relation to diagnoses and bacteriological findings in a 600-bed Norwegian university hospital. Twelve point-prevalence studies of antibiotic use were conducted between 1996 and 1999. In the point-prevalence studies, 1,096 of 6,588 adult patients (16.6%) used on average 1.25 antibiotics each. Of the patients who received antibiotics, 35% were treated for hospital-acquired infections. Lower respiratory tract and urinary tract infections accounted for more than half of all antibiotic use. Pencillins represented 54% of antibiotic use, cephalosporins 9%, quinolones 6% and antifungal agents 0.7%. The prescribed daily doses for the penicillins were 2-3 times higher than the defined daily doses. Bacteriological samples were obtained from 929 (85%) patients. Compliance with the guidelines was > 90% and was highest when the results of bacteriological samples were positive. Good compliance led to low prevalence of antibiotic use and the use of narrow-spectrum antibiotics.
PubMed ID
11874166 View in PubMed
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[Are too many antibiotics prescribed to Norwegian children?]

https://arctichealth.org/en/permalink/ahliterature31192
Source
Tidsskr Nor Laegeforen. 2002 Nov 20;122(28):2690
Publication Type
Article
Date
Nov-20-2002

A controlled intervention study to improve antibiotic use in a Russian paediatric hospital.

https://arctichealth.org/en/permalink/ahliterature158257
Source
Int J Antimicrob Agents. 2008 May;31(5):478-83
Publication Type
Article
Date
May-2008
Author
Dag Berild
Tore G Abrahamsen
Stein Andresen
Egil Bjørløw
Ola Haug
Irina M Kossenko
Olga I Kubar
Michaela Lelek
Svetlana I Mintchenko
Maria F Pyasetskaya
Signe H Ringertz
Galina A Sysenko
Author Affiliation
Department of Infectious Diseases, Aker University Hospital, Oslo, Norway. dag.berild@medisin.uio.no
Source
Int J Antimicrob Agents. 2008 May;31(5):478-83
Date
May-2008
Language
English
Publication Type
Article
Keywords
Adolescent
Anti-Bacterial Agents - therapeutic use
Bacterial Infections - drug therapy - microbiology - mortality
Child
Child, Preschool
Gastroenteritis - drug therapy - microbiology
Guideline Adherence
Hospitals
Humans
Infant
Infant, Newborn
Intervention Studies
Length of Stay
Practice Guidelines as Topic
Respiratory Tract Infections - drug therapy - microbiology
Russia
Treatment Outcome
Abstract
A controlled intervention study was performed in a paediatric hospital in Russia to improve antibiotic use and to see whether improvements persisted. During October-December 2002, clinical and microbiological data, antibiotic use, costs and outcome were recorded at two wards for gastrointestinal infections (GIIs) and two wards for respiratory tract infections (RTIs). Guidelines for diagnosis and treatment of infections were developed and implemented at one ward for GIIs and one ward for RTIs in 2003. The other two wards served as controls. The same data were recorded during the same 3-month periods in 2003 and 2004. At the intervention ward, the percentage of patients with GII who received antibiotics decreased from 94% in 2002 to 41% in 2003, but increased to 73% in 2004. In RTI patients these percentages were 90% in 2002, 53% in 2003 and 83% in 2004. The proportions of patients who received antibiotics in 2004 were still lower than in 2002: risk difference (RD)=0.217 (P
PubMed ID
18343641 View in PubMed
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Educational intervention for parents and healthcare providers leads to reduced antibiotic use in acute otitis media.

https://arctichealth.org/en/permalink/ahliterature31343
Source
Scand J Infect Dis. 2002;34(9):657-9
Publication Type
Article
Date
2002
Author
Lars Småbrekke
Dag Berild
Anton Giaever
Torni Myrbakk
Airin Fuskevåg
Johanna U Ericson
Trond Flaegstad
Orjan Olsvik
Signe H Ringertz
Author Affiliation
Regional Drug Information Centre, Tromsø University Hospital, Norway. lars.smabrekke@unn.no
Source
Scand J Infect Dis. 2002;34(9):657-9
Date
2002
Language
English
Publication Type
Article
Keywords
Acute Disease
Adolescent
Anti-Bacterial Agents - administration & dosage
Child
Child, Preschool
Health education
Humans
Infant
Norway
Otitis Media - drug therapy
Penicillin V - therapeutic use
Physician's Practice Patterns - trends
Abstract
We used a controlled before-and-after design with the aims of reducing both the total consumption of antibiotics and the use of broad-spectrum antibiotics against acute otitis media (AOM), and to study to what extent prescriptions for antibiotics against AOM were dispensed. Information on evidence-based treatment of uncomplicated AOM was provided to doctors and nurses, and written guidelines were implemented. Pamphlets and oral information concerning symptomatic treatment and the limited effect of antibiotic use in AOM were given to parents. Eligible patients were 819 children aged 1-15 y. The proportion of patients receiving a prescription for antibiotics was reduced from 90% at baseline to 74% during the study period. The proportion of prescriptions for penicillin V increased from 72% at baseline to 85% during the study period. There were no significant changes at the control site. The proportion of dispensed prescriptions was 70% both at baseline and during the study period. Educational efforts reduced the total consumption of antibiotics and the use of broad-spectrum antibiotics for AOM in children aged 1-15 y at an emergency call service. Data on antibiotic use in AOM based only on prescribing overestimates the use of antibiotics.
PubMed ID
12374355 View in PubMed
Less detail
Source
Scand J Infect Dis. 2005;37(6-7):534-7
Publication Type
Article
Date
2005
Author
Mogens Jensenius
Trond Flaegstad
Tore Stenstad
Tor Gjølberg
Ljiljana Vlatkovic
Line Schjøth-Iversen
Dag Berild
Gerard Bordmann
Bjørn Myrvang
Author Affiliation
Division of Infectious Diseases, Department of Internal Medicine, Aker University Hospital, Oslo, Norway. mogens.jensenius@ioks.uio.no
Source
Scand J Infect Dis. 2005;37(6-7):534-7
Date
2005
Language
English
Publication Type
Article
Keywords
Adult
Anthelmintics - therapeutic use
Benzimidazoles - therapeutic use
Child, Preschool
Emigration and Immigration
Ethiopia
Fascioliasis - diagnosis - epidemiology
Female
Humans
Liver - pathology
Male
Middle Aged
Norway - epidemiology
Praziquantel - therapeutic use
Vietnam
Abstract
We report 3 cases of fascioliasis imported to Norway: a 24-y-old male Vietnamese immigrant and a 51-y-old female Vietnamese immigrant with acute fascioliasis, and a 2-y-old male Ethiopian adoptee with chronic fascioliasis. Diagnosis was confirmed by detection of specific antibodies to Fasciola hepatica in the 2 first cases and by demonstration of Fasciola hepatica eggs in stool samples in the latter case. Treatment with oral triclabendazole led to prompt cure in all 3 patients. Imported fascioliasis is rarely reported but should be suspected in patients with a travel history to endemic areas, abdominal symptoms and hypereosinophilia of the blood.
PubMed ID
16012024 View in PubMed
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21 records – page 1 of 3.