Skip header and navigation

Refine By

   MORE

5 records – page 1 of 1.

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
Cites: JAMA. 1999 Oct 20;282(15):1458-6510535437
Cites: Scand J Prim Health Care. 2009;27(4):208-1519929185
Cites: Br J Gen Pract. 1999 Jun;49(443):436-4010562741
Cites: Tidsskr Nor Laegeforen. 2001 Mar 10;121(7):827-3011301708
Cites: Tidsskr Nor Laegeforen. 2002 Oct 10;122(24):2376-812448254
Cites: Eur J Clin Microbiol Infect Dis. 2004 Mar;23(3):163-714986159
Cites: J Am Geriatr Soc. 1991 Oct;39(10):963-721918783
Cites: Postgrad Med. 1993 Jun;93(8):173-808506175
Cites: Lancet. 2005 Feb 12-18;365(9459):579-8715708101
Cites: J Hosp Infect. 2005 Aug;60(4):312-615951057
Cites: Am J Med. 2006 Nov;119(11):958-6317071164
Cites: J Antimicrob Chemother. 2007 May;59(5):971-617329270
Cites: Scand J Infect Dis. 2007;39(6-7):536-4117577815
Cites: Scand J Infect Dis. 2008;40(5):393-818418800
Cites: Crit Care. 2008;12(1):20318279531
Cites: Tidsskr Nor Laegeforen. 2008 Oct 23;128(20):2324-919096488
Cites: Int J Antimicrob Agents. 2009 Mar;33 Suppl 1:S24-819303565
Cites: Tidsskr Nor Laegeforen. 2009 Mar 26;129(7):623-719337330
Comment In: J Urol. 2013 Jan;189(1):15623235224
PubMed ID
22188479 View in PubMed
Less detail

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
Cites: Intern Med J. 2012 Jul;42(7):e157-6421241444
Cites: J Antimicrob Chemother. 2012 Dec;67(12):2982-722865381
Cites: BMC Geriatr. 2012;12:7323176555
Cites: BMC Urol. 2012;12:3323171154
Cites: BMC Infect Dis. 2013;13:1923327474
Cites: JAMA. 1999 Oct 20;282(15):1458-6510535437
Cites: Infect Dis Clin North Am. 2014 Mar;28(1):75-8924484576
Cites: J Am Geriatr Soc. 2001 Mar;49(3):270-611300237
Cites: Infect Control Hosp Epidemiol. 2001 Mar;22(3):167-7511310697
Cites: BMC Geriatr. 2014;14:3024625344
Cites: J Am Med Dir Assoc. 2015 Mar;16(3):229-3725458444
Cites: Age Ageing. 2003 Jan;32(1):12-812540342
Cites: J Am Med Dir Assoc. 2003 Mar-Apr;4(2 Suppl):S52-912807571
Cites: N Engl J Med. 1981 Sep 24;305(13):731-57266615
Cites: Rev Infect Dis. 1987 Nov-Dec;9(6):1127-393321363
Cites: Ann Intern Med. 1989 Jan 15;110(2):138-502462391
Cites: Clin Microbiol Rev. 1996 Jan;9(1):1-178665472
Cites: JAMA. 1999 Feb 10;281(6):517-2310022107
Cites: Clin Infect Dis. 2005 Mar 1;40(5):643-5415714408
Cites: Int J Antimicrob Agents. 2005 Nov;26(5):380-816243229
Cites: Tidsskr Nor Laegeforen. 2006 Apr 6;126(8):1058-6016619066
Cites: Infection. 2007 Jun;35(3):150-317565455
Cites: Clin Infect Dis. 2007 Aug 1;45(3):273-8017599303
Cites: BMJ. 2008;337:a143818801866
Cites: Tidsskr Nor Laegeforen. 2008 Oct 23;128(20):2324-919096488
Cites: BMC Fam Pract. 2011;12:3621592413
Cites: S Afr Med J. 2011 May;101(5):328-3121837876
Cites: Scand J Urol Nephrol. 2011 Sep;45(4):265-921452928
Cites: Scand J Urol Nephrol. 2011 Dec;45(6):401-521815861
Cites: Scand J Prim Health Care. 2012 Mar;30(1):10-522188479
Cites: Infect Control Hosp Epidemiol. 2012 Apr;33(4):416-2022418641
Cites: Clin Microbiol Infect. 2013 Oct;19(10):962-823279375
Cites: Eur J Clin Microbiol Infect Dis. 2013 Dec;32(12):1545-5624213913
Cites: J Infect Dis. 2001 Mar 1;183 Suppl 1:S5-811171003
PubMed ID
26238248 View in PubMed
Less detail

A simple intervention to reduce inappropriate ciprofloxacin prescribing in the emergency department.

https://arctichealth.org/en/permalink/ahliterature260132
Source
Scand J Infect Dis. 2014 Jul;46(7):481-5
Publication Type
Article
Date
Jul-2014
Author
Mark Fagan
Morten Lindbæk
Harald Reiso
Dag Berild
Source
Scand J Infect Dis. 2014 Jul;46(7):481-5
Date
Jul-2014
Language
English
Publication Type
Article
Keywords
Amdinocillin - therapeutic use
Anti-Bacterial Agents - therapeutic use
Ciprofloxacin - therapeutic use
Cystitis - drug therapy - microbiology
Emergency Service, Hospital
Female
Humans
Inappropriate Prescribing - prevention & control
Male
Norway
Practice Guidelines as Topic
Pyelonephritis - drug therapy - microbiology
Urinary Tract Infections - drug therapy
Abstract
According to Norwegian guidelines for antibiotic use in primary care, ciprofloxacin is reserved for complicated urinary tract infections (UTI). Despite these recommendations, ciprofloxacin use has increased in Norway in recent years. We aimed to reduce inappropriate ciprofloxacin prescribing in the emergency department.
An intervention study was performed by removing ciprofloxacin from the local antibiotic formulary and including a suggestion list for antibiotic use with all point of care urine dipstick testing in an emergency department. An emergency department in the neighbouring county served as the control. Prescriptions for UTI were registered 1 y prior to and 1 y after the intervention.
In the targeted emergency department, there was a significant (p
PubMed ID
24552583 View in PubMed
Less detail

U.S. and Canadian internal medicine clerkship directors' opinions about teaching procedural and interpretive skills to medical students.

https://arctichealth.org/en/permalink/ahliterature177760
Source
Acad Med. 2004 Nov;79(11):1108-13
Publication Type
Article
Date
Nov-2004
Author
D Michael Elnicki
Jose van Londen
Paul A Hemmer
Mark Fagan
Raymond Wong
Author Affiliation
Department of Medicine, University of Pittsburgh Medical Center Shadyside, 5230 Centre Avenue, Pittsburgh, PA 15232, USA. elnickim@upmc.edu
Source
Acad Med. 2004 Nov;79(11):1108-13
Date
Nov-2004
Language
English
Publication Type
Article
Keywords
Adult
Aged
Attitude of Health Personnel
Canada
Clinical Clerkship - standards
Curriculum
Data Collection
Female
Humans
Internal Medicine - education
Male
Middle Aged
Professional Competence
United States
Abstract
Although medical students gain experience in performing procedures during their clinical clerkships, which skills they should acquire remains unclear. The authors sought opinions from internal medicine clerkship directors regarding procedural and interpretive skills students should and do learn during clerkships.
In 2002, the 123 members of the Clerkship Directors in Internal Medicine (CDIM) were confidentially surveyed using a 79-item questionnaire about the appropriateness of 20 procedural skills, demographics, clerkship characteristics, and curricula in procedural skills. Participants had the choice of completing a mailed paper questionnaire or an electronic version on the CDIM's Web site. After univariate analysis, adjusted comparisons among participants were made using linear regression.
Surveys were completed by 89 clerkship directors (72%). Most thought that students should be taught 17 of 20 procedural skills. However, the majority thought students do not learn five of these skills. Over 80% of respondents thought students should learn: chest x-ray interpretation, electrocardiogram interpretation, phlebotomy, throat culture, blood culture, urinalysis, Pap smear, central line placement, peripheral blood smear. However, the majority thought students do not learn five of these skills. The mean of skills that should be taught and are learned were 15 (standard deviation [SD] = 3) and 12 (SD = 4), respectively. About half used formal teaching in procedures (44%), used logs (51%) and tested competency (45%).
CDIM members thought medical students should be taught a variety of procedural skills but thought students fail to learn many. These findings may help prioritize which procedures to teach. It may be helpful to develop standardized curricular materials on teaching procedures.
PubMed ID
15504782 View in PubMed
Less detail

[Use of fluoroquinolones in nursing homes].

https://arctichealth.org/en/permalink/ahliterature139897
Source
Tidsskr Nor Laegeforen. 2010 Oct 21;130(20):2022-4
Publication Type
Article
Date
Oct-21-2010
Author
Mark Fagan
Stian Bøe Skotheim
Author Affiliation
Institutt for allmenn- og samfunnsmedisin, Universitetet i Oslo, Postboks 1130 Blindern, 0318 Oslo, Norway. marfaga@online.no
Source
Tidsskr Nor Laegeforen. 2010 Oct 21;130(20):2022-4
Date
Oct-21-2010
Language
Norwegian
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Anti-Bacterial Agents - administration & dosage - adverse effects
Anti-Infective Agents - administration & dosage - adverse effects
Anti-Infective Agents, Urinary - administration & dosage - adverse effects
Ciprofloxacin - administration & dosage - adverse effects
Drug Resistance, Bacterial
Drug Utilization
Female
Fluoroquinolones - administration & dosage - adverse effects
Humans
Male
Norway
Nursing Homes
Respiratory Tract Infections - drug therapy - microbiology
Urinary Tract Infections - drug therapy - microbiology
Abstract
In Norway, a substantial increase in the use of fluoroquinolones (in the last years) has occurred in parallel with a disconcertering increase in ciprofloxacin resistant E. Coli bacteria. Elderly patients (over 70 years) use most antibiotics. The purpose of this study is to investigate prescribing of fluoroquinolone in nursing homes within a Norwegian municipality.
Clinical information was recorded for nursing home patients treated with fluoroquinolone in Arendal municipality in the period 01.12.06-31.11.07.
94 courses of ciprofloxacin were prescribed for 78 patients. No patients were treated with ofloxacine. Urinary tract infection was the most common indication for patients both in long- term (78%) and short term (40%) wards. In short-term wards, respiratory tract infection was also a common indication for prescribing ciprofloxacin (37%), but not in long- term wards (4%). 44 infections (47%) were verified by microbiology culture. 12 infections were caused by a bacterium susceptible only to ciprofloxacin.
Ciprofloxacin was used in a large proportion of the patients in cases when another antibiotic should have been the first choice according to Norwegian national guidelines. Results of microbiology culture showed that most pathogens were susceptible to antibiotics with a narrower spectrum than ciprofloxacin.
PubMed ID
20967041 View in PubMed
Less detail