Abstract:
PURPOSE OF REVIEW:Antibiotic resistance continues to rise, whereas development of new agents to counter it has slowed. A heightened need exists to maintain the effectiveness of currently available agents. This review focuses on the need for better antimicrobial stewardship, expected benefits of well designed antimicrobial stewardship programs (ASPs), and provides suggestions for development of an effective ASP. RECENT FINDINGS:Healthcare-associated infections (HAIs) are a significant cause of poor treatment outcomes and elevated healthcare and societal costs worldwide. HAIs are often caused by antibiotic-resistant pathogens; overuse of antibiotics has been linked with antibiotic resistance. Benefits of improved antimicrobial stewardship include reduced emergence of antibiotic resistance, limitation of drug-related adverse events, minimization of other consequences of antibiotic use (e.g., superinfection), and reduction of societal and healthcare-related costs. In 2007, the Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA) provided guidelines for the development of institutional programs to enhance antimicrobial stewardship. Experiences at The Ohio State University Medical Center (OSUMC) reinforce this message, while providing specific examples of ways to optimize ASP development and implementation. The focus of an ASP should be on improving quality of care, reducing drug resistance, and cost savings. When implementing an ASP, it is important to identify those most likely to resist the ASP, understand their concerns, and develop easy-to-understand messages that address these concerns and highlight the benefits of the proposed changes. Antibiograms play a key role in identifying local and interdepartmental trends in antibiotic susceptibility or resistance. These data are important not only in devising best-treatment practices for the institution, but also in evaluating the impact of a recently implemented ASP. Other measures of the impact of an ASP should include patient outcomes and overall costs or savings. SUMMARY:Better antimicrobial stewardship is needed to limit the emergence of antibiotic resistance, prolong the effectiveness of currently available agents, improve patient outcomes, and reduce healthcare and societal costs associated with HAIs. Guidelines from the IDSA/SHEA and experiences at OSUMC provide examples of how best to develop an institutional ASP to accomplish these goals.
journal_name
Curr Opin Infect Disjournal_title
Current opinion in infectious diseasesauthors
Goff DAdoi
10.1097/01.qco.0000393484.17894.05subject
Has Abstractpub_date
2011-02-01 00:00:00pages
S11-20eissn
0951-7375issn
1473-6527pii
00001432-201102001-00002journal_volume
24 Suppl 1pub_type
杂志文章,评审abstract:PURPOSE OF REVIEW:Bacillus Calmette-Guerin (BCG) vaccination has been performed since 1921, and remains the best method of preventing severe infections caused by Mycobacterium tuberculosis. Tuberculosis, in its various forms, remains a public health problem, and more than 100 countries continue BCG vaccination in an ef...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/01.qco.0000160895.97362.4f
更新日期:2005-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Despite progress in the management of pulmonary infections in the hematopoietic cell transplant (HCT) population, substantial diagnostic, and therapeutic uncertainty remains. RECENT FINDINGS:A growing HCT population reflects more transplants and improved long-term survival. We continue to learn about...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章
doi:10.1097/QCO.0000000000000626
更新日期:2020-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Migrants living in high-income countries are disproportionately affected by HIV infection and frequently have characteristics associated with poor HIV clinical outcomes. HIV epidemiology among migrants is influenced by changes in migration patterns and variations in transmission risk behaviors. Here w...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/QCO.0000000000000415
更新日期:2018-02-01 00:00:00
abstract:PURPOSE OF REVIEW:Co-infection with Plasmodium falciparum malaria and Epstein-Barr virus (EBV) are implicated in the cause of endemic Burkitt lymphoma (eBL), the most prevalent pediatric cancer in equatorial Africa. Although the causal association between EBV and eBL has been established, P. falciparum malaria's role i...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/QCO.0b013e328349ac4f
更新日期:2011-10-01 00:00:00
abstract:PURPOSE OF REVIEW:This review will focus on the epidemiology and cause of diarrheal illness in solid organ transplant and stem-cell transplant population recipients with a specific focus on the role of advanced multiplex technology in the diagnosis of diarrhea within this patient population. RECENT FINDINGS:A wide ran...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/QCO.0000000000000586
更新日期:2019-10-01 00:00:00
abstract:PURPOSE OF REVIEW:Integrase strand transfer inhibitors (INSTIs) have become a key component of antiretroviral therapy since the approval of twice-daily raltegravir in 2007 and the more recent approval of elvitegravir in 2012. At the same time, a third compound, dolutegravir, is in late-phase clinical trials, being test...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/QCO.0b013e32835ba81c
更新日期:2013-02-01 00:00:00
abstract:PURPOSE OF REVIEW:The aim of this article is to review recent publications relevant to understanding the interaction of urinary tract infection and diabetes mellitus, including epidemiology, pathogenesis, microbiology, and treatment. RECENT FINDINGS:The largest number of identified reports described aspects of epidemi...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/00001432-200502000-00009
更新日期:2005-02-01 00:00:00
abstract:PURPOSE OF REVIEW:Dengue, the most common arbovirus, is an increasingly significant cause of morbidity worldwide. After decades of research, an approved tetravalent dengue vaccine is finally available. Models constructed using recently available vaccine efficacy data allow for a data-driven discussion of the potential ...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/QCO.0000000000000394
更新日期:2017-10-01 00:00:00
abstract:PURPOSE OF REVIEW:Giardiasis is one of the most common causes of diarrheal disease worldwide, yet existing antimicrobial therapies are not always effective and drug resistance occurs in vivo and in vitro. The review focuses on recent advances in the development of new antigiardial drug candidates. RECENT FINDINGS:Modi...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/QCO.0b013e32834ad401
更新日期:2011-10-01 00:00:00
abstract:PURPOSE OF REVIEW:Toxoplasmosis in haematopoietic cell transplant (HCT) recipients is associated with high morbidity and mortality rates. Prophylaxis following HCT is recommended for high-risk pre-HCT toxoplasma-seropositive (pre-HCTSP) recipients. However, there is no agreement or consistency among programmes on wheth...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/QCO.0000000000000169
更新日期:2015-08-01 00:00:00
abstract:PURPOSE OF REVIEW:This review focuses on recent developments on evaluation of 8-aminoquinoline analogs with broader efficacy and reduced toxicity, which would provide better drugs for treatment of protozoal infections. RECENT FINDINGS:The earlier efforts towards development of 8-aminoquinoline analogs have been direct...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/QCO.0b013e328010b848
更新日期:2006-12-01 00:00:00
abstract:PURPOSE OF REVIEW:The early treatment of invasive fungal infection is critical but is hampered by the non-specific nature of clinical and radiological signs and the insensitivity of current laboratory diagnostic methods. If mortality due to invasive fungal infection is to be reduced, new, preemptive therapeutic strateg...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/00001432-200312000-00002
更新日期:2003-12-01 00:00:00
abstract:PURPOSE OF REVIEW:To consider new treatment options for cytomegalovirus (CMV) infection, review recent trials, and anticipate their use in clinical practice, focussing on bone marrow transplantation, congenital infection, and intervention during pregnancy. RECENT FINDINGS:Three double-blind randomized placebo-controll...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/QCO.0000000000000107
更新日期:2014-12-01 00:00:00
abstract:PURPOSE OF REVIEW:Despite the availability of new antifungals and improved antifungal formulations, there is a continued need for the development of new drugs to treat invasive fungal infections. In high-risk populations, including heavily immunocompromised patients, those with multiple comorbidities, and patients in i...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/QCO.0000000000000203
更新日期:2015-12-01 00:00:00
abstract:PURPOSE OF REVIEW:This review offers an update on hepatitis A, B and E vaccines based on relevant literature published in 2011-2012. Hepatitis A and B vaccines have been commercially available for years; however, the development of the hepatitis E vaccine is still facing some challenges. RECENT FINDINGS:Current scient...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/QCO.0b013e328357e65c
更新日期:2012-10-01 00:00:00
abstract:PURPOSE OF REVIEW:The aim of this review is to summarize recent developments in our understanding of the modifiable behavioural and biological factors contributing to the transmission of genital herpes simplex infection, and the limited data on the use of antiviral agents for reducing transmission risk in serodiscordan...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/00001432-200402000-00009
更新日期:2004-02-01 00:00:00
abstract:PURPOSE OF REVIEW:Human brucellosis is a neglected, underrecognized infection of widespread geographic distribution. It causes acute febrile illness and a potentially debilitating chronic infection in humans, and livestock infection has substantial socioeconomic impact. This review describes new information regarding t...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/QCO.0b013e3283638104
更新日期:2013-10-01 00:00:00
abstract:PURPOSE OF REVIEW:The emergence of 2009 pandemic H1N1 influenza A (pH1N1) has provided a unique challenge to influenza control in healthcare settings. We provide an overview of the early lessons from the 2009 pandemic. RECENT FINDINGS:The modes of influenza transmission and their contributions to the development of in...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/QCO.0b013e32833bb804
更新日期:2010-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Skin and soft tissue infections (SSTIs) in patients with hematological malignancies are frequent, but dedicated epidemiological studies are limited. The aim of this review is to provide updated description of the main etiological agents, differential diagnosis, and treatment. RECENT FINDINGS:In addit...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章
doi:10.1097/QCO.0000000000000632
更新日期:2020-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Hidradenitis suppurativa is a chronic or relapsing inflammatory cutaneous disorder manifested by recurrent formation of abscesses, fistulating sinus and scarring in the apocrine-gland-bearing skin. This review discusses the different aetiological theories and management opportunities. RECENT FINDINGS...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/QCO.0b013e3283428d07
更新日期:2011-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Hepatitis E, a disease transmitted by hepatitis E virus, is increasingly recognized as being indigenous to affluent, temperate-zone countries. Issues pertaining to disease acquisition and hepatitis E virus infection, particularly in Western countries, are reviewed and highlighted. RECENT FINDINGS:Cli...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/01.qco.0000244052.61629.49
更新日期:2006-10-01 00:00:00
abstract::Cystic fibrosis is the most common lethal inherited disorder with autosomal recessive inheritance. Major progress has been made in understanding the molecular mechanisms leading to increased susceptibility to Pseudomonas aeruginosa colonization. Persistent respiratory infection with P. aeruginosa leads to progressive ...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/00001432-200204000-00013
更新日期:2002-04-01 00:00:00
abstract:PURPOSE OF REVIEW:This review focuses on some of the recent advances in the understanding of HIV immunopathogenesis and the diagnosis and treatment of several autoimmune conditions associated with HIV in the era of potent antiretroviral therapy. RECENT FINDINGS:Chronic immune activation with progressive immune exhaust...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/QCO.0b013e3283210006
更新日期:2009-02-01 00:00:00
abstract::The implementation of surveillance systems for HIV and of large cohort studies have allowed for the construction of models that more accurately describe the HIV epidemic. This review focuses on changes in the epidemiological pattern, and the effect of changes in behaviour and of antiretroviral therapy. ...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章
doi:10.1097/00001432-199802000-00004
更新日期:1998-02-01 00:00:00
abstract:PURPOSE OF REVIEW:To discuss the currently available evidence about the use oritavancin and dalbavancin for the treatment of acute bacterial skin and skin structure infections (ABSSSI) and for other potential indications. RECENT FINDINGS:In this review, we briefly summarize the available data on efficacy (from randomi...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章
doi:10.1097/QCO.0000000000000714
更新日期:2021-01-05 00:00:00
abstract::The subject of bacterial skin infection in the tropics has shown some significant advances in the past few years, although it is still relatively understudied. Of special interest is the emerging concern about the public health aspects of pyoderma, either primary or secondary to scabies, in developing countries. In ad...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/00001432-200104000-00002
更新日期:2001-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Pneumocystis pneumonia (PCP) is a frequent opportunistic infection associated with a high mortality rate. PCP is of increasing importance in non-HIV immunocompromised patients, who present with severe respiratory distress with low fungal loads. Molecular detection of Pneumocystis in broncho-alveolar l...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/QCO.0000000000000559
更新日期:2019-08-01 00:00:00
abstract::Development of vaccines against viral haemorrhagic fevers is a public health priority. Recent advances in our knowledge of pathogenesis and of the immune responses elicited by these viruses emphasize the crucial role of the immune system in the control of infection, but also its probable involvement in pathogenesis. S...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/00001432-200110000-00003
更新日期:2001-10-01 00:00:00
abstract:PURPOSE OF REVIEW:Prion diseases such as Creutzfeldt-Jakob disease represent a unique infection control problem because prions exhibit an unusual resistance to conventional chemical and physical decontamination methods. This paper reviews the recent literature and provides recommendations for the prevention of nosocomi...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/00001432-200208000-00011
更新日期:2002-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Despite the current success of artemisinin combination therapy, the threat of drug-resistant falciparum malaria remains severe. Reversal of resistance to old drugs remains one strategy to deal with this problem. This review highlights recent significant findings. RECENT FINDINGS:This review provides ...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/QCO.0b013e3282f1673a
更新日期:2007-12-01 00:00:00