Antibiotics policies

The advocates of a free prescribing policy argue that strict antibiotic policies are both... 

Despite much effort, antibiotic resistance continues to increase [61]. Looking back, it is clear that this was an inevitable consequence of antibiotic use [62], Antibiotic resistance, which has been recognized to be an important clinical problem, varies in prevalence from one country to another and among the pathogens themselves. This has great clinical, economic, political and environmental implications worldwide [63]. Strict adherence to the ongoing measures of infection control, education and antibiotic policy should minimize antibiotic resistance [64],... 

Gould IM A review of the role of antibiotic policies in the control of antibiotic resistance. J Antimicrob Ther 1999 43 459-465. 

Diarrhea is a well-known complication of antibiotic therapy. Rates of antibiotic-associated diarrhea (AAD) vary from 5 to 25%. Some antibiotics are more likely to cause diarrhea than others, specifically, those that are broad spectrum and those that target anaerobic flora. This paper reviews the effects of antibiotics on the fecal flora as well as host factors which contribute to AAD. Clinical features and treatment of AAD are also described. Prevention of AAD rests on wise antibiotic policies, the use of probiotics and prevention of acquisition in the hospital setting. Data from clinical trials suggest that poorly absorbed antimicrobials might have a decreased risk of causing AAD and Clostridium difficile-associated disease, as concluded from studies of antibiotics used for preoperative bowel decontamination and poorly absorbed antibiotics used for traveler s diarrhea. Controlled trials would prove this but are not yet available. Probiotics may be a good adjunct to poorly absorbed antibiotics to minimize the risk of diarrhea associated with antibiotics. 

Prevention of acquisition of C. difficile in a hospital setting includes careful attention to hand washing, disposable gloves, wise antibiotic policies and enteric precautions. 

Gh[85] (VA) To evaluate impact of antibiotic policy on hospital costs and quality of patient care OA Pre/post None DCA, duration of antibiotics, LOS, mortality Decreased monthly antibiotic costs by 7600 average savings 91,200 annually fewer deaths decreased LOS ... 

The following patients are admitted to hospital suffering from Invasive salmonellosis. Your hospital s antibiotic policy states that ciprofloxacin is the antibiotic of choice for this condition unless cautioned due to a pre-existing medical condition or interaction. It would be appropriate for you to advise that ciprofloxacin should be used with caution in which of these patients ... 

Who can—or should—act The answer is simple regulatory agencies. The time has come for them to strengthen the rules for pharmaceutical companies intending to bring new compounds on the market and also to scrutinize more closely compounds that are already in use. Antibiotic-induced adverse environmental effects are serious and could be reduced by more adequate antibiotics policies. 

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