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Pharmacy
Special Issues
Improving Antimicrobial Use in Hospitalized Patients 2.0
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Improving Antimicrobial Use in Hospitalized Patients 2.0

A special issue of Pharmacy (ISSN 2226-4787). This special issue belongs to the section "Pharmacy Practice and Practice-Based Research".

Deadline for manuscript submissions: closed (15 March 2023) | Viewed by 8980

Special Issue Editors

Dr. Kayla R. Stover

E-Mail Website
Guest Editor
Department of Pharmacy Practice, University of Mississippi School of Pharmacy, Jackson, MS 39216, USA
Interests: infectious diseases; antifungals; antimicrobial stewardship; pharmacy education and training
Special Issues, Collections and Topics in MDPI journals
Dr. Katie E. Barber

E-Mail Website
Guest Editor
Department of Pharmacy Practice, University of Mississippi School of Pharmacy, Jackson, MS 39216, USA
Interests: optimizing pharmacokinetics/pharmacodynamics to overcome bacterial resistance; evaluating clinical outcomes in patients with altered pharmacokinetics/pharmacodynamics
Special Issues, Collections and Topics in MDPI journals
Dr. Jamie L. Wagner

E-Mail Website
Guest Editor
Department of Pharmacy Practice, University of Mississippi School of Pharmacy, Jackson, MS 39216, USA
Interests: antimicrobial stewardship; gram-negative resistance; clinical outcomes
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are editing a Special Issue in the journal Pharmacy, focusing on “Improving Antimicrobial Use in Hospitalized Patients”. Overuse and misuse of antibiotics have resulted in rapidly increasing rates of resistance, making common infectious diseases more difficult to treat. The use of antimicrobial stewardship principles to slow the emergence and spread of resistant bacteria has been recognized globally as an important tool in optimizing antimicrobial usage. Through optimization of drug, dose, duration, and spectrum of activity, antimicrobial stewards can improve patient outcomes, reduce hospital-associated costs, and reduce the development of further bacterial resistance. In order to achieve these objectives, stewards and other practitioners are implementing innovative initiatives that provide practical guidance for antimicrobial use and solutions to potential barriers, as well as enhancing accountability of antibiotic prescribing to ultimately improve patient outcomes. Sharing these initiatives is invaluable, therefore, we invite you to submit your research and/or innovative methods that you’ve employed to improve antimicrobial use at your institution or health system.

We invite you to share your approaches and successes in improving antimicrobial use in hospitalized patients. We welcome submissions of all types, including original research, brief reports of original research, reviews, or short communications. In addition, we welcome submission of resident or trainee research projects that focused on improving antimicrobial use in hospitalized patients. We hope this Special Issue will inspire other stewards and practitioners to share their own practices, adopt new approaches, and innovate to advance stewardship principles.

Dr. Kayla R. Stover
Dr. Katie E. Barber
Dr. Jamie L. Wagner
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Pharmacy is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • antimicrobial use
  • stewardship
  • resistance
  • outcomes
  • process measures
  • metrics

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Published Papers (3 papers)

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Research

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12 pages, 820 KiB  
Article
Evaluation of Systemic Antifungal Use in a Latin American General Care Hospital: A Retrospective Study
by Abigail Fallas-Mora, Jose Pablo Díaz-Madriz, Jose Miguel Chaverri-Fernández and Esteban Zavaleta-Monestel
Pharmacy 2023, 11(4), 108; https://doi.org/10.3390/pharmacy11040108 - 24 Jun 2023
Cited by 2 | Viewed by 1708
Abstract
Background: Invasive fungal infections significantly contribute to mortality and morbidity rates. Despite the presence of all four major classes of antifungal medications, it is estimated that these infections result in the death of 1.5 million people each year, and death rates are increasing [...] Read more.
Background: Invasive fungal infections significantly contribute to mortality and morbidity rates. Despite the presence of all four major classes of antifungal medications, it is estimated that these infections result in the death of 1.5 million people each year, and death rates are increasing at an alarming rate. With increasing concerns about the emergence of antifungal resistance, there is a growing consideration in many countries to incorporate antifungal stewardship into existing antimicrobial stewardship programs. This approach aims to address issues hindering the appropriate use of antifungal drugs and to optimize their utilization. Methods: An analytical retrospective study of 48 hospitalized patients was conducted to assess factors related to the use of systemic antifungals and develop and implement an internal protocol to improve its use. Results: All patients with severe comorbidity had SOFA scores linked with a mortality risk of more than 10%. Based on 48 evaluations of antifungal orders, 62.5% were considered appropriate, 14.6% were considered debatable, and 22.9% were considered inappropriate. Infectious disease physicians made most of the prescriptions considered appropriate in this study. Conclusions: Comorbidities and risk factors in patients receiving systemic antifungals can be associated with the development of more serious fungal infections; hence, the implementation of antifungal stewardship as a complement to antimicrobial stewardship programs can help facilitate decision-making when dealing with a suspected case of fungal infection. Full article
(This article belongs to the Special Issue Improving Antimicrobial Use in Hospitalized Patients 2.0)
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11 pages, 280 KiB  
Article
Risk Factors for Bloodstream Infections Due to ESBL-Producing Escherichia coli, Klebsiella spp., and Proteus mirabilis
by Mary Kathryn Vance, David A. Cretella, Lori M. Ward, Prakhar Vijayvargiya, Zerelda Esquer Garrigos and Mary Joyce B. Wingler
Pharmacy 2023, 11(2), 74; https://doi.org/10.3390/pharmacy11020074 - 13 Apr 2023
Cited by 4 | Viewed by 4165
Abstract
(1) Background: Risk factors for extended-spectrum beta-lactamase (ESBL) infections could vary geographically. The purpose of this study was to identify local risk factors for ESBL production in patients with Gram-negative bacteremia. (2) Methods: This retrospective observational study included adult patients admitted from January [...] Read more.
(1) Background: Risk factors for extended-spectrum beta-lactamase (ESBL) infections could vary geographically. The purpose of this study was to identify local risk factors for ESBL production in patients with Gram-negative bacteremia. (2) Methods: This retrospective observational study included adult patients admitted from January 2019 to July 2021 and had positive blood cultures for E. coli, K. pneumoniae, K. oxytoca, and P. mirabilis. Patients with ESBL infection were matched to a non-ESBL-producing infection with the same organism. (3) Results: A total of 150 patients were included: 50 in the ESBL group and 100 in the non-ESBL group. Patients in the ESBL group had a longer length of stay (11 vs. 7 days, p < 0.001), but not increased mortality (14% vs. 15%, p = 0.87) Multivariate analysis identified the receipt of >1 antibiotic in the last 90 days as a risk factor for ESBL infection (OR = 3.448, 95% CI = 1.494–7.957; p = 0.004); (4) Conclusions: Recent antimicrobial use was identified as an independent risk factors for ESBL-producing Enterobacterales infections. Knowledge of this risk may improve empirical therapy and reduce inappropriate use. Full article
(This article belongs to the Special Issue Improving Antimicrobial Use in Hospitalized Patients 2.0)

Other

Jump to: Research

7 pages, 218 KiB  
Brief Report
Evaluation of Anti-Methicillin-Resistant Staphylococcus aureus (MRSA) Prescribing Habits in Patients with a Positive MRSA Nasal Swab in the Absence of Positive Cultures
by Madeline Pelham, Madeline Ganter, Joshua Eudy and Daniel T. Anderson
Pharmacy 2023, 11(3), 81; https://doi.org/10.3390/pharmacy11030081 - 3 May 2023
Viewed by 2459
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) polymerase chain reaction (PCR) nasal swabs are guideline-recommended de-escalation tools in certain patients with pneumonia. Prior studies have demonstrated reduced anti-MRSA therapy with negative results, but the impact on durations of therapy has been poorly elucidated in patients with [...] Read more.
Methicillin-resistant Staphylococcus aureus (MRSA) polymerase chain reaction (PCR) nasal swabs are guideline-recommended de-escalation tools in certain patients with pneumonia. Prior studies have demonstrated reduced anti-MRSA therapy with negative results, but the impact on durations of therapy has been poorly elucidated in patients with positive PCRs. The objective of this review was to evaluate anti-MRSA treatment durations in patients with a positive MRSA PCR in the absence of MRSA growth on culture. This was a single-center, retrospective observational study evaluating 52 hospitalized, adult patients receiving anti-MRSA therapy with positive MRSA PCRs. The overall median duration of anti-MRSA therapy was five days, including a median of four days after PCR results. This was consistent among intensive care unit (ICU) and non-ICU patient populations and in patients with suspected community-acquired pneumonia (CAP). Among patients with hospital-acquired pneumonia (HAP), the median duration of anti-MRSA therapy was seven days, with a median of six days after PCR results. Overall, patients received a median duration of anti-MRSA therapy that would constitute a full treatment course for many respiratory infections, which indicates that providers may equate a positive MRSA nasal PCR with positive culture growth and highlights the need for education on the interpretation of positive tests. Full article
(This article belongs to the Special Issue Improving Antimicrobial Use in Hospitalized Patients 2.0)
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