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Antibiotic stewardship interventions for acute respiratory infections are possible and effective and can significantly reduce overuse in emergency departments and emergency care centers. This is the conclusion of a study to be published in the July 2019 issue of University Emergency Medicine (AEM), a journal of the Society for Academic Emergency Medicine (SAEM).
The multi-center interventional study – the first to badess the effectiveness of the basics of ambulatory antibiotic management when implemented centrally – compared two approaches designed to help physicians make better prescribing decisions. antibiotics for acute viral respiratory infections (ARI) without limiting the choices available.
The main author of the study is Kabir Yadav, MD, MS, MSHS, Department of Emergency Medicine, Harbor? UCLA Medical Center, Torrance, California, and the Los Angeles Institute of Biomedical Research, Torrance, California.
Yadav et al. found that while overall improvements in performance are still needed in high-performance and low-performance systems, the study demonstrates that the complete removal of inappropriate use of antibiotics for IRA is a potentially achievable goal, as well as for institutions with inappropriate average or high prescription rates, overuse of antibiotics can be cut by a third, with special attention to the problem.
David A. Talan, MD, Professor of Medicine in Residence (Emeritus), David Geffen School of Medicine at UCLA and President Emeritus of the School of Emergency Medicine, Division of Infectious Diseases, Olive View-UCLA Medical Center:
"Although this study did not demonstrate a significant reduction in the inappropriate use of antibiotics for upper respiratory tract infections with a heightened education campaign supplemented by peer comparison, the good news is that its rates are already remarkably low (~ 5%) in some Emergency Departments (EDs), and these campaigns seem feasible for those looking for more comprehensive models of stewardship improvement and for application to other targets, such as urinary tract infections and empirically broad-spectrum IV therapy (eg, vancomycin and piperaciline / tazobactam). "
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