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1

Schulz-Stübner, Sebastian. Antibiotic Stewardship im Krankenhaus. Berlin, Heidelberg: Springer Berlin Heidelberg, 2021. http://dx.doi.org/10.1007/978-3-662-60558-5.

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Schulz-Stübner, Sebastian. Antibiotic Stewardship in Arztpraxis und Ambulanz. Berlin, Heidelberg: Springer Berlin Heidelberg, 2020. http://dx.doi.org/10.1007/978-3-662-60560-8.

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Schulz-Stübner, Sebastian. Antibiotic Stewardship in Krankenhaus und Arztpraxis. Berlin, Heidelberg: Springer Berlin Heidelberg, 2024. http://dx.doi.org/10.1007/978-3-662-68836-6.

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4

Prins, Jan, Suzanne Geerlings, Marlies Hulscher, Dilip Nathwani, and Peter Davey. Practical Antibiotic Stewardship. Wiley & Sons, Incorporated, John, 2017.

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Prins, Jan, Suzanne Geerlings, Marlies Hulscher, Dilip Nathwani, and Peter Davey. Practical Antibiotic Stewardship. Wiley & Sons, Incorporated, John, 2017.

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6

Prins, Jan, Suzanne Geerlings, Marlies Hulscher, Dilip Nathwani, and Peter Davey. Practical Antibiotic Stewardship. Wiley & Sons, Incorporated, John, 2017.

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7

Schulz-Stübner, Sebastian. Antibiotic Stewardship im Krankenhaus. Springer, 2020.

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8

Schulz-Stübner, Sebastian. Antibiotic Stewardship in Arztpraxis und Ambulanz. Springer, 2020.

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9

Antibiotic Stewardship in Krankenhaus und Arztpraxis. Springer Berlin / Heidelberg, 2024.

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10

Barlam, Tamar F., Melinda M. Neuhauser, Pranita D. Tamma, and Kavita K. Trivedi, eds. Practical Implementation of an Antibiotic Stewardship Program. Cambridge University Press, 2018. http://dx.doi.org/10.1017/9781316694411.

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11

Barlam, Tamar F., Melinda M. Neuhauser, Pranita D. Tamma, and Kavita K. Trivedi. Practical Implementation of an Antibiotic Stewardship Program. Cambridge University Press, 2018.

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12

Barlam, Tamar F., Melinda M. Neuhauser, Pranita D. Tamma, and Kavita K. Trivedi. Practical Implementation of an Antibiotic Stewardship Program. University of Cambridge ESOL Examinations, 2018.

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13

Practical Implementation of an Antibiotic Stewardship Program. Cambridge University Press, 2018.

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14

Whitney, Laura, and Tihana Bicanic. Antifungal stewardship. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198758792.003.0016.

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Although the principles of antifungal stewardship are similar to those of antibiotic stewardship, there are a number of key differences, as outlined in this chapter. Antifungal prescribing occupies a specialist niche: it occurs much less frequently than antibacterial prescribing due to the smaller, but increasing, population at risk of fungal infection. Antifungal stewardship is thus less established compared with programmes directed at antibacterials, with a narrower and more complex evidence base. This chapter provides examples of successful stewardship programmes in different settings, allowing readers to understand the challenges of antifungal stewardship and how to address these and enabling them to build a successful stewardship programme at their own institution.
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15

Wickens, Hayley. Measuring antibiotic consumption and outcomes. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198758792.003.0006.

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Understanding how antimicrobial usage is monitored and reported is crucial when reading the literature on antimicrobial stewardship and assessing outcomes of local programmes. This chapter covers the methods used to monitor antimicrobial usage and the associated terminology, such as defined daily dose (DDD), average daily quantities (ADQs), and days of therapy (DOT), and gives and overview of usage monitoring in primary and secondary healthcare in the UK and beyond. This chapter also covers potential roles for electronic prescribing and information management systems in the monitoring of antimicrobial usage, and highlights some issues in the monitoring process and the outcome of antimicrobial stewardship initiatives.
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16

Edgeworth, Jonathan. Antibiotic resistance in the ICU. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0289.

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The two objectives of ensuring early appropriate antimicrobial treatment for septic patients on the intensive care unit (ICU), and limiting emergence and spread of antimicrobial resistance are both complicated and potentially conflicting. Increasingly unpredictable resistance, particularly amongst Gram-negative bacteria, through both local selection and transmission, and importation of globally successful resistant clones encourages the use of broad-spectrum empiric antimicrobials for septic patients, including in combination. This may lead to a vicious cycle whereby increasing antibiotic use increases resistance, which in turn leads to higher levels of inappropriate therapy. In response, the multi-disciplinary ICU-team implements infection prevention and control, and antimicrobial stewardship programmes. Antimicrobial stewardship programmes provide interventions and guidance to optimize appropriate therapy,whilelimiting unnecessary use through a variety of measures. The development of rapid molecular testing for bacterial identification and antimicrobial susceptibility prediction could potentially bring useful microbiological information to the bedside at the time of therapeutic decision making.
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17

Ball, Jonathan. Antimicrobial stewardship in the intensive care setting. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198758792.003.0012.

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Intensive care units (ICUs) care for patients with life-threatening infections and thus harbour reservoirs of pathogenic microorganisms. Furthermore, as a direct consequence of their critical illness/injury, ICU patients commonly have a significant degree of acutely acquired, innate, and adaptive immune system dysfunction. Critically ill patients therefore present unique challenges for antibiotic stewardship. Antibiotic stewardship in ICUs should address both the timely delivery of effective empiric therapy and the minimization of the use of broad-spectrum agents. Solutions to these challenges are usually adaptations of general principles rather than novel interventions. In ICUs, as elsewhere, antibiotic stewardship should be viewed as a key component of the overall infection control strategy.
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18

Fleming, Naomi. Stewardship in the primary care and long-term care settings. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198758792.003.0015.

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This chapter focuses on stewardship in the primary care and long-term care settings. Antibiotic prescribing in the community accounts for 80% total antibiotic prescribing and approximately 75% of this is for acute respiratory tract infections, many of which are viral. There is also significant variation in prescribing practices that is not explained by differences in presenting patients. These factors suggest that antimicrobial stewardship programmes are necessary. This chapter identifies the components of stewardship that have been successful in influencing antibiotic prescribing in primary care and shares local experiences with practical examples. The lack of UK evidence about antimicrobial stewardship in long-term care facilities is discussed, along with successful interventions from overseas. Challenges within these settings are highlighted, including patient demand, lack of access to microbiological and diagnostic tools, competing targets, time pressures, and clinical uncertainty.
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19

Charani, Esmita, and Gabriel Birgand. Managing behaviours: social, cultural, and psychological aspects of antibiotic prescribing and use. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198758792.003.0003.

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Antibiotic prescribing in secondary care is suboptimal. The collective term for the myriad of interventions targeting antibiotic prescribing is antimicrobial stewardship. These interventions all aim to help optimize antibiotic prescribing by changing prescribing behaviours. However, there is currently very little evidence from social science incorporated into the design and implementation of these interventions. This is despite emerging evidence suggesting that antibiotic prescribing is influenced by a set of unique cultural and social determinants. In order to better understand how the prescribing process occurs in hospitals and how we can optimize it we need to undertake research into understanding the context in which prescribing decisions are made. Interventions need to be developed which are multidisciplinary in nature and involve active engagement with the teams in which they are implemented. To aid this process we also need to ensure that healthcare professionals proactively receive feedback and education about their prescribing behaviours.
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20

Recommendations for Implementing Antimicrobial Stewardship Programs in Latin America and the Caribbean: Manual for Public Health Decision-Makers. Organización Panamericana de la Salud, 2018. http://dx.doi.org/10.37774/9789275120408.

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As a public good, antimicrobial medicines require rational use if their effectiveness is to be preserved. However, up to 50% of antibiotic use is inappropriate, adding considerable costs to patient care, and increasing morbidity and mortality. In addition, there is compelling evidence that antimicrobial resistance is driven by the volume of antimicrobial agents used. High rates of antimicrobial resistance to common treatments are currently reported all over the world, both in health care settings and in the community. For over two decades, the Region of the Americas has been a pioneer in confronting antimicrobial resistance from a public health perspective. However, those efforts need to be stepped up if we are to have an impact on antimicrobial resistance and want to quantify said impact.
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21

Scobie, Antonia, Mark Gilchrist, Laura Whitney, and Matthew Laundy. Managing antimicrobials on the shop floor. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198758792.003.0005.

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Reducing antimicrobial usage is key to stewardship, reducing adverse effects, and potentially stemming the tide of resistance. Establishment of an antimicrobial team on the shop floor to develop and manage a practical programme is discussed. Suggested methods of reducing antimicrobial usage include preventing initiation of unnecessary antimicrobials by the use of evidence-based guidelines and biomarker-directed clinical pathways, restricting durations to the shortest effective course—with automatic stop orders and separate antibiotic prescription charts, parenteral to oral switch programmes and utilization of outpatient parenteral antimicrobial therapy services when available. Finally, cessation of inappropriate treatment and reducing the use of broad-spectrum antimicrobials are essential and can be achieved by restrictive strategies such as pre-authorization and persuasive strategies such as audit and feedback via stewardship ward rounds. Different approaches to implementing audit and feedback within hospitals are covered in detail in this chapter.
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22

Mahlberg, Rolf, Sebastian Schulz-Stübner, Frauke Mattner, Elisabeth Meyer, and Markus Dettenkofer. Multiresistente Erreger: Diagnostik - Epidemiologie - Hygiene - Antibiotika-„Stewardship". Springer, 2019.

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23

Mahlberg, Rolf, Sebastian Schulz-Stübner, Frauke Mattner, Elisabeth Meyer, and Markus Dettenkofer. Multiresistente Erreger: Diagnostik - Epidemiologie - Hygiene - Antibiotika-"Stewardship". Springer, 2015.

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24

Mahlberg, Rolf, Sebastian Schulz-Stübner, Frauke Mattner, Elisabeth Meyer, and Markus Dettenkofer. Multiresistente Erreger: Diagnostik - Epidemiologie - Hygiene - Antibiotika- Stewardship. Springer London, Limited, 2015.

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25

Protocol for Enhanced Isolate-Level Antimicrobial Resistance Surveillance in the Americas. Primary Phase: Bloodstream Infections. Pan American Health Organization, 2021. http://dx.doi.org/10.37774/9789275122686.

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Antimicrobial resistance (AMR) surveillance plays an important role in the early detection of resistant strains of public health importance and prompt response to outbreaks in hospitals and the community. Surveillance findings are needed to inform medical practice, antibiotic stewardship, and policy and interventions to combat AMR. Appropriate use of antimicrobials, informed by surveillance, improves patients’ treatment outcomes and reduces the emergence and spread of AMR. This protocol describes the steps and procedures to establish/enhance AMR surveillance in Latin America and the Caribbean. It provides technical guidance to integrate patient, laboratory, and epidemiological data to monitor AMR emergence, trends, and effects in the population. It also provides the necessary elements to move from aggregated data to isolate-level data surveillance starting with blood isolates. It facilitates uniform data collection processes, methods, and tools to ensure data comparability within the Region of the Americas. Finally, it builds on over a decade of experience of the regional AMR surveillance network—ReLAVRA by its Spanish acronym—and its procedures are aligned with the Global Antimicrobial Resistance Surveillance System (GLASS) methodology, enabling countries to participate in the global GLASS AMR surveillance.
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26

Damani, Nizam. Manual of Infection Prevention and Control. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780198815938.001.0001.

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The Manual of Infection Prevention and Control provides practical guidance on all aspects of healthcare-associated infections (HAIs). It outlines the basic concepts of infection prevention and control (IPC), modes of transmission, surveillance, control of outbreaks, epidemiology, and biostatistics. The book provides up-to-date advice on the triage and isolation of patients and on new and emerging infectious diseases, and with the use of illustrations, it provides a step-by-step approach on how to perform hand hygiene and how to don and take off personal protective equipment correctly. In addition, this section also outlines how to minimize cross-infection by healthcare building design and prevent the transmission of various infectious diseases from infected patients after death. The disinfection and sterilization section reviews how to risk assess, disinfect and/or sterilize medical items and equipment, antimicrobial activities, and the use of various chemical disinfectants and antiseptics, and how to decontaminate endoscopes. The section on the prevention of HAIs reviews and updates IPC guidance on the prevention of the most common HAIs, i.e. surgical site infections, infections associated with intravascular and urinary catheters, and hospital- and ventilator-acquired pneumonias. In view of the global emergence of antimicrobial resistance to the various pathogens, the book examines and provides practical advice on how to implement an antibiotic stewardship programme and prevent cross-infection against various multi-drug resistant pathogens. Amongst other pathogens, the book also reviews IPC precautions against various haemorrhagic and bloodborne viral infections. The section on support services discusses the protection of healthcare workers, kitchen, environmental cleaning, catering, laundry services, and clinical waste disposal services.
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27

Wijdicks, Eelco F. M., and Sarah L. Clark. Drugs Used to Prevent Complications. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190684747.003.0017.

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Comprehensive neurosciences nursing care goes far in providing optimal support, but the acute immobilization and anticipated prolonged bed rest requires the use of prophylactic drugs. Many options relate to failure to move limbs, failure to breathe adequately and placement of intravenous catheters This chapter covers the more critical preventive measures.Prevention of deep venous thrombosis, hyperglycemia, stress ulcers, ventilator-associated pneumonia, urinary tract infections, vascular access infections, ventriculitis, and post-craniotomy infections are discussed in this chapter. Pharmacists assist in effective stewardship and surveillance of critically ill patients by helping select the appropriate antibiotics, determining the need for drug levels, and initiating or stopping preventative medications.
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