Impact of the NICE guideline recommending cessation of antibiotic prophylaxis for prevention of infective endocarditis: before and after study: A Review Thornhill et al.’s article on the cessation of antibiotic prophylaxis and its impact on infective endocarditis examined, both, prescriptions for antibiotics of a standard premedication dose (3g amoxicillin or 600mg clindamycin) and diagnoses or deaths due to infective endocarditis between January 2000 and April 2010. The time frame chosen for this study was critical due to the release of updated NICE guidelines, stating providers should cease use of any antibiotic prophylaxis for dental and other medical procedures. By examining the time surrounding the NICE guidelines, the researchers hoped to evaluate any relationship between premedicative prescriptions and incidents of infective endocarditis. They hypothesized that in order to see evidence that the NICE guidelines were valid, there would be minimal to no change in rate of infective endocarditis after the NICE guidelines became effective compared to before, even though the amount of prescription decreased. The researchers felt that this study was necessary due to the limited large-scale studies relating to recent changes in …show more content…
The two most significant weakness related to the lack of specificity in etiological origin of the endocarditis, and an expanded discussion in relevance of results. The researchers explained that due to gathering their data from hospitals there was often a lack in specificity of microorganism identification in the codes submitted. More importantly, the researchers largely discussed the limitations in their study, rather than discussing the uses and significance of the article. While it is good to identify possible sources of error, the researchers overly focused on this, decreasing the confidence for readers in their
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In the last decade, the number of prescriptions for antibiotics has increases. Even though, antibiotics are helpful, an excess amount of antibiotics can be dangerous. Quite often antibiotics are wrongly prescribed to cure viruses when they are meant to target bacteria. Antibiotics are a type of medicine that is prone to kill microorganisms, or bacteria. By examining the PBS documentary Hunting the Nightmare Bacteria and the article “U.S. government taps GlaxoSmithKline for New Antibiotics” by Ben Hirschler as well as a few other articles can help depict the problem that is of doctors prescribing antibiotics wrongly or excessively, which can led to becoming harmful to the body.
Antibiotics-resistant organisms have become one of the most serious threats to public health, infecting over two million people and killing approximately 23,000 people annually.1 According to the CDC, “total inappropriate antibiotic use,” such as prescribing unnecessary antibiotics or giving the wrong dose or duration, makes up to 50% of all outpatient antibiotic use,2,3 and in 2009, the United States spent $10.7 billion on antibiotics, indicating that there is a lot of potential money to save.4
First, the article provides a short explanation regarding central line associated bloodstream infections (CLABSI) and CLABSI related deaths that occur annually in the US. A national campaign, ‘On the CUSP,’ is briefly discussed. This was a collaborative cohort study of 1,071 adult intensive care units (ICUs) in 44 states, Puerto Rico, and Washington D.C. Their goal was to evaluate the impact of the ‘On the CUSP’ campaign in relation to CLASI reduction. Extensive education and training was provided prior and during the intervention. The multi-level Poisson regression model showed CLABSIs dropped from 1.96 to 1.15 per 1,000 line-days, a 43% decrease. Limitations included: this was not a randomized controlled trial (RCT), lack of resources to validate CLABSI data or collect intervention compliance data. However, the study indicates CLABSIs are preventable with standardized nursing interventions, which improves patient outcomes.
Furthermore, in a study by Vyas, Ongari, Hou, & Ali (2016), the purpose was to determine CDI in 1000 PD and the utilization of broad spectrum antibiotics (BSA) before and after the implementation of the ASP. The study was designed as an interventional, retrospective analysis and the sample consisted of 763 adult patients in three different university hospitals over a nine months period. The patients were separated into one group before the implementation of the ASP and second group after the implementation of the ASP that received BSA. The study noted that the risk of acquiring CDI is increased with the over use of BSA, therefore with the implementation of the ASP in hospitals, there has been a reduction in the rate of hospital-acquired
While Shapiro et al. was not able to recommend antimicrobial prophylaxis with amoxicillin Nadelman et al. devised
Infective endocarditis has been around for many centuries. A man named Lazaire Riviere, while performing an autopsy, first discovered infective endocarditis in 1674 (Brusch, 2015). Since the first findings documented were after death, there was still much research to do in this area of cardiovascular science. William Olser was the first person to compile an in-depth explanation of infective endocarditis in English in the year of 1885. Furthermore, in 1966, the first modern-times symposium of infective endocarditis was developed as a series of journal articles by authors Lerner and Weinstein, which was published in the New England Journal of Medicine (Brusch, 2015). Although the understanding and research of this disease is well understood
This video shows the reunion of a Belgian Malinois “Pretty” and her previous trainer, and friend being reintroduced after a year or more of separation. The video is rather short but the response from Pretty when she lays her eyes on Bryan is remarkable. Pretty, immediately recognizes Bryan and runs too him and jumps on him overjoyed to see him once again. This video takes place outside somewhere and pretty is being led by a young woman to Bryan as soon as Pretty recognizes her wanting for her, she immediately responds abundant jovialness. In fact, Pretty clings to Bryan for almost the entire length of the video which is about seventeen seconds long. I choose this video because it showed a dog recognizing and greeting someone from her past
Inappropriate use of antibiotics plays a significant part in developing of drug-resistant HAI. Use antibiotics for viral infections; over prescriptions; prescription following “better be safe, then sorry ” rule; fear of health care providers (HCP) being sued, if no medication was prescribed; reimbursement to the acute care facilities for drug cost and expenses for MDRO treatment by insurance companies, all these factors provide no incentive to minimize use of antibiotics.(5)
Baddour, L. M., Wilson, W. R., Bayer, A. S., Fowler, V. G., Tleyjeh, I. M., Rybak, M. J., ... & Bolger, A. F. (2015). Infective endocarditis in adults: diagnosis, antimicrobial therapy, and management of complications: a scientific statement for healthcare professionals from the American Heart Association. Circulation, 132(15), 1435-1486.
This study is a retrospective chart review of 360 patients with definite or possible Infective Endocarditis according to modified Duke Criteria [1-2] who were admitted to Detroit Receiving Hospital and Harper University Hospital in Detroit from 2006 to 2014. Both hospitals are teaching hospitals in Detroit, Michigan. For a patient with repeated episodes of Infective Endocarditis, one episode was only included at our institutions. Clinical, microbiological, and echocardiographic data of all patients with definite IE were collected using a standard data collection form.
According with the new guidelines of the AHA, the conditions that require preventive antibiotics (premedication) prior to dental treatment are artificial heart valves, a history of infective endocarditis, serious congenital heart conditions, and a cardiac transplant that develops a problem in a heart valve. For patients that present one or more of these conditions the standard regimen for premedication is 2 grams of amoxicillin orally, 30 to 60 minutes before procedure; and for patients allergic to amoxicillin, 600 mg of clindamycin 30 to 60
Jim Collins and his research team have done a wonderful job identifying what it takes for a company to go from good to great. I found this book extremely interesting and would like to share several of my thoughts. The study looks at companies that appeared on the Fortune 500 from the years of 1965 to 1995, looking for those that, for 15 years, either tracked or underperformed the stock market, followed by a transition, and subsequently returning at least 3 times the stock market for at least 15 years. The eleven companies included in the
Eighty percent of antibiotic prescribing takes place in general practice (Haddox, 2013). Therefore, focus of limiting antibiotic
Chetan Bhagat is one of the celebrity among youths as well as most of the reading community. Almost all of his books are blockbuster besides this; he is a motivational speaker and columnist. He is seen as youth icon than a writer. His other outstanding works are Five point someone :what not to do at IIT(2004), one night @ the call center(2005), the 3 mistakes of my life(2008),2 states: the story of my marriage(2009),revolution2020:love,corruption,ambition(2011) and what young India wants (2012) is his first non-fiction book.