Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Antibiotics get a “time-out”

18.11.2014

MUHC study examines the effect of regular re-evaluation of antibiotic use on cost and C. difficile infection rates

Resistance to antibiotics is an important health concern that affects both the spread of infections, like Clostridium difficile, and the medication budget. Researchers at the McGill University Health Centre (MUHC) examined the effectiveness of adopting an antibiotic “time-out” during treatment, which involves regularly re-evaluating the treatment strategy as the clinical situation evolves.

The study, published in this month’s issue of the Annals of Internal Medicine, showed that structured time-outs, using a locally developed online checklist, resulted in decreased antibiotic costs coupled with decreased use of targeted medications. There was also a small decline in C. difficile infections.

“According the Centers for Disease Control and Prevention (CDC) nearly 50 per cent of antibiotic use is unnecessary or inappropriate,” says first author of the study Dr. Todd Lee, MUHC attending physician and assistant professor of Medicine at McGill University. “Given this statistic, and our own concerns about antimicrobial resistance, we decided to implement a tailored time-out program at the MUHC and evaluate its effectiveness.”

Time out means clinical review
The study involved 679 patients and was conducted over a period of 18 months on the internal medicine clinical teaching units at the Montreal General Hospital of the MUHC. The time-out concept was introduced to physicians and trainees as an opportunity to review the indication, dose and duration of antibiotic use when new clinical information became available.

The staff were also educated on antibiotic guidelines and participated in a twice weekly structured review of all patients receiving antibiotics. This approach led to changes in doses, duration of treatment, and changes in the type of antibiotic prescribed, which in turn led to cost reductions and a small decrease in C. difficile.

“Our approach tied specific education about antibiotic use with a structural tool to review and guide this use,” says senior author of the study Dr. Louise Pilote, researcher at the Research Institute of the MUHC, chief of General Internal Medicine at the MUHC and a professor of medicine at McGill University. “This could translate into better prescribing practices. In general, physicians believed the process improved their comfort with antibiotics and provided clinical value.”

“We hope this approach will permit a more widespread implementation of antibiotic auditing and that this will affect future prescribing, turning today’s high rates of inappropriate antibiotic use into tomorrow’s historical footnote,” adds Dr. Lee.


About the study:

Once the embargo lifts you will find the article online at:

http://www.annals.org/article.aspx?doi=10.7326/M13-3016

This paper is part of a special November supplement of the Annals of Internal Medicine supported by the Robert Wood Johnson Foundation (RWJF) Clinical Scholars program.

This work was completed without outside funding.

The paper Antibiotic Self-stewardship: Trainee-Led Structured Antibiotic Time-outs to Improve Antimicrobial Use was co-authored by Todd C. Lee (Division of General Internal Medicine, Division of Infectious Diseases, Department of Medicine, MUHC and McGill Centre for Quality Improvement, Montreal, Canada); Charles Frenette (Division of Infectious Diseases, Department of Medicine, MUHC, Montreal, Canada); Dev Jayaraman and Laurence Green (Division of General Internal Medicine, Department of Medicine, MUHC, Montreal, Canada); and Louise Pilote (Division of General Internal Medicine, Department of Medicine, MUHC, Montreal, Canada).


Related links:

• McGill University Health Centre (MUHC): muhc.ca
• Research Institute of the MUHC: rimuhc.ca
• McGill University: mcgill.ca


Media contact:

Julie Robert
Public Affairs & Strategic planning
McGill University Health Centre
514 934-1934 ext. 71381
julie.robert@muhc.mcgill.ca
facebook.com/cusm.muhc|www.muhc.ca  

Julie Robert | McGill University Health Centre
Further information:
http://www.muhc.mcgill.ca

More articles from Life Sciences:

nachricht World’s Largest Study on Allergic Rhinitis Reveals new Risk Genes
17.07.2018 | Helmholtz Zentrum München - Deutsches Forschungszentrum für Gesundheit und Umwelt

nachricht Plant mothers talk to their embryos via the hormone auxin
17.07.2018 | Institute of Science and Technology Austria

All articles from Life Sciences >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: First evidence on the source of extragalactic particles

For the first time ever, scientists have determined the cosmic origin of highest-energy neutrinos. A research group led by IceCube scientist Elisa Resconi, spokesperson of the Collaborative Research Center SFB1258 at the Technical University of Munich (TUM), provides an important piece of evidence that the particles detected by the IceCube neutrino telescope at the South Pole originate from a galaxy four billion light-years away from Earth.

To rule out other origins with certainty, the team led by neutrino physicist Elisa Resconi from the Technical University of Munich and multi-wavelength...

Im Focus: Magnetic vortices: Two independent magnetic skyrmion phases discovered in a single material

For the first time a team of researchers have discovered two different phases of magnetic skyrmions in a single material. Physicists of the Technical Universities of Munich and Dresden and the University of Cologne can now better study and understand the properties of these magnetic structures, which are important for both basic research and applications.

Whirlpools are an everyday experience in a bath tub: When the water is drained a circular vortex is formed. Typically, such whirls are rather stable. Similar...

Im Focus: Breaking the bond: To take part or not?

Physicists working with Roland Wester at the University of Innsbruck have investigated if and how chemical reactions can be influenced by targeted vibrational excitation of the reactants. They were able to demonstrate that excitation with a laser beam does not affect the efficiency of a chemical exchange reaction and that the excited molecular group acts only as a spectator in the reaction.

A frequently used reaction in organic chemistry is nucleophilic substitution. It plays, for example, an important role in in the synthesis of new chemical...

Im Focus: New 2D Spectroscopy Methods

Optical spectroscopy allows investigating the energy structure and dynamic properties of complex quantum systems. Researchers from the University of Würzburg present two new approaches of coherent two-dimensional spectroscopy.

"Put an excitation into the system and observe how it evolves." According to physicist Professor Tobias Brixner, this is the credo of optical spectroscopy....

Im Focus: Chemical reactions in the light of ultrashort X-ray pulses from free-electron lasers

Ultra-short, high-intensity X-ray flashes open the door to the foundations of chemical reactions. Free-electron lasers generate these kinds of pulses, but there is a catch: the pulses vary in duration and energy. An international research team has now presented a solution: Using a ring of 16 detectors and a circularly polarized laser beam, they can determine both factors with attosecond accuracy.

Free-electron lasers (FELs) generate extremely short and intense X-ray flashes. Researchers can use these flashes to resolve structures with diameters on the...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Leading experts in Diabetes, Metabolism and Biomedical Engineering discuss Precision Medicine

13.07.2018 | Event News

Conference on Laser Polishing – LaP: Fine Tuning for Surfaces

12.07.2018 | Event News

11th European Wood-based Panel Symposium 2018: Meeting point for the wood-based materials industry

03.07.2018 | Event News

 
Latest News

Microscopic trampoline may help create networks of quantum computers

17.07.2018 | Information Technology

In borophene, boundaries are no barrier

17.07.2018 | Materials Sciences

The role of Sodium for the Enhancement of Solar Cells

17.07.2018 | Power and Electrical Engineering

VideoLinks
Science & Research
Overview of more VideoLinks >>>