The Experts below are selected from a list of 11049 Experts worldwide ranked by ideXlab platform
F. Lopes Cardoso - One of the best experts on this subject based on the ideXlab platform.
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Ten key points for the appropriate use of antibiotics in Hospitalised patients: a consensus from the Antimicrobial Stewardship and Resistance Working Groups of the International Society of Chemotherapy
International Journal of Antimicrobial Agents, 2016Co-Authors: G. Levy Hara, S.s. Kanj, L. Pagani, L. Abbo, A. Endimiani, H.f.l. Wertheim, C. Amábile-cuevas, P. Tattevin, S. Mehtar, F. Lopes CardosoAbstract:The Antibiotic Stewardship and Resistance Working Groups of the International Society for Chemotherapy propose ten key points for the appropriate use of antibiotics in Hospital settings. (i) Get appropriate microbiological samples before antibiotic administration and carefully interpret the results: in the absence of clinical signs of infection, colonisation rarely requires antimicrobial treatment. (ii) Avoid the use of antibiotics to ‘treat’ fever: use them to treat infections, and investigate the root cause of fever prior to starting treatment. (iii) Start empirical antibiotic treatment after taking cultures, tailoring it to the site of infection, risk factors for multidrug-resistant bacteria, and the local microbiology and susceptibility patterns. (iv) Prescribe drugs at their optimal dosing and for an appropriate duration, adapted to each clinical situation and patient characteristics. (v) Use antibiotic combinations only where the current evidence suggests some benefit. (vi) When possible, avoid antibiotics with a higher likelihood of promoting drug resistance or Hospital-acquired infections, or use them only as a last resort. (vii) Drain the infected foci quickly and remove all potentially or proven infected devices: control the infection source. (viii) Always try to de-escalate/streamline antibiotic treatment according to the clinical situation and the microbiological results. (ix) Stop unnecessarily prescribed antibiotics once the absence of infection is likely. And (x) Do not work alone: set up local teams with an infectious diseases specialist, clinical microbiologist, Hospital Pharmacist, infection control practitioner or Hospital epidemiologist, and comply with Hospital antibiotic policies and guidelines. © 2016
Saad A W Shakir - One of the best experts on this subject based on the ideXlab platform.
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the uk bio trac study a cross sectional study of product and batch traceability for biologics in clinical practice and electronic adverse drug reaction reporting in the uk
Drug Safety, 2020Co-Authors: Kevin Klein, Lorna Hazell, Pieter Stolk, Saad A W ShakirAbstract:Due to the complexity of biologics and the inherent challenges for manufacturing, it is important to know the specific brand name and batch number of suspected biologics in adverse drug reaction (ADR) reports. The aim of this study was to assess the extent to which biologics are traceable by brand name and batch number in UK Hospital practice and in ADRs reported by patients and healthcare professionals. We performed an online Hospital Pharmacist survey to capture information on how specific product details are recorded during the processes of prescribing, dispensing and administration of biologics in routine UK Hospital practice. We also assessed the proportion of ADR reports specifying brand name and batch number from electronic ADR reports submitted to the UK national spontaneous reporting database, the Yellow Card Scheme, between 1 January 2009 and 30 September 2017. Brand name recording in routine Hospital processes ranged from 79 to 91%, whereas batch numbers were less routinely recorded, ranging from 38 to 58%. Paper-based recording of product details was more commonly used for recording information. A total of 6108 electronic ADR reports were submitted to the Yellow Card Scheme for recombinant biologics, of which 38% and 15%, respectively, had an identifiable brand name and batch numbers. Whereas batch number traceability in electronic ADR reports improved slightly after the implementation of the European Union pharmacovigilance legislation in 2012, no improvement of brand name traceability was observed. Brand name and batch number traceability for biologics in UK ADR reports are generally low. Shortcomings in the systematic recording of product details in UK clinical practice may contribute to the limited traceability.
Henk-jan Guchelaar - One of the best experts on this subject based on the ideXlab platform.
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A Computerized Adverse Drug Event Alerting System Using Clinical Rules
Drug Safety, 2011Co-Authors: Mirjam K. Rommers, Irene M. Teepe-twiss, Henk-jan GuchelaarAbstract:Background: Adverse drug events (ADEs) are an important problem in Hospital practice. Computerized physician order entry (CPOE) and clinical decision support systems (CDSS) are useful tools in the prevention of ADEs. In the Netherlands there are some basic CDSS within CPOE systems, but there is not much experience with sophisticated systems. We have recently developed a more advanced CDSS, a computerized adverse drug event alerting system (ADEAS). Objective: The aim of the study was to compare the newly developed ADEAS, which uses a set of clinical rules, with the conventional medication surveillance, a basic CDSS within a CPOE, to assess its additional value in detecting patients with a potential ADE. Setting: Leiden University Medical Center (LUMC), a university Hospital in Leiden, the Netherlands. Design: Two studies were carried out; one retrospective and one prospective.The retrospective comparison of ADEAS with conventional medicationsurveillance was conducted on all patients admitted to the Hospital (exceptintensive care unit patients) during a 1-month period (15 November-15 December2006). A prospective comparison of both systems was performedduring a 6-month period (May–October 2007) on one general internal medicineward. Measurements: The endpoint was the total number of alerts and content of alerts generated by both methods. In the prospective study we also focused on the number of unique alerts and interventions by the Hospital Pharmacist following the alerts. Results: In the retrospective study, ADEAS generated 2010 alerts compared with 2322 generated by the conventional method. In the prospective study, 248 and 177 alerts were generated by ADEAS and the conventional method, respectively. The number of unique alerts was 85 (of which 72 were considered true positive alerts) and 136, respectively. The Hospital Pharmacist made 14 (19.4%) interventions following a true positive alert with ADEAS and 5 (3.7%) with the conventional method. The contents of alerts generated by ADEAS were different to the safety alerts generated by conventional medication surveillance. The conventional medication surveillance generated safety alerts regarding drug-drug interactions and drug-overdosing. ADEAS generated alerts regarding declined renal function or other laboratory abnormalities and absence of essential concurrent medication. Conclusions: Compared with our conventional medication surveillance, the computerized alert system ADEAS selected different patients at risk for an ADE. This makes ADEAS in our Hospital of additional value to the Hospital Pharmacist as a suitable tool in reducing the number of preventable ADEs.
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Medication Errors
Drugs, 2005Co-Authors: Henk-jan Guchelaar, Hadewig B. B. Colen, Mathijs D. Kalmeijer, Patrick T. W. Hudson, Irene M. Teepe-twissAbstract:In recent years medication error has justly received considerable attention, as it causes substantial mortality, morbidity and additional healthcare costs. Risk assessment models, adapted from commercial aviation and the oil and gas industries, are currently being developed for use in clinical pharmacy. The Hospital Pharmacist is best placed to oversee the quality of the entire drug distribution chain, from prescribing, drug choice, dispensing and preparation to the administration of drugs, and can fulfil a vital role in improving medication safety. Most elements of the drug distribution chain can be optimised; however, because comparative intervention studies are scarce, there is little scientific evidence available demonstrating improvements in medication safety through such interventions. Possible interventions aimed at reducing medication errors, such as developing methods for detection of patients with increased risk of adverse drug events, performing risk assessment in clinical pharmacy and optimising the drug distribution chain are discussed. Moreover, the specific role of the clinical Pharmacist in improving medication safety is highlighted, both at an organisational level and in individual patient care.
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medication errors Hospital Pharmacist perspective
Drugs, 2005Co-Authors: Henk-jan Guchelaar, Hadewig B. B. Colen, Mathijs D. Kalmeijer, Patrick T. W. Hudson, Irene M TeepetwissAbstract:In recent years medication error has justly received considerable attention, as it causes substantial mortality, morbidity and additional healthcare costs. Risk assessment models, adapted from commercial aviation and the oil and gas industries, are currently being developed for use in clinical pharmacy. The Hospital Pharmacist is best placed to oversee the quality of the entire drug distribution chain, from prescribing, drug choice, dispensing and preparation to the administration of drugs, and can fulfil a vital role in improving medication safety. Most elements of the drug distribution chain can be optimised; however, because comparative intervention studies are scarce, there is little scientific evidence available demonstrating improvements in medication safety through such interventions. Possible interventions aimed at reducing medication errors, such as developing methods for detection of patients with increased risk of adverse drug events, performing risk assessment in clinical pharmacy and optimising the drug distribution chain are discussed. Moreover, the specific role of the clinical Pharmacist in improving medication safety is highlighted, both at an organisational level and in individual patient care.
G. Levy Hara - One of the best experts on this subject based on the ideXlab platform.
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Ten key points for the appropriate use of antibiotics in Hospitalised patients: a consensus from the Antimicrobial Stewardship and Resistance Working Groups of the International Society of Chemotherapy
International Journal of Antimicrobial Agents, 2016Co-Authors: G. Levy Hara, S.s. Kanj, L. Pagani, L. Abbo, A. Endimiani, H.f.l. Wertheim, C. Amábile-cuevas, P. Tattevin, S. Mehtar, F. Lopes CardosoAbstract:The Antibiotic Stewardship and Resistance Working Groups of the International Society for Chemotherapy propose ten key points for the appropriate use of antibiotics in Hospital settings. (i) Get appropriate microbiological samples before antibiotic administration and carefully interpret the results: in the absence of clinical signs of infection, colonisation rarely requires antimicrobial treatment. (ii) Avoid the use of antibiotics to ‘treat’ fever: use them to treat infections, and investigate the root cause of fever prior to starting treatment. (iii) Start empirical antibiotic treatment after taking cultures, tailoring it to the site of infection, risk factors for multidrug-resistant bacteria, and the local microbiology and susceptibility patterns. (iv) Prescribe drugs at their optimal dosing and for an appropriate duration, adapted to each clinical situation and patient characteristics. (v) Use antibiotic combinations only where the current evidence suggests some benefit. (vi) When possible, avoid antibiotics with a higher likelihood of promoting drug resistance or Hospital-acquired infections, or use them only as a last resort. (vii) Drain the infected foci quickly and remove all potentially or proven infected devices: control the infection source. (viii) Always try to de-escalate/streamline antibiotic treatment according to the clinical situation and the microbiological results. (ix) Stop unnecessarily prescribed antibiotics once the absence of infection is likely. And (x) Do not work alone: set up local teams with an infectious diseases specialist, clinical microbiologist, Hospital Pharmacist, infection control practitioner or Hospital epidemiologist, and comply with Hospital antibiotic policies and guidelines. © 2016
Kevin Klein - One of the best experts on this subject based on the ideXlab platform.
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the uk bio trac study a cross sectional study of product and batch traceability for biologics in clinical practice and electronic adverse drug reaction reporting in the uk
Drug Safety, 2020Co-Authors: Kevin Klein, Lorna Hazell, Pieter Stolk, Saad A W ShakirAbstract:Due to the complexity of biologics and the inherent challenges for manufacturing, it is important to know the specific brand name and batch number of suspected biologics in adverse drug reaction (ADR) reports. The aim of this study was to assess the extent to which biologics are traceable by brand name and batch number in UK Hospital practice and in ADRs reported by patients and healthcare professionals. We performed an online Hospital Pharmacist survey to capture information on how specific product details are recorded during the processes of prescribing, dispensing and administration of biologics in routine UK Hospital practice. We also assessed the proportion of ADR reports specifying brand name and batch number from electronic ADR reports submitted to the UK national spontaneous reporting database, the Yellow Card Scheme, between 1 January 2009 and 30 September 2017. Brand name recording in routine Hospital processes ranged from 79 to 91%, whereas batch numbers were less routinely recorded, ranging from 38 to 58%. Paper-based recording of product details was more commonly used for recording information. A total of 6108 electronic ADR reports were submitted to the Yellow Card Scheme for recombinant biologics, of which 38% and 15%, respectively, had an identifiable brand name and batch numbers. Whereas batch number traceability in electronic ADR reports improved slightly after the implementation of the European Union pharmacovigilance legislation in 2012, no improvement of brand name traceability was observed. Brand name and batch number traceability for biologics in UK ADR reports are generally low. Shortcomings in the systematic recording of product details in UK clinical practice may contribute to the limited traceability.