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IDSA Practice Guidelines

Practice guidelines are systematically developed statements to assist practitioners and patients in making decisions about appropriate health care for specific clinical circumstances. [Institute of Medicine Committee to Advise the Public Health Service on Clinical Practice Guidelines, 1990]

Attributes of good guidelines include validity, reliability, reproducibility, clinical applicability, clinical flexibility, clarity, multidisciplinary process, review of evidence, and documentation. [Institute of Medicine Committee to Advise the Public Health Service on Clinical Practice Guidelines, 1990]

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Implementing an Antibiotic Stewardship Program

Status: Current

Evidence-based guidelines for implementation and measurement of antibiotic stewardship interventions in inpatient populations including long-term care were prepared by a multidisciplinary expert panel of the Infectious Diseases Society of America

Evidence-based guidelines for implementation and measurement of antibiotic stewardship interventions in inpatient populations including long-term care were prepared by a multidisciplinary expert panel of the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. The panel included clinicians and investigators representing internal medicine, emergency medicine, microbiology, critical care, surgery, epidemiology, pharmacy, and adult and pediatric infectious diseases specialties. These recommendations address the best approaches for antibiotic stewardship programs to influence the optimal use of antibiotics. Full text*Every 12 to 18 months following publication, IDSA reviews its guidelines to determine whether an update is required. The guideline was published April of 2016 and is the most current version.

Antimicrobial Prophylaxis for Surgery

Status: Current

These guidelines were developed jointly by the American Society of Health-System Pharmacists (ASHP), the Infectious Diseases Society of America (IDSA), the Surgical Infection Society (SIS), and the Society for Healthcare

These guidelines were developed jointly by the American Society of Health-System Pharmacists (ASHP), the Infectious Diseases Society of America (IDSA), the Surgical Infection Society (SIS), and the Society for Healthcare Epidemiology of America (SHEA). This work represents an update to the previously published ASHP Therapeutic Guidelines on Antimicrobial Prophylaxis in Surgery, as well as guidelines from IDSA and SIS. The guidelines are intended to provide practitioners with a standardized approach to the rational, safe, and effective useof antimicrobial agents for the prevention of surgical-site infections (SSIs) based on currently available clinical evidence and emerging issues. Prophylaxis refers to the prevention of an infection and can be characterized as primary prophylaxis, secondary prophylaxis, or eradication. Primary prophylaxis refers to the prevention of an initial infection. Secondary prophylaxis refers to the prevention of recurrence or reactivation of a preexisting infection. Eradication refers to the elimination of a colonized organism to prevent the development of an infection. These guidelines focus on primary perioperative prophylaxis. Full text*For information on the timing of future updates of this guideline, please contact the ASHP

Combat-Related Infections

Status: Current, Endorsed

Despite advances in resuscitation and surgical management of combat wounds, infection remains a concerning and potentially preventable complication of combat-related injuries. Interventions currently used to prevent these infections have not

Despite advances in resuscitation and surgical management of combat wounds, infection remains a concerning and potentially preventable complication of combat-related injuries. Interventions currently used to prevent these infections have not been either clearly defined or subjected to rigorous clinical trials. Current infection prevention measures and wound management practices are derived from retrospective review of wartime experiences, from civilian trauma data, and from in vitro and animal data. This update to the guidelines published in 2008 incorporates evidence that has become available since 2007. These guidelines focus on care provided within hours to days of injury, chiefly within the combat zone, to those combat-injured patients with open wounds or burns. New in this update are a consolidation of antimicrobial agent recommendations to a backbone of high-dose cefazolin with or without metronidazole for most post injury indications, and recommendations for redosing of antimicrobial agents, for use of negative pressure wound therapy, and for oxygen supplementation in flight.*For information on the timing of an update to this guideline, please contact the AFIDS.

Vancomycin

Status: Update in Progress

Vancomycin is a glycopeptideantibiotic that has been in clinical use for nearly 50 years as a penicillin alternative to treat penicillinase-producing strains of Staphylococcus aureus. It is one of the most

Vancomycin is a glycopeptideantibiotic that has been in clinical use for nearly 50 years as a penicillin alternative to treat penicillinase-producing strains of Staphylococcus aureus. It is one of the most widely used antibiotics in the United States for the treatment of serious gram-positive infections involving methicillin-resistant S.aureus (MRSA). Early use of vancomycin was associated with a number of adverse effects, including infusion-related toxicities, nephrotoxicity, and possible ototoxicity. Upon further investigation, it appears that the impurities in early formulations of vancomycin caused many of these adverse events. Its overall use was curtailed significantly with the development of semisynthetic penicillins (e.g., methicillin, oxacillin, nafcillin) that were considered less toxic. However, the steady rise in the number of MRSA infections since the early 1980s has once again brought vancomycin into the forefront as the primary treatment for infections caused by this organism.Full text*For information on the timing of this update, please contact the ASHP.

Antimicrobial Stewardship

Status: Retired

This document presents guidelines for developing institutional programs to enhance antimicrobial stewardship, an activity that includes appropriate selection, dosing, route, and duration of antimicrobial therapy. The primary goal of antimicrobial

This document presents guidelines for developing institutional programs to enhance antimicrobial stewardship, an activity that includes appropriate selection, dosing, route, and duration of antimicrobial therapy. The primary goal of antimicrobial stewardship is to optimize clinical outcomes while minimizing unintended consequences of antimicrobial use, including toxicity, the selection of pathogenic organisms (such as Clostridium difficile), and the emergence of resistance. Thus, the appropriate use of antimicrobials is an essential part of patient safety and deserves careful oversight and guidance. Full text *Information contained in the following guideline is outdated or superseded by another publication and should be used for historical purposes only. For recommendations on Implementing an Antimicrobial Stewardship Program, please see the new guidelines.

Outpatient Parenteral Anti-Infective Therapy (OPAT)

Status: Update in Progress

These guidelines were formulated to assist physicians and other health care professionals with various aspects of the administration of outpatient parenteral antimicrobial therapy (OPAT). Although there are many reassuring retrospective

These guidelines were formulated to assist physicians and other health care professionals with various aspects of the administration of outpatient parenteral antimicrobial therapy (OPAT). Although there are many reassuring retrospective studies on the efficacy and safety of OPAT, few prospective studies have been conducted to compare the risks and outcomes for patients who receive treatment as outpatients rather than as inpatients. Because truly evidence-based studies are lacking, the present guidelines are formulated from the collective experience of the committee members and advisors from related organizations.  Full text*Projected Publication, Spring 2018

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