Shifting the paradigm for promoting appropriate antibiotic use

Shifting the Paradigm for Promoting Appropriate Antibiotic use Shifting the Paradigm for Promoting Appropriate Antibiotic use Hoàng Thị Hằng hanght1416@gmail com Alexander Fleming 1928 penicillin Is p[.]

SHIFTING THE PARADIGM FOR PROMOTING APPROPRIATE ANTIBIOTIC USE Hoàng Thị Hằng hanght1416@gmail.com ALEXANDER FLEMING 1928- PENICILLIN Is penicillin discovery one of the most wonderful things in the 20th century? /ˌæntibaɪˈɒtɪk/ What is “antibiotic”? When to use antibiotics? When not to use antibiotics? WARM UP Definition of “antibiotic overuse”, “antibiotic underuse” What are some consequences of antibiotic overuse? Resistance, weaker immune system need to find new antibiotics time &money What are some solutions to antibiotic overuse? TERMS 10 11 Diagnostic strategies Diagnostic algorithm Clinical practice guidelines Ambulatory care Perspective Clinical care Clinical outcome; patient-centered outcome Clinical algorithm Clinical decision making Clinical settings Clinical syndrome Paradigm shift Magic bullet strategies Diagnostic uncertainty Stakeholder Variable reduction Sustainable reduction Judicious antibiotic use Barrier VOCABULARY Persistent (a) continuing for a long time Famine is a persistent problem in many parts of the world Ambulatory care= outpatient care The studies highlighted the persistent problem of poor quality of antibiotic use in ambulatory care Diagnostic (a) related to identifying sth Heterogeneity /ˌhetərədʒəˈniːəti/ state of many people There is much heterogeneity among these institutions attenuate (v) to make sth weaker or less effective (The drug attenuates the effects of the virus) Algorithm(n) set of rules that must be followed 7 Triage (n) The triage normally takes a few minutes Feasible (a) possible Scalabitily /ˌskeɪləˈbɪləti/ possibility to adapt to sth The strategies are feasible interventions with established scalability 10 Incorporate (v) to include sth Previous studies are important to incorporate in strategies for reducing antibiotic use 11 Stakeholder (n) a member of 12 Recalcitrance (n) the quality of being difficult to control They stated the recalcitrant nature of antibiotic prescribing practices in the US 13 trade-off (n) the act of balancing things (There is a trade-off between the benefits of the drug and the risk of side effects.) 14 Align (v) change sth 15 Judicious (a) careful and sensible QUESTIONS What did the studies find out? A- Litvin et all B- Nakhoul and Hickner What is the persistent problem? What did the investigators try to do? Explain the use of antibiotics for ARIs What are broad issues of strategies to reduce unsuitable antibiotic prescription? 4 What are the negative aspects from the study by Litvin and Nakhoul? What problems of antibiotic overuse did Shortell and damschroder find out? What is the role of local context? What should be done? What is the conclusion? What did the studies find out? A- Litvin et all B- Nakhoul and Hickner A- not reduce use of antibiotics overall/ specific target conditions B- more than 50% of patients with + rapid test & DNA test What is the persistent problem? What did the investigators try to do? Explain the use of antibiotics for ARIs A- poor quality of antibiotic use in ambulatory care B- focus on reducing + inappropriate overuse of antibiotics (non-bacterial, selflimited infections) +inappropriate underuse  not use antibiotic when necessary What are broad issues of strategies to reduce unsuitable antibiotic prescription? A- heterogeneity of clinical settings B- importance of multidimentional interventions C- requirement for implementation strategies What are the negative aspects from the study by Litvin and Nakhoul? What problems of antibiotic overuse did Shortell and damschroder find out? What is the role of local context? What should be done? What is the conclusion? What are the negative aspects from the study by Litvin and Nakhoul? Not include components related to patient attitudes and expectations for antibiotics Patient and provider educational interventions Social marketing campaigns success in health promotions & behavior change What problems of antibiotic overuse did Shortell and damschroder find out? What is the role of local context? What should be done? Problems Lack of connection between changing behavior and benefits of change Lack of organization readiess to change Low compatibility with exiting values and social norms of staff & pts Local context success of Diagnostic algorithms Educational programs Decision support tools What should be done Individualize treatment Strategies with local adaptation of interventions