Search

Your search keyword '"Manzano-Nunez, Ramiro"' showing total 13 results
Start Over Author "Manzano-Nunez, Ramiro" Database OAIster
13 results on '"Manzano-Nunez, Ramiro"'

1. Outcomes and management approaches of resuscitative endovascular balloon occlusion of the aorta based on the income of countries

Author

Manzano-Nunez, Ramiro, McGreevy, David, Orlas, Claudia P., García, Alberto F., Hörer, Tal M., DuBose, Joseph, Ordoñez, Carlos A., Manzano-Nunez, Ramiro, McGreevy, David, Orlas, Claudia P., García, Alberto F., Hörer, Tal M., DuBose, Joseph, and Ordoñez, Carlos A.

Abstract

BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) could provide a survival benefit to severely injured patients as it may improve their initial ability to survive the hemorrhagic shock. Although the evidence supporting the use of REBOA is not conclusive, its use has expanded worldwide. We aim to compare the management approaches and clinical outcomes of trauma patients treated with REBOA according to the countries' income based on the World Bank Country and Lending Groups. METHODS: We used data from the AORTA (USA) and the ABOTrauma (multinational) registries. Patients were stratified into two groups: (1) high-income countries (HICs) and (2) low-to-middle income countries (LMICs). Propensity score matching extracted 1:1 matched pairs of subjects who were from an LMIC or a HIC based on age, gender, the presence of pupillary response on admission, impeding hypotension (SBP ≤ 80), trauma mechanism, ISS, the necessity of CPR on arrival, the location of REBOA insertion (emergency room or operating room) and the amount of PRBCs transfused in the first 24 h. Logistic regression (LR) was used to examine the association of LMICs and mortality. RESULTS: A total of 817 trauma patients from 14 countries were included. Blind percutaneous approach and surgical cutdown were the preferred means of femoral cannulation in HICs and LIMCs, respectively. Patients from LMICs had a significantly higher occurrence of MODS and respiratory failure. LR showed no differences in mortality for LMICs when compared to HICs; neither in the non-matched cohort (OR = 0.63; 95% CI: 0.36‑1.09; p = 0.1) nor in the matched cohort (OR = 1.45; 95% CI: 0.63‑3,33; p = 0.3). CONCLUSION: There is considerable variation in the management practices of REBOA and the outcomes associated with this intervention between HICs and LMICs. Although we found significant differences in multiorgan and respiratory failure rates, there were no differences in the risk-adjusted odds of mortality betwe

Published
2020
Full Text
View/download PDF

2. Effects of very early start of norepinephrine in patients with septic shock: A propensity score-based analysis

Author

Ospina-Tascón, Gustavo Adolfo, Hernandez, Glenn, Alvarez, Ingrid, Calderón-Tapia, Luis Eduardo, Manzano-Nunez, Ramiro, Sánchez-Ortiz, Alvaro A.I., Quiñones, Egardo, Ruiz-Yucuma, Juan J.E., Aldana, José J.L., Teboul, Jean Louis, Cavalcanti, Alexandre Biasi, De Backer, Daniel, Bakker, Jan, Ospina-Tascón, Gustavo Adolfo, Hernandez, Glenn, Alvarez, Ingrid, Calderón-Tapia, Luis Eduardo, Manzano-Nunez, Ramiro, Sánchez-Ortiz, Alvaro A.I., Quiñones, Egardo, Ruiz-Yucuma, Juan J.E., Aldana, José J.L., Teboul, Jean Louis, Cavalcanti, Alexandre Biasi, De Backer, Daniel, and Bakker, Jan

Abstract

Background: Optimal timing for the start of vasopressors (VP) in septic shock has not been widely studied since it is assumed that fluids must be administered in advance. We sought to evaluate whether a very early start of VP, even without completing the initial fluid loading, might impact clinical outcomes in septic shock. Methods: A total of 337 patients with sepsis requiring VP support for at least 6 h were initially selected from a prospectively collected database in a 90-bed mixed-ICU during a 24-month period. They were classified into very-early (VE-VPs) or delayed vasopressor start (D-VPs) categories according to whether norepinephrine was initiated or not within/before the next hour of the first resuscitative fluid load. Then, VE-VPs (n = 93) patients were 1:1 propensity matched to D-VPs (n = 93) based on age; source of admission (emergency room, general wards, intensive care unit); chronic and acute comorbidities; and lactate, heart rate, systolic, and diastolic pressure at vasopressor start. A risk-adjusted Cox proportional hazard model was fitted to assess the association between VE-VPs and day 28 mortality. Finally, a sensitivity analysis was performed also including those patients requiring VP support for less than 6 h. Results: Patients subjected to VE-VPs received significantly less resuscitation fluids at vasopressor starting (0[0-510] vs. 1500[650-2300] mL, p < 0.001) and during the first 8 h of resuscitation (1100[500-1900] vs. 2600[1600-3800] mL, p < 0.001), with no significant increase in acute renal failure and/or renal replacement therapy requirements. VE-VPs was related with significant lower net fluid balances 8 and 24 h after VPs. VE-VPs was also associated with a significant reduction in the risk of death compared to D-VPs (HR 0.31, CI95% 0.17-0.57, p < 0.001) at day 28. Such association was maintained after including patients receiving vasopressors for < 6 h. Conclusion: A very early start of vasopressor support seems to be safe, might lim, SCOPUS: ar.j, info:eu-repo/semantics/published

Published
2020

3. Metformin treatment in young children with fragile X syndrome.

Author

Biag, Hazel Maridith B, Biag, Hazel Maridith B, Potter, Laura A, Wilkins, Victoria, Afzal, Sumra, Rosvall, Alexis, Salcedo-Arellano, Maria Jimena, Rajaratnam, Akash, Manzano-Nunez, Ramiro, Schneider, Andrea, Tassone, Flora, Rivera, Susan M, Hagerman, Randi J, Biag, Hazel Maridith B, Biag, Hazel Maridith B, Potter, Laura A, Wilkins, Victoria, Afzal, Sumra, Rosvall, Alexis, Salcedo-Arellano, Maria Jimena, Rajaratnam, Akash, Manzano-Nunez, Ramiro, Schneider, Andrea, Tassone, Flora, Rivera, Susan M, and Hagerman, Randi J

Abstract

BackgroundMetformin is a drug commonly used in individuals with type 2 diabetes, obesity, and impaired glucose tolerance. It has a strong safety profile in both children and adults. Studies utilizing the Drosophila model and knock out mouse model of fragile X syndrome (FXS) have found metformin to rescue memory, social novelty deficits, and neuroanatomical abnormalities. These studies provided preliminary evidence that metformin could be used as a targeted treatment for the cognitive and behavioral problems associated with FXS. Previously, a case series of children and adults with FXS treated with metformin demonstrated improvements in irritability, social responsiveness, language, and hyperactivity.MethodsHere, we present nine children with FXS between 2 and 7 years of age who were treated clinically with metformin and monitored for behavioral and metabolic changes.ResultsParent reports and developmental testing before and after metformin are presented. There were improvements in language development and behavior (such as lethargy and stereotypy) in most of the patients.ConclusionThese results support the need for a controlled trial of metformin in children with FXS under 7 years old whose brains are in a critical developmental window and thus may experience a greater degree of clinical benefit from metformin.

Published
2019

4. Metformin treatment in young children with fragile X syndrome.

Author

Biag, Hazel Maridith B, Biag, Hazel Maridith B, Potter, Laura A, Wilkins, Victoria, Afzal, Sumra, Rosvall, Alexis, Salcedo-Arellano, Maria Jimena, Rajaratnam, Akash, Manzano-Nunez, Ramiro, Schneider, Andrea, Tassone, Flora, Rivera, Susan M, Hagerman, Randi J, Biag, Hazel Maridith B, Biag, Hazel Maridith B, Potter, Laura A, Wilkins, Victoria, Afzal, Sumra, Rosvall, Alexis, Salcedo-Arellano, Maria Jimena, Rajaratnam, Akash, Manzano-Nunez, Ramiro, Schneider, Andrea, Tassone, Flora, Rivera, Susan M, and Hagerman, Randi J

Abstract

BackgroundMetformin is a drug commonly used in individuals with type 2 diabetes, obesity, and impaired glucose tolerance. It has a strong safety profile in both children and adults. Studies utilizing the Drosophila model and knock out mouse model of fragile X syndrome (FXS) have found metformin to rescue memory, social novelty deficits, and neuroanatomical abnormalities. These studies provided preliminary evidence that metformin could be used as a targeted treatment for the cognitive and behavioral problems associated with FXS. Previously, a case series of children and adults with FXS treated with metformin demonstrated improvements in irritability, social responsiveness, language, and hyperactivity.MethodsHere, we present nine children with FXS between 2 and 7 years of age who were treated clinically with metformin and monitored for behavioral and metabolic changes.ResultsParent reports and developmental testing before and after metformin are presented. There were improvements in language development and behavior (such as lethargy and stereotypy) in most of the patients.ConclusionThese results support the need for a controlled trial of metformin in children with FXS under 7 years old whose brains are in a critical developmental window and thus may experience a greater degree of clinical benefit from metformin.

Published
2019

5. Incidence, Risk Factors, and Outcomes of Intra-Abdominal Hypertension in Critically Ill Patients-A Prospective Multicenter Study (IROI Study)

Author

Blaser, Annika Reintam, Regli, Adrian, De Keulenaer, Bart, Kimball, Edward J., Starkopf, Liis, Davis, Wendy A., Greiffenstein, Patrick, Starkopf, Joel, Palermo, Annamaria, Tamme, Kadri, Maddison, Liivi, Jakobson, Triin, Kirov, Mikhail, Smetkin, Alexey, Ilyina, Yana, Litvin, Andrey, Kazlova, Anastasiya, Filatov, Aliaksandr, Pracca, Francisco, Sosa, Gustavo, Dos Santos, Maicol, Grigoras, Ioana, Ristescu, Irina, Blejusca, Adina, Bodnar, Zsolt, Tidrenczel, Edit, Oliveira, Gina, Albuquerque, Ana, Fernandes, Manuela, Kirsimagi, Ulle, Ordonez, Carlos A., Manzano-Nunez, Ramiro, Pereira, Bruno M., Moore, Margaret M., Dabrowski, Wojciech, Blaser, Annika Reintam, Regli, Adrian, De Keulenaer, Bart, Kimball, Edward J., Starkopf, Liis, Davis, Wendy A., Greiffenstein, Patrick, Starkopf, Joel, Palermo, Annamaria, Tamme, Kadri, Maddison, Liivi, Jakobson, Triin, Kirov, Mikhail, Smetkin, Alexey, Ilyina, Yana, Litvin, Andrey, Kazlova, Anastasiya, Filatov, Aliaksandr, Pracca, Francisco, Sosa, Gustavo, Dos Santos, Maicol, Grigoras, Ioana, Ristescu, Irina, Blejusca, Adina, Bodnar, Zsolt, Tidrenczel, Edit, Oliveira, Gina, Albuquerque, Ana, Fernandes, Manuela, Kirsimagi, Ulle, Ordonez, Carlos A., Manzano-Nunez, Ramiro, Pereira, Bruno M., Moore, Margaret M., and Dabrowski, Wojciech

Published
2019

6. Incidence, Risk Factors, and Outcomes of Intra-Abdominal Hypertension in Critically Ill Patients-A Prospective Multicenter Study (IROI Study)

Author

Blaser, Annika Reintam, Regli, Adrian, De Keulenaer, Bart, Kimball, Edward J., Starkopf, Liis, Davis, Wendy A., Greiffenstein, Patrick, Starkopf, Joel, Palermo, Annamaria, Tamme, Kadri, Maddison, Liivi, Jakobson, Triin, Kirov, Mikhail, Smetkin, Alexey, Ilyina, Yana, Litvin, Andrey, Kazlova, Anastasiya, Filatov, Aliaksandr, Pracca, Francisco, Sosa, Gustavo, Dos Santos, Maicol, Grigoras, Ioana, Ristescu, Irina, Blejusca, Adina, Bodnar, Zsolt, Tidrenczel, Edit, Oliveira, Gina, Albuquerque, Ana, Fernandes, Manuela, Kirsimagi, Ulle, Ordonez, Carlos A., Manzano-Nunez, Ramiro, Pereira, Bruno M., Moore, Margaret M., Dabrowski, Wojciech, Blaser, Annika Reintam, Regli, Adrian, De Keulenaer, Bart, Kimball, Edward J., Starkopf, Liis, Davis, Wendy A., Greiffenstein, Patrick, Starkopf, Joel, Palermo, Annamaria, Tamme, Kadri, Maddison, Liivi, Jakobson, Triin, Kirov, Mikhail, Smetkin, Alexey, Ilyina, Yana, Litvin, Andrey, Kazlova, Anastasiya, Filatov, Aliaksandr, Pracca, Francisco, Sosa, Gustavo, Dos Santos, Maicol, Grigoras, Ioana, Ristescu, Irina, Blejusca, Adina, Bodnar, Zsolt, Tidrenczel, Edit, Oliveira, Gina, Albuquerque, Ana, Fernandes, Manuela, Kirsimagi, Ulle, Ordonez, Carlos A., Manzano-Nunez, Ramiro, Pereira, Bruno M., Moore, Margaret M., and Dabrowski, Wojciech

Published
2019

7. A meta-analysis of the incidence of complications associated with groin access after the use of resuscitative endovascular balloon occlusion of the aorta in trauma patients.

Author

Manzano-Nunez, Ramiro, Orlas, Claudia P., Herrera-Escobar, Juan P., Galvagno, Samuel, DuBose, Joseph, Melendez, Juan J., Serna, Jose J., Salcedo, Alexander, Peña, Camilo A., Angamarca, Edison, Hörer, Tal M., Salazar, Camilo J., Lopez-Castilla, Valeria, Ruiz-Yucuma, Juan, Rodriguez, Fernando, Parra, Michael W., Ordoñez, Carlos A., Manzano-Nunez, Ramiro, Orlas, Claudia P., Herrera-Escobar, Juan P., Galvagno, Samuel, DuBose, Joseph, Melendez, Juan J., Serna, Jose J., Salcedo, Alexander, Peña, Camilo A., Angamarca, Edison, Hörer, Tal M., Salazar, Camilo J., Lopez-Castilla, Valeria, Ruiz-Yucuma, Juan, Rodriguez, Fernando, Parra, Michael W., and Ordoñez, Carlos A.

Abstract

BACKGROUND: Serious complications related to groin access have been reported with the use of resuscitative endovascular balloon occlusion of the aorta (REBOA). We performed a systematic review and meta-analysis to estimate the incidence of complications related to groin access from the use of REBOA in adult trauma patients. METHODS: We identified articles in MEDLINE and EMBASE. We reviewed all studies that involved adult trauma patients that underwent the placement of a REBOA and included only those that reported the incidence of complications related to groin access. A meta-analysis of proportions was performed RESULTS: We 13 studies with a total of 424 patients. REBOA was inserted most commonly by trauma surgeons or emergency room physicians. Information regarding puncture technique was reported in 12 studies and was available for a total of 414 patients. Percutaneous access and surgical cutdown were performed in 304 (73.4%) and 110 (26.5%) patients respectively. Overall, complications related to groin access occurred in 5.6% of patients (n=24/424). Lower limb amputation was required in 2.1% of patients (9/424), of which three cases (3/424 [0.7%]) were directly related to the vascular puncture from the REBOA insertion. A meta-analysis which used the logit transformation showed a 5% (95% CI 3%-9%) incidence of complications without significant heterogeneity (LR test: χ2 = 0.73, p=0.2, Tau-square=0.2). In a second meta-analysis, we used the Freeman-Turkey double arcsine transformation and found an incidence of complications of 4% (95% CI 2%-7%) with low heterogeneity (I2 = 16.3%). CONCLUSION: We found that the incidence of complications related to groin access was of four to five percent based on a meta-analysis of 13 studies published worldwide. Currently, there are no benchmarks or quality measures as a reference to compare, and thus, further work is required to identify these benchmarks and improve the practice of REBOA in trauma surgery. LEVEL OF EVIDENCE: Syste

Published
2018
Full Text
View/download PDF

8. Raising concerns about the Sepsis-3 definitions

Author

Universitat Rovira i Virgili, Catena, Fausto, Yuan, Kuo-Ching, Ulrych, Jan, Trana, Cristian, Talving, Peep, Siribumrungwong, Boonying, Shah, Jay N., Sato, Norio, Kafil, Hossein Samadi, Sakakushev, Boris, Reis, Tarcisio, Pupelis, Guntars, Ponce-de-Leon, Alfredo, Pintar, Tadeja, Picetti, Edoardo, Paolillo, Ciro, Ouadii, Mouaqit, Ordonez, Carlos A., Olaoye, Iyiade, Ofori-Asenso, Richard, Negoi, Ionut, Naidoo, Noel, Moore, Frederick A., Moore, Ernest E., Mesina, Cristian, Memish, Ziad A., McFarlane, Michael, Marwah, Sanjay, Major, Piotr, Manzano-Nunez, Ramiro, Machain, Gustavo M., Litvin, Andrey, Lee, Jae G., Latifi, Rifat, Labricciosa, Francesco M., Isik, Arda, Kok, Kenneth Y. Y., Koike, Kaoru, Khokha, Vladimir, Khamis, Faryal, Kenig, Jakub, Karamarkovic, Aleksandar, Kanj, Souha S., Gomes, Carlos A., Ghnnam, Wagih, Frattima, Sabrina, Fraga, Gustavo P., Ferrada, Paula, Enani, Mushira A., Elmangory, Mutasim M., Dogjani, Agron, Di Saverio, Salomone, Diaz, Jose J., Dhingra, Sameer, Davies, R. Justin, Cui, Yunfeng, de Souza, Hamilton P., De Simone, Belinda, Demetrashvili, Zaza, Jusoh, Asri Che, Beltran, Marcelo A., Baraket, Oussema, Bala, Miklosh, Baiocchi, Gian L., Augustin, Goran, Adesunkanmi, Abdulrashid K., Abu-Zidan, Fikri M., Coccolini, Federico, Giamarellou, Eleni, Bassetti, Matteo, Watkins, Richard R., Rello, Jordi, Hardcastle, Timothy C., Ansaloni, Luca, Kluger, Yoram, Sartelli, Massimo, Universitat Rovira i Virgili, Catena, Fausto, Yuan, Kuo-Ching, Ulrych, Jan, Trana, Cristian, Talving, Peep, Siribumrungwong, Boonying, Shah, Jay N., Sato, Norio, Kafil, Hossein Samadi, Sakakushev, Boris, Reis, Tarcisio, Pupelis, Guntars, Ponce-de-Leon, Alfredo, Pintar, Tadeja, Picetti, Edoardo, Paolillo, Ciro, Ouadii, Mouaqit, Ordonez, Carlos A., Olaoye, Iyiade, Ofori-Asenso, Richard, Negoi, Ionut, Naidoo, Noel, Moore, Frederick A., Moore, Ernest E., Mesina, Cristian, Memish, Ziad A., McFarlane, Michael, Marwah, Sanjay, Major, Piotr, Manzano-Nunez, Ramiro, Machain, Gustavo M., Litvin, Andrey, Lee, Jae G., Latifi, Rifat, Labricciosa, Francesco M., Isik, Arda, Kok, Kenneth Y. Y., Koike, Kaoru, Khokha, Vladimir, Khamis, Faryal, Kenig, Jakub, Karamarkovic, Aleksandar, Kanj, Souha S., Gomes, Carlos A., Ghnnam, Wagih, Frattima, Sabrina, Fraga, Gustavo P., Ferrada, Paula, Enani, Mushira A., Elmangory, Mutasim M., Dogjani, Agron, Di Saverio, Salomone, Diaz, Jose J., Dhingra, Sameer, Davies, R. Justin, Cui, Yunfeng, de Souza, Hamilton P., De Simone, Belinda, Demetrashvili, Zaza, Jusoh, Asri Che, Beltran, Marcelo A., Baraket, Oussema, Bala, Miklosh, Baiocchi, Gian L., Augustin, Goran, Adesunkanmi, Abdulrashid K., Abu-Zidan, Fikri M., Coccolini, Federico, Giamarellou, Eleni, Bassetti, Matteo, Watkins, Richard R., Rello, Jordi, Hardcastle, Timothy C., Ansaloni, Luca, Kluger, Yoram, and Sartelli, Massimo

Abstract

The Global Alliance for Infections in Surgery appreciates the great effort of the task force who derived and validated the Sepsis-3 definitions and considers the new definitions an important step forward in the evolution of our understanding of sepsis. Nevertheless, more than a year after their publication, we have a few concerns regarding the use of the Sepsis-3 definitions.

Published
2018

9. Could resuscitative endovascular balloon occlusion of the aorta improve survival among severely injured patients with post-intubation hypotension?

Author

Manzano-Nunez, Ramiro, Herrera-Escobar, Juan Pablo, DuBose, Joseph, Hörer, Tal M., Galvagno, Samuel, Orlas, Claudia Patricia, Parra, Michael W., Coccolini, Federico, Sartelli, Massimo, Falla-Martinez, Juan Camilo, García, Alberto Federico, Chica, Julian, Naranjo, Maria Paula, Sanchez, Alvaro Ignacio, Salazar, Camilo Jose, Calderón-Tapia, Luis Eduardo, Lopez-Castilla, Valeria, Ferrada, Paula, Moore, Ernest E., Ordonez, Carlos A., Manzano-Nunez, Ramiro, Herrera-Escobar, Juan Pablo, DuBose, Joseph, Hörer, Tal M., Galvagno, Samuel, Orlas, Claudia Patricia, Parra, Michael W., Coccolini, Federico, Sartelli, Massimo, Falla-Martinez, Juan Camilo, García, Alberto Federico, Chica, Julian, Naranjo, Maria Paula, Sanchez, Alvaro Ignacio, Salazar, Camilo Jose, Calderón-Tapia, Luis Eduardo, Lopez-Castilla, Valeria, Ferrada, Paula, Moore, Ernest E., and Ordonez, Carlos A.

Abstract

Current literature shows the association of post-intubation hypotension and increased odds of mortality in critically ill non-trauma and trauma populations. However, there is a lack of research on potential interventions that can prevent or ameliorate the consequences of endotracheal intubation and thus improve the prognosis of trauma patients with post-intubation hypotension. This review paper hypothesizes that the deployment of REBOA among trauma patients with PIH, by its physiologic effects, will reduce the odds of mortality in this population. The objective of this paper is to review the current literature on REBOA and post-intubation hypotension, and, furthermore, to provide a rational hypothesis on the potential role of REBOA in severely injured patients with post-intubation hypotension.

Published
2018
Full Text
View/download PDF

10. The Global Alliance for Infections in Surgery: defining a model for antimicrobial stewardship-results from an international cross-sectional survey

Author

Sartelli, Massimo, Labricciosa, Francesco M., Barbadoro, Pamela, Pagani, Leonardo, Ansaloni, Luca, Brink, Adrian J., Carlet, Jean, Khanna, Ashish, Chichom-Mefire, Alain, Coccolini, Federico, Di Saverio, Salomone, May, Addison K., Viale, Pierluigi, Watkins, Richard R., Scudeller, Luigia, Abbo, Lilian M., Abu-Zidan, FikriM., Adesunkanmi, Abdulrashid K., Al-Dahir, Sara, Al-Hasan, Majdi N., Alis, Halil, Alves, Carlos, Araujo da Silva, Andre R., Augustin, Goran, Bala, Miklosh, Barie, Philip S., Beltran, Marcelo A., Bhangu, Aneel, Bouchra, Belefquih, Brecher, Stephen M., Cainzos, Miguel A., Camacho-Ortiz, Adrian, Catani, Marco, Chandy, Sujith J., Jusoh, Asri Che, Cherry-Bukowiec, Jill R., Chiara, Osvaldo, Colak, Elif, Cornely, Oliver A., Cui, Yunfeng, Demetrashvili, Zaza, De Simone, Belinda, De Waele, Jan J., Dhingra, Sameer, Di Marzo, Francesco, Dogjani, Agron, Dorj, Gereltuya, Dortet, Laurent, Duane, ThereseM., Elmangory, Mutasim M., Enani, Mushira A., Ferrada, Paula, Foianini, J. Esteban, Gachabayov, Mahir, Gandhi, Chinmay, Ghnnam, Wagih Mommtaz, Giamarellou, Helen, Gkiokas, Georgios, Gomi, Harumi, Goranovic, Tatjana, Griffiths, Ewen A., Guerra Gronerth, Rosio I., Haidamus Monteiro, Julio C., Hardcastle, Timothy C., Hecker, Andreas, Hodonou, Adrien M., Ioannidis, Orestis, Isik, Arda, Iskandar, Katia A., Kafil, Hossein S., Kanj, Souha S., Kaplan, Lewis J., Kapoor, Garima, Karamarkovic, Aleksandar R., Kenig, Jakub, Kerschaever, Ivan, Khamis, Faryal, Khokha, Vladimir, Kiguba, Ronald, Kim, Hong B., Ko, Wen-Chien, Koike, Kaoru, Kozlovska, Iryna, Kumar, Anand, Lagunes, Leonel, Latifi, Rifat, Lee, Jae G., Lee, Young R., Leppaniemi, Ari, Li, Yousheng, Liang, Stephen Y., Lowman, Warren, Machain, Gustavo M., Maegele, Marc, Major, Piotr, Malama, Sydney, Manzano-Nunez, Ramiro, Marinis, Athanasios, Martinez Casas, Isidro, Marwah, Sanjay, Maseda, Emilio, McFarlane, Michael E., Memish, Ziad, Mertz, Dominik, Mesina, Cristian, Mishra, ShyamK., Moore, Ernest E., Munyika, Akutu, Mylonakis, Eleftherios, Napolitano, Lena, Negoi, Ionut, Nestorovic, Milica D., Nicolau, David P., Omari, Abdelkarim H., Ordonez, Carlos A., Paiva, Jose-Artur, Pant, Narayan D., Parreira, Jose G., Pedziwiatr, Michal, Pereira, BrunoM., Ponce-de-Leon, Alfredo, Poulakou, Garyphallia, Preller, Jacobus, Pulcini, Celine, Pupelis, Guntars, Quiodettis, Martha, Rawson, Timothy M., Reis, Tarcisio, Rems, Miran, Rizoli, Sandro, Roberts, Jason, Pereira, Nuno Rocha, Rodriguez-Bano, Jesus, Sakakushev, Boris, Sanders, James, Santos, Natalia, Sato, Norio, Sawyer, Robert G., Scarpelini, Sandro, Scoccia, Loredana, Shafiq, Nusrat, Shelat, Vishalkumar, Sifri, Costi D., Siribumrungwong, Boonying, Soreide, Kjetil, Soto, Rodolfo, de Souza, Hamilton P., Talving, Peep, Trung, Ngo Tat, Tessier, Jeffrey M., Tumbarello, Mario, Ulrych, Jan, Uranues, Selman, Van Goor, Harry, Vereczkei, Andras, Wagenlehner, Floriann, Xiao, Yonghong, Yuan, Kuo-Ching, Wechsler-Foerdoes, Agnes, Zahar, Jean-Ralph, Zakrison, Tanya L., Zuckerbraun, Brian, Zuidema, Wietse P., Catena, Fausto, Sartelli, Massimo, Labricciosa, Francesco M., Barbadoro, Pamela, Pagani, Leonardo, Ansaloni, Luca, Brink, Adrian J., Carlet, Jean, Khanna, Ashish, Chichom-Mefire, Alain, Coccolini, Federico, Di Saverio, Salomone, May, Addison K., Viale, Pierluigi, Watkins, Richard R., Scudeller, Luigia, Abbo, Lilian M., Abu-Zidan, FikriM., Adesunkanmi, Abdulrashid K., Al-Dahir, Sara, Al-Hasan, Majdi N., Alis, Halil, Alves, Carlos, Araujo da Silva, Andre R., Augustin, Goran, Bala, Miklosh, Barie, Philip S., Beltran, Marcelo A., Bhangu, Aneel, Bouchra, Belefquih, Brecher, Stephen M., Cainzos, Miguel A., Camacho-Ortiz, Adrian, Catani, Marco, Chandy, Sujith J., Jusoh, Asri Che, Cherry-Bukowiec, Jill R., Chiara, Osvaldo, Colak, Elif, Cornely, Oliver A., Cui, Yunfeng, Demetrashvili, Zaza, De Simone, Belinda, De Waele, Jan J., Dhingra, Sameer, Di Marzo, Francesco, Dogjani, Agron, Dorj, Gereltuya, Dortet, Laurent, Duane, ThereseM., Elmangory, Mutasim M., Enani, Mushira A., Ferrada, Paula, Foianini, J. Esteban, Gachabayov, Mahir, Gandhi, Chinmay, Ghnnam, Wagih Mommtaz, Giamarellou, Helen, Gkiokas, Georgios, Gomi, Harumi, Goranovic, Tatjana, Griffiths, Ewen A., Guerra Gronerth, Rosio I., Haidamus Monteiro, Julio C., Hardcastle, Timothy C., Hecker, Andreas, Hodonou, Adrien M., Ioannidis, Orestis, Isik, Arda, Iskandar, Katia A., Kafil, Hossein S., Kanj, Souha S., Kaplan, Lewis J., Kapoor, Garima, Karamarkovic, Aleksandar R., Kenig, Jakub, Kerschaever, Ivan, Khamis, Faryal, Khokha, Vladimir, Kiguba, Ronald, Kim, Hong B., Ko, Wen-Chien, Koike, Kaoru, Kozlovska, Iryna, Kumar, Anand, Lagunes, Leonel, Latifi, Rifat, Lee, Jae G., Lee, Young R., Leppaniemi, Ari, Li, Yousheng, Liang, Stephen Y., Lowman, Warren, Machain, Gustavo M., Maegele, Marc, Major, Piotr, Malama, Sydney, Manzano-Nunez, Ramiro, Marinis, Athanasios, Martinez Casas, Isidro, Marwah, Sanjay, Maseda, Emilio, McFarlane, Michael E., Memish, Ziad, Mertz, Dominik, Mesina, Cristian, Mishra, ShyamK., Moore, Ernest E., Munyika, Akutu, Mylonakis, Eleftherios, Napolitano, Lena, Negoi, Ionut, Nestorovic, Milica D., Nicolau, David P., Omari, Abdelkarim H., Ordonez, Carlos A., Paiva, Jose-Artur, Pant, Narayan D., Parreira, Jose G., Pedziwiatr, Michal, Pereira, BrunoM., Ponce-de-Leon, Alfredo, Poulakou, Garyphallia, Preller, Jacobus, Pulcini, Celine, Pupelis, Guntars, Quiodettis, Martha, Rawson, Timothy M., Reis, Tarcisio, Rems, Miran, Rizoli, Sandro, Roberts, Jason, Pereira, Nuno Rocha, Rodriguez-Bano, Jesus, Sakakushev, Boris, Sanders, James, Santos, Natalia, Sato, Norio, Sawyer, Robert G., Scarpelini, Sandro, Scoccia, Loredana, Shafiq, Nusrat, Shelat, Vishalkumar, Sifri, Costi D., Siribumrungwong, Boonying, Soreide, Kjetil, Soto, Rodolfo, de Souza, Hamilton P., Talving, Peep, Trung, Ngo Tat, Tessier, Jeffrey M., Tumbarello, Mario, Ulrych, Jan, Uranues, Selman, Van Goor, Harry, Vereczkei, Andras, Wagenlehner, Floriann, Xiao, Yonghong, Yuan, Kuo-Ching, Wechsler-Foerdoes, Agnes, Zahar, Jean-Ralph, Zakrison, Tanya L., Zuckerbraun, Brian, Zuidema, Wietse P., and Catena, Fausto

Abstract

Background: Antimicrobial Stewardship Programs (ASPs) have been promoted to optimize antimicrobial usage and patient outcomes, and to reduce the emergence of antimicrobial-resistant organisms. However, the best strategies for an ASP are not definitively established and are likely to vary based on local culture, policy, and routine clinical practice, and probably limited resources in middle-income countries. The aim of this study is to evaluate structures and resources of antimicrobial stewardship teams (ASTs) in surgical departments from different regions of the world. Methods: A cross-sectional web-based survey was conducted in 2016 on 173 physicians who participated in the AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections) project and on 658 international experts in the fields of ASPs, infection control, and infections in surgery. Results: The response rate was 19.4%. One hundred fifty-six (98.7%) participants stated their hospital had a multidisciplinary AST. The median number of physicians working inside the team was five [interquartile range 4-6]. An infectious disease specialist, a microbiologist and an infection control specialist were, respectively, present in 80.1, 76.3, and 67.9% of the ASTs. A surgeon was a component in 59.0% of cases and was significantly more likely to be present in university hospitals (89.5%, p < 0.05) compared to community teaching (83.3%) and community hospitals (66.7%). Protocols for pre-operative prophylaxis and for antimicrobial treatment of surgical infections were respectively implemented in 96.2 and 82.3% of the hospitals. The majority of the surgical departments implemented both persuasive and restrictive interventions (72.8%). The most common types of interventions in surgical departments were dissemination of educational materials (62.5%), expert approval (61.0%), audit and feedback (55.1%), educational outreach (53.7%), and compulsory order forms (51.5%). Conclusion: T

Published
2017

11. A Global Declaration on Appropriate Use of Antimicrobial Agents across the Surgical Pathway

Author

Sartelli, Massimo, Kluger, Yoram, Ansaloni, Luca, Carlet, Jean, Brink, Adrian, Hardcastle, Timothy C., Khanna, Ashish, Chicom-Mefire, Alain, Rodriguez-Bano, Jesus, Nathwani, Dilip, Mendelson, Marc, Watkins, Richard R., Pulcini, Celine, Beovic, Bojana, May, Addison K., Itani, Kamal M. F., Mazuski, John E., Fry, Donald E., Coccolini, Federico, Rasa, Kemal, Montravers, Philippe, Eckmann, Christian, Abbo, Lilian M., Abubakar, Salisu, Abu-Zidan, Fikri M., Adesunkanmi, Abdulrashid Kayode, Al-Hasan, Majdi N., Althani, Asma A., Ticas, Jorge Eduardo Alvarenga, Ansari, Shamshul, Ansumana, Rashid, Araujo da Silva, Andre Ricardo, Augustin, Goran, Bala, Miklosh, Balogh, Zsolt J., Baraket, Oussema, Bassett, Matteo, Bellanova, Giovanni, Beltran, Marcelo A., Ben-Ishay, Ofir, Biffl, Walter L., Boermeester, Marja A., Brecher, Stephen M., Bueno, Juan, Cainzos, Miguel A., Cairns, Kelly, Camacho-Ortiz, Adrian, Ceresoli, Marco, Chandy, Sujith J., Cherry-Bukowiec, Jill R., Cirocchi, Roberto, Colak, Elif, Corcione, Antonio, Cornely, Oliver A., Cortese, Francesco, Cui, Yunfeng, Curcio, Daniel, Damaskos, Dimitris, Das, Koray, Delibegovic, Samir, Deme-Trashvili, Zaza, De Simone, Belinda, de Souza, Hamilton Petry, De Waele, Jan, Dhingra, Sameer, Diaz, Jose J., Di Carlo, Isidoro, Di Marzo, Francesco, Di Saverio, Salomone, Dogjani, Agron, Dorj, Gereltuya, Dortet, Laurent, Duane, Therese M., Dupont, Herve, Egiev, Valery N., Eid, Hani O., Elmangory, Mutasim, Marei, Hany El-Sayed, Enani, Mushira Abdulaziz, Escandon-Vargas, Kevin, Faro Junior, Mario P., Ferrada, Paula, Foghetti, Domitilla, Foianini, Esteban, Fraga, Gustavo P., Frattima, Sabrina, Gandhi, Chinmay, Gattuso, Gianni, Giamarellou, Eleni, Ghnnam, Wagih, Gkiokas, George, Girardis, Massimo, Goff, Debbie A., Gomes, Carlos Augusto, Gomi, Harumi, Guerra Gronerth, Rosio Isabel, Guirao, Xavier, Guzman-Blanco, Manuel, Haque, Mainul, Hecker, Andreas, Hell, Markus, Herzog, Torsten, Hicks, Lauri, Kafka-Ritsch, Reinhold, Kao, Lillian S., Kanj, Souha S., Kaplan, Lewis J., Kapoor, Garima, Karamarkovic, Aleksandar, Kashuk, Jeffry, Kenig, Jakub, Khamis, Faryal, Khokha, Vladimir, Kiguba, Ronald, Kirkpatrick, Andrew W., Korner, Hartwig, Koike, Kaoru, Kok, Kenneth Y. Y., Kon, Kateryna, Kong, Victor, Inaba, Kenji, Ioannidis, Orestis, Isik, Arda, Iskandar, Katia, Labbate, Maurizio, Labricciosa, Francesco M., Lagrou, Katrien, Lagunes, Leonel, Latifi, Rifat, Lasithiotakis, Kostas, Laxminarayan, Ramanan, Lee, Jae Gil, Leone, Marc, Leppaniemi, Ari, Li, Yousheng, Liang, Stephen Y., Liau, Kui-Hin, Litvin, Andrey, Loho, Tonny, Lowman, Warren, Machain, Gustavo M., Maier, Ronald V., Manzano-Nunez, Ramiro, Marinis, Athanasios, Marmorale, Cristina, Martin-Loeches, Ignacio, Marwah, Sanjay, Maseda, Emilio, McFarlane, Michael, de Melo, Renato Bessa, Melotti, Maria Rita, Memish, Ziad, Mertz, Dominik, Mesina, Cristian, Menichetti, Francesco, Mishra, Shyam Kumar, Montori, Giulia, Moore, Ernest E., Moore, Frederick A., Naidoo, Noel, Napolitano, Lena, Negoi, Ionut, Nicolau, David P., Nikolopoulos, Ioannis, Nord, Carl Erik, Ofori-Asenso, Richard, Olaoye, Iyiade, Omari, Abdelkarim H., Ordonez, Carlos A., Ouadii, Mouaqit, Ouedraogo, Abdoul-Salam, Pagani, Leonardo, Paiva, Jose Artur, Parreira, Jose Gustavo, Pata, Francesco, Pereira, Jorge, Pereira, Nuno R., Petrosillo, Nicola, Picetti, Edoardo, Pintar, Tadeja, Ponce-de-Leon, Alfredo, Popovski, Zagorka, Poulakou, Garyphallia, Preller, Jacobus, Guerrero, Adrian Puello, Pupelis, Guntars, Quiodettis, Martha, Rawson, Timothy M., Reichert, Martin, Reinhart, Konrad, Rems, Miran, Rello, Jordi, Rizoli, Sandro, Roberts, Jason, Rubio-Perez, Ines, Ruppc, Etienne, Sakakushev, Boris, Sall, Ibrahima, Kafil, Hossein Samadi, Sanders, James, Sato, Norio, Sawyer, Robert G., Scalea, Thomas, Scibe, Rodolfo, Scudeller, Luigia, Segovia Lohse, Helmut, Sganga, Gabriele, Shafiq, Nusrat, Shah, Jay N., Spigaglia, Patrizia, Suroowan, Shanoo, Tsioutis, Constantinos, Sifri, Costi D., Siribumrungwong, Boonying, Sugrue, Michael, Talving, Peep, Tan, Boun Kim, Tarasconi, Antonio, Tascini, Carlo, Tilsed, Jonathan, Timsit, Jean-Francois, Tumbarello, Mario, Ulrych, Jan, Uranues, Selman, Velmahos, George, Vereczkei, Andras G., Viale, Pierluigi, Vila Estape, Jordi, Viscoli, Claudio, Wagenlehner, Florian, Wright, Brian J., Xiao, Yonghong, Yuan, Kuo-Ching, Zachariah, Sanoop K., Zahar, Jean Ralph, Mergulhao, Paulo, Catena, Fausto, Sartelli, Massimo, Kluger, Yoram, Ansaloni, Luca, Carlet, Jean, Brink, Adrian, Hardcastle, Timothy C., Khanna, Ashish, Chicom-Mefire, Alain, Rodriguez-Bano, Jesus, Nathwani, Dilip, Mendelson, Marc, Watkins, Richard R., Pulcini, Celine, Beovic, Bojana, May, Addison K., Itani, Kamal M. F., Mazuski, John E., Fry, Donald E., Coccolini, Federico, Rasa, Kemal, Montravers, Philippe, Eckmann, Christian, Abbo, Lilian M., Abubakar, Salisu, Abu-Zidan, Fikri M., Adesunkanmi, Abdulrashid Kayode, Al-Hasan, Majdi N., Althani, Asma A., Ticas, Jorge Eduardo Alvarenga, Ansari, Shamshul, Ansumana, Rashid, Araujo da Silva, Andre Ricardo, Augustin, Goran, Bala, Miklosh, Balogh, Zsolt J., Baraket, Oussema, Bassett, Matteo, Bellanova, Giovanni, Beltran, Marcelo A., Ben-Ishay, Ofir, Biffl, Walter L., Boermeester, Marja A., Brecher, Stephen M., Bueno, Juan, Cainzos, Miguel A., Cairns, Kelly, Camacho-Ortiz, Adrian, Ceresoli, Marco, Chandy, Sujith J., Cherry-Bukowiec, Jill R., Cirocchi, Roberto, Colak, Elif, Corcione, Antonio, Cornely, Oliver A., Cortese, Francesco, Cui, Yunfeng, Curcio, Daniel, Damaskos, Dimitris, Das, Koray, Delibegovic, Samir, Deme-Trashvili, Zaza, De Simone, Belinda, de Souza, Hamilton Petry, De Waele, Jan, Dhingra, Sameer, Diaz, Jose J., Di Carlo, Isidoro, Di Marzo, Francesco, Di Saverio, Salomone, Dogjani, Agron, Dorj, Gereltuya, Dortet, Laurent, Duane, Therese M., Dupont, Herve, Egiev, Valery N., Eid, Hani O., Elmangory, Mutasim, Marei, Hany El-Sayed, Enani, Mushira Abdulaziz, Escandon-Vargas, Kevin, Faro Junior, Mario P., Ferrada, Paula, Foghetti, Domitilla, Foianini, Esteban, Fraga, Gustavo P., Frattima, Sabrina, Gandhi, Chinmay, Gattuso, Gianni, Giamarellou, Eleni, Ghnnam, Wagih, Gkiokas, George, Girardis, Massimo, Goff, Debbie A., Gomes, Carlos Augusto, Gomi, Harumi, Guerra Gronerth, Rosio Isabel, Guirao, Xavier, Guzman-Blanco, Manuel, Haque, Mainul, Hecker, Andreas, Hell, Markus, Herzog, Torsten, Hicks, Lauri, Kafka-Ritsch, Reinhold, Kao, Lillian S., Kanj, Souha S., Kaplan, Lewis J., Kapoor, Garima, Karamarkovic, Aleksandar, Kashuk, Jeffry, Kenig, Jakub, Khamis, Faryal, Khokha, Vladimir, Kiguba, Ronald, Kirkpatrick, Andrew W., Korner, Hartwig, Koike, Kaoru, Kok, Kenneth Y. Y., Kon, Kateryna, Kong, Victor, Inaba, Kenji, Ioannidis, Orestis, Isik, Arda, Iskandar, Katia, Labbate, Maurizio, Labricciosa, Francesco M., Lagrou, Katrien, Lagunes, Leonel, Latifi, Rifat, Lasithiotakis, Kostas, Laxminarayan, Ramanan, Lee, Jae Gil, Leone, Marc, Leppaniemi, Ari, Li, Yousheng, Liang, Stephen Y., Liau, Kui-Hin, Litvin, Andrey, Loho, Tonny, Lowman, Warren, Machain, Gustavo M., Maier, Ronald V., Manzano-Nunez, Ramiro, Marinis, Athanasios, Marmorale, Cristina, Martin-Loeches, Ignacio, Marwah, Sanjay, Maseda, Emilio, McFarlane, Michael, de Melo, Renato Bessa, Melotti, Maria Rita, Memish, Ziad, Mertz, Dominik, Mesina, Cristian, Menichetti, Francesco, Mishra, Shyam Kumar, Montori, Giulia, Moore, Ernest E., Moore, Frederick A., Naidoo, Noel, Napolitano, Lena, Negoi, Ionut, Nicolau, David P., Nikolopoulos, Ioannis, Nord, Carl Erik, Ofori-Asenso, Richard, Olaoye, Iyiade, Omari, Abdelkarim H., Ordonez, Carlos A., Ouadii, Mouaqit, Ouedraogo, Abdoul-Salam, Pagani, Leonardo, Paiva, Jose Artur, Parreira, Jose Gustavo, Pata, Francesco, Pereira, Jorge, Pereira, Nuno R., Petrosillo, Nicola, Picetti, Edoardo, Pintar, Tadeja, Ponce-de-Leon, Alfredo, Popovski, Zagorka, Poulakou, Garyphallia, Preller, Jacobus, Guerrero, Adrian Puello, Pupelis, Guntars, Quiodettis, Martha, Rawson, Timothy M., Reichert, Martin, Reinhart, Konrad, Rems, Miran, Rello, Jordi, Rizoli, Sandro, Roberts, Jason, Rubio-Perez, Ines, Ruppc, Etienne, Sakakushev, Boris, Sall, Ibrahima, Kafil, Hossein Samadi, Sanders, James, Sato, Norio, Sawyer, Robert G., Scalea, Thomas, Scibe, Rodolfo, Scudeller, Luigia, Segovia Lohse, Helmut, Sganga, Gabriele, Shafiq, Nusrat, Shah, Jay N., Spigaglia, Patrizia, Suroowan, Shanoo, Tsioutis, Constantinos, Sifri, Costi D., Siribumrungwong, Boonying, Sugrue, Michael, Talving, Peep, Tan, Boun Kim, Tarasconi, Antonio, Tascini, Carlo, Tilsed, Jonathan, Timsit, Jean-Francois, Tumbarello, Mario, Ulrych, Jan, Uranues, Selman, Velmahos, George, Vereczkei, Andras G., Viale, Pierluigi, Vila Estape, Jordi, Viscoli, Claudio, Wagenlehner, Florian, Wright, Brian J., Xiao, Yonghong, Yuan, Kuo-Ching, Zachariah, Sanoop K., Zahar, Jean Ralph, Mergulhao, Paulo, and Catena, Fausto

Abstract

This declaration, signed by an interdisciplinary task force of 234 experts from 83 different countries with different backgrounds, highlights the threat posed by antimicrobial resistance and the need for appropriate use of antibiotic agents and antifungal agents in hospitals worldwide especially focusing on surgical infections. As such, it is our intent to raise awareness among healthcare workers and improve antimicrobial prescribing. To facilitate its dissemination, the declaration was translated in different languages.

Published
2017

12. The Global Alliance for Infections in Surgery: defining a model for antimicrobial stewardship-results from an international cross-sectional survey

Author

Sartelli, Massimo, Labricciosa, Francesco M., Barbadoro, Pamela, Pagani, Leonardo, Ansaloni, Luca, Brink, Adrian J., Carlet, Jean, Khanna, Ashish, Chichom-Mefire, Alain, Coccolini, Federico, Di Saverio, Salomone, May, Addison K., Viale, Pierluigi, Watkins, Richard R., Scudeller, Luigia, Abbo, Lilian M., Abu-Zidan, FikriM., Adesunkanmi, Abdulrashid K., Al-Dahir, Sara, Al-Hasan, Majdi N., Alis, Halil, Alves, Carlos, Araujo da Silva, Andre R., Augustin, Goran, Bala, Miklosh, Barie, Philip S., Beltran, Marcelo A., Bhangu, Aneel, Bouchra, Belefquih, Brecher, Stephen M., Cainzos, Miguel A., Camacho-Ortiz, Adrian, Catani, Marco, Chandy, Sujith J., Jusoh, Asri Che, Cherry-Bukowiec, Jill R., Chiara, Osvaldo, Colak, Elif, Cornely, Oliver A., Cui, Yunfeng, Demetrashvili, Zaza, De Simone, Belinda, De Waele, Jan J., Dhingra, Sameer, Di Marzo, Francesco, Dogjani, Agron, Dorj, Gereltuya, Dortet, Laurent, Duane, ThereseM., Elmangory, Mutasim M., Enani, Mushira A., Ferrada, Paula, Foianini, J. Esteban, Gachabayov, Mahir, Gandhi, Chinmay, Ghnnam, Wagih Mommtaz, Giamarellou, Helen, Gkiokas, Georgios, Gomi, Harumi, Goranovic, Tatjana, Griffiths, Ewen A., Guerra Gronerth, Rosio I., Haidamus Monteiro, Julio C., Hardcastle, Timothy C., Hecker, Andreas, Hodonou, Adrien M., Ioannidis, Orestis, Isik, Arda, Iskandar, Katia A., Kafil, Hossein S., Kanj, Souha S., Kaplan, Lewis J., Kapoor, Garima, Karamarkovic, Aleksandar R., Kenig, Jakub, Kerschaever, Ivan, Khamis, Faryal, Khokha, Vladimir, Kiguba, Ronald, Kim, Hong B., Ko, Wen-Chien, Koike, Kaoru, Kozlovska, Iryna, Kumar, Anand, Lagunes, Leonel, Latifi, Rifat, Lee, Jae G., Lee, Young R., Leppaniemi, Ari, Li, Yousheng, Liang, Stephen Y., Lowman, Warren, Machain, Gustavo M., Maegele, Marc, Major, Piotr, Malama, Sydney, Manzano-Nunez, Ramiro, Marinis, Athanasios, Martinez Casas, Isidro, Marwah, Sanjay, Maseda, Emilio, McFarlane, Michael E., Memish, Ziad, Mertz, Dominik, Mesina, Cristian, Mishra, ShyamK., Moore, Ernest E., Munyika, Akutu, Mylonakis, Eleftherios, Napolitano, Lena, Negoi, Ionut, Nestorovic, Milica D., Nicolau, David P., Omari, Abdelkarim H., Ordonez, Carlos A., Paiva, Jose-Artur, Pant, Narayan D., Parreira, Jose G., Pedziwiatr, Michal, Pereira, BrunoM., Ponce-de-Leon, Alfredo, Poulakou, Garyphallia, Preller, Jacobus, Pulcini, Celine, Pupelis, Guntars, Quiodettis, Martha, Rawson, Timothy M., Reis, Tarcisio, Rems, Miran, Rizoli, Sandro, Roberts, Jason, Pereira, Nuno Rocha, Rodriguez-Bano, Jesus, Sakakushev, Boris, Sanders, James, Santos, Natalia, Sato, Norio, Sawyer, Robert G., Scarpelini, Sandro, Scoccia, Loredana, Shafiq, Nusrat, Shelat, Vishalkumar, Sifri, Costi D., Siribumrungwong, Boonying, Soreide, Kjetil, Soto, Rodolfo, de Souza, Hamilton P., Talving, Peep, Trung, Ngo Tat, Tessier, Jeffrey M., Tumbarello, Mario, Ulrych, Jan, Uranues, Selman, Van Goor, Harry, Vereczkei, Andras, Wagenlehner, Floriann, Xiao, Yonghong, Yuan, Kuo-Ching, Wechsler-Foerdoes, Agnes, Zahar, Jean-Ralph, Zakrison, Tanya L., Zuckerbraun, Brian, Zuidema, Wietse P., Catena, Fausto, Sartelli, Massimo, Labricciosa, Francesco M., Barbadoro, Pamela, Pagani, Leonardo, Ansaloni, Luca, Brink, Adrian J., Carlet, Jean, Khanna, Ashish, Chichom-Mefire, Alain, Coccolini, Federico, Di Saverio, Salomone, May, Addison K., Viale, Pierluigi, Watkins, Richard R., Scudeller, Luigia, Abbo, Lilian M., Abu-Zidan, FikriM., Adesunkanmi, Abdulrashid K., Al-Dahir, Sara, Al-Hasan, Majdi N., Alis, Halil, Alves, Carlos, Araujo da Silva, Andre R., Augustin, Goran, Bala, Miklosh, Barie, Philip S., Beltran, Marcelo A., Bhangu, Aneel, Bouchra, Belefquih, Brecher, Stephen M., Cainzos, Miguel A., Camacho-Ortiz, Adrian, Catani, Marco, Chandy, Sujith J., Jusoh, Asri Che, Cherry-Bukowiec, Jill R., Chiara, Osvaldo, Colak, Elif, Cornely, Oliver A., Cui, Yunfeng, Demetrashvili, Zaza, De Simone, Belinda, De Waele, Jan J., Dhingra, Sameer, Di Marzo, Francesco, Dogjani, Agron, Dorj, Gereltuya, Dortet, Laurent, Duane, ThereseM., Elmangory, Mutasim M., Enani, Mushira A., Ferrada, Paula, Foianini, J. Esteban, Gachabayov, Mahir, Gandhi, Chinmay, Ghnnam, Wagih Mommtaz, Giamarellou, Helen, Gkiokas, Georgios, Gomi, Harumi, Goranovic, Tatjana, Griffiths, Ewen A., Guerra Gronerth, Rosio I., Haidamus Monteiro, Julio C., Hardcastle, Timothy C., Hecker, Andreas, Hodonou, Adrien M., Ioannidis, Orestis, Isik, Arda, Iskandar, Katia A., Kafil, Hossein S., Kanj, Souha S., Kaplan, Lewis J., Kapoor, Garima, Karamarkovic, Aleksandar R., Kenig, Jakub, Kerschaever, Ivan, Khamis, Faryal, Khokha, Vladimir, Kiguba, Ronald, Kim, Hong B., Ko, Wen-Chien, Koike, Kaoru, Kozlovska, Iryna, Kumar, Anand, Lagunes, Leonel, Latifi, Rifat, Lee, Jae G., Lee, Young R., Leppaniemi, Ari, Li, Yousheng, Liang, Stephen Y., Lowman, Warren, Machain, Gustavo M., Maegele, Marc, Major, Piotr, Malama, Sydney, Manzano-Nunez, Ramiro, Marinis, Athanasios, Martinez Casas, Isidro, Marwah, Sanjay, Maseda, Emilio, McFarlane, Michael E., Memish, Ziad, Mertz, Dominik, Mesina, Cristian, Mishra, ShyamK., Moore, Ernest E., Munyika, Akutu, Mylonakis, Eleftherios, Napolitano, Lena, Negoi, Ionut, Nestorovic, Milica D., Nicolau, David P., Omari, Abdelkarim H., Ordonez, Carlos A., Paiva, Jose-Artur, Pant, Narayan D., Parreira, Jose G., Pedziwiatr, Michal, Pereira, BrunoM., Ponce-de-Leon, Alfredo, Poulakou, Garyphallia, Preller, Jacobus, Pulcini, Celine, Pupelis, Guntars, Quiodettis, Martha, Rawson, Timothy M., Reis, Tarcisio, Rems, Miran, Rizoli, Sandro, Roberts, Jason, Pereira, Nuno Rocha, Rodriguez-Bano, Jesus, Sakakushev, Boris, Sanders, James, Santos, Natalia, Sato, Norio, Sawyer, Robert G., Scarpelini, Sandro, Scoccia, Loredana, Shafiq, Nusrat, Shelat, Vishalkumar, Sifri, Costi D., Siribumrungwong, Boonying, Soreide, Kjetil, Soto, Rodolfo, de Souza, Hamilton P., Talving, Peep, Trung, Ngo Tat, Tessier, Jeffrey M., Tumbarello, Mario, Ulrych, Jan, Uranues, Selman, Van Goor, Harry, Vereczkei, Andras, Wagenlehner, Floriann, Xiao, Yonghong, Yuan, Kuo-Ching, Wechsler-Foerdoes, Agnes, Zahar, Jean-Ralph, Zakrison, Tanya L., Zuckerbraun, Brian, Zuidema, Wietse P., and Catena, Fausto

Abstract

Background: Antimicrobial Stewardship Programs (ASPs) have been promoted to optimize antimicrobial usage and patient outcomes, and to reduce the emergence of antimicrobial-resistant organisms. However, the best strategies for an ASP are not definitively established and are likely to vary based on local culture, policy, and routine clinical practice, and probably limited resources in middle-income countries. The aim of this study is to evaluate structures and resources of antimicrobial stewardship teams (ASTs) in surgical departments from different regions of the world. Methods: A cross-sectional web-based survey was conducted in 2016 on 173 physicians who participated in the AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections) project and on 658 international experts in the fields of ASPs, infection control, and infections in surgery. Results: The response rate was 19.4%. One hundred fifty-six (98.7%) participants stated their hospital had a multidisciplinary AST. The median number of physicians working inside the team was five [interquartile range 4-6]. An infectious disease specialist, a microbiologist and an infection control specialist were, respectively, present in 80.1, 76.3, and 67.9% of the ASTs. A surgeon was a component in 59.0% of cases and was significantly more likely to be present in university hospitals (89.5%, p < 0.05) compared to community teaching (83.3%) and community hospitals (66.7%). Protocols for pre-operative prophylaxis and for antimicrobial treatment of surgical infections were respectively implemented in 96.2 and 82.3% of the hospitals. The majority of the surgical departments implemented both persuasive and restrictive interventions (72.8%). The most common types of interventions in surgical departments were dissemination of educational materials (62.5%), expert approval (61.0%), audit and feedback (55.1%), educational outreach (53.7%), and compulsory order forms (51.5%). Conclusion: T

Published
2017

13. A Global Declaration on Appropriate Use of Antimicrobial Agents across the Surgical Pathway

Author

Sartelli, Massimo, Kluger, Yoram, Ansaloni, Luca, Carlet, Jean, Brink, Adrian, Hardcastle, Timothy C., Khanna, Ashish, Chicom-Mefire, Alain, Rodriguez-Bano, Jesus, Nathwani, Dilip, Mendelson, Marc, Watkins, Richard R., Pulcini, Celine, Beovic, Bojana, May, Addison K., Itani, Kamal M. F., Mazuski, John E., Fry, Donald E., Coccolini, Federico, Rasa, Kemal, Montravers, Philippe, Eckmann, Christian, Abbo, Lilian M., Abubakar, Salisu, Abu-Zidan, Fikri M., Adesunkanmi, Abdulrashid Kayode, Al-Hasan, Majdi N., Althani, Asma A., Ticas, Jorge Eduardo Alvarenga, Ansari, Shamshul, Ansumana, Rashid, Araujo da Silva, Andre Ricardo, Augustin, Goran, Bala, Miklosh, Balogh, Zsolt J., Baraket, Oussema, Bassett, Matteo, Bellanova, Giovanni, Beltran, Marcelo A., Ben-Ishay, Ofir, Biffl, Walter L., Boermeester, Marja A., Brecher, Stephen M., Bueno, Juan, Cainzos, Miguel A., Cairns, Kelly, Camacho-Ortiz, Adrian, Ceresoli, Marco, Chandy, Sujith J., Cherry-Bukowiec, Jill R., Cirocchi, Roberto, Colak, Elif, Corcione, Antonio, Cornely, Oliver A., Cortese, Francesco, Cui, Yunfeng, Curcio, Daniel, Damaskos, Dimitris, Das, Koray, Delibegovic, Samir, Deme-Trashvili, Zaza, De Simone, Belinda, de Souza, Hamilton Petry, De Waele, Jan, Dhingra, Sameer, Diaz, Jose J., Di Carlo, Isidoro, Di Marzo, Francesco, Di Saverio, Salomone, Dogjani, Agron, Dorj, Gereltuya, Dortet, Laurent, Duane, Therese M., Dupont, Herve, Egiev, Valery N., Eid, Hani O., Elmangory, Mutasim, Marei, Hany El-Sayed, Enani, Mushira Abdulaziz, Escandon-Vargas, Kevin, Faro Junior, Mario P., Ferrada, Paula, Foghetti, Domitilla, Foianini, Esteban, Fraga, Gustavo P., Frattima, Sabrina, Gandhi, Chinmay, Gattuso, Gianni, Giamarellou, Eleni, Ghnnam, Wagih, Gkiokas, George, Girardis, Massimo, Goff, Debbie A., Gomes, Carlos Augusto, Gomi, Harumi, Guerra Gronerth, Rosio Isabel, Guirao, Xavier, Guzman-Blanco, Manuel, Haque, Mainul, Hecker, Andreas, Hell, Markus, Herzog, Torsten, Hicks, Lauri, Kafka-Ritsch, Reinhold, Kao, Lillian S., Kanj, Souha S., Kaplan, Lewis J., Kapoor, Garima, Karamarkovic, Aleksandar, Kashuk, Jeffry, Kenig, Jakub, Khamis, Faryal, Khokha, Vladimir, Kiguba, Ronald, Kirkpatrick, Andrew W., Korner, Hartwig, Koike, Kaoru, Kok, Kenneth Y. Y., Kon, Kateryna, Kong, Victor, Inaba, Kenji, Ioannidis, Orestis, Isik, Arda, Iskandar, Katia, Labbate, Maurizio, Labricciosa, Francesco M., Lagrou, Katrien, Lagunes, Leonel, Latifi, Rifat, Lasithiotakis, Kostas, Laxminarayan, Ramanan, Lee, Jae Gil, Leone, Marc, Leppaniemi, Ari, Li, Yousheng, Liang, Stephen Y., Liau, Kui-Hin, Litvin, Andrey, Loho, Tonny, Lowman, Warren, Machain, Gustavo M., Maier, Ronald V., Manzano-Nunez, Ramiro, Marinis, Athanasios, Marmorale, Cristina, Martin-Loeches, Ignacio, Marwah, Sanjay, Maseda, Emilio, McFarlane, Michael, de Melo, Renato Bessa, Melotti, Maria Rita, Memish, Ziad, Mertz, Dominik, Mesina, Cristian, Menichetti, Francesco, Mishra, Shyam Kumar, Montori, Giulia, Moore, Ernest E., Moore, Frederick A., Naidoo, Noel, Napolitano, Lena, Negoi, Ionut, Nicolau, David P., Nikolopoulos, Ioannis, Nord, Carl Erik, Ofori-Asenso, Richard, Olaoye, Iyiade, Omari, Abdelkarim H., Ordonez, Carlos A., Ouadii, Mouaqit, Ouedraogo, Abdoul-Salam, Pagani, Leonardo, Paiva, Jose Artur, Parreira, Jose Gustavo, Pata, Francesco, Pereira, Jorge, Pereira, Nuno R., Petrosillo, Nicola, Picetti, Edoardo, Pintar, Tadeja, Ponce-de-Leon, Alfredo, Popovski, Zagorka, Poulakou, Garyphallia, Preller, Jacobus, Guerrero, Adrian Puello, Pupelis, Guntars, Quiodettis, Martha, Rawson, Timothy M., Reichert, Martin, Reinhart, Konrad, Rems, Miran, Rello, Jordi, Rizoli, Sandro, Roberts, Jason, Rubio-Perez, Ines, Ruppc, Etienne, Sakakushev, Boris, Sall, Ibrahima, Kafil, Hossein Samadi, Sanders, James, Sato, Norio, Sawyer, Robert G., Scalea, Thomas, Scibe, Rodolfo, Scudeller, Luigia, Segovia Lohse, Helmut, Sganga, Gabriele, Shafiq, Nusrat, Shah, Jay N., Spigaglia, Patrizia, Suroowan, Shanoo, Tsioutis, Constantinos, Sifri, Costi D., Siribumrungwong, Boonying, Sugrue, Michael, Talving, Peep, Tan, Boun Kim, Tarasconi, Antonio, Tascini, Carlo, Tilsed, Jonathan, Timsit, Jean-Francois, Tumbarello, Mario, Ulrych, Jan, Uranues, Selman, Velmahos, George, Vereczkei, Andras G., Viale, Pierluigi, Vila Estape, Jordi, Viscoli, Claudio, Wagenlehner, Florian, Wright, Brian J., Xiao, Yonghong, Yuan, Kuo-Ching, Zachariah, Sanoop K., Zahar, Jean Ralph, Mergulhao, Paulo, Catena, Fausto, Sartelli, Massimo, Kluger, Yoram, Ansaloni, Luca, Carlet, Jean, Brink, Adrian, Hardcastle, Timothy C., Khanna, Ashish, Chicom-Mefire, Alain, Rodriguez-Bano, Jesus, Nathwani, Dilip, Mendelson, Marc, Watkins, Richard R., Pulcini, Celine, Beovic, Bojana, May, Addison K., Itani, Kamal M. F., Mazuski, John E., Fry, Donald E., Coccolini, Federico, Rasa, Kemal, Montravers, Philippe, Eckmann, Christian, Abbo, Lilian M., Abubakar, Salisu, Abu-Zidan, Fikri M., Adesunkanmi, Abdulrashid Kayode, Al-Hasan, Majdi N., Althani, Asma A., Ticas, Jorge Eduardo Alvarenga, Ansari, Shamshul, Ansumana, Rashid, Araujo da Silva, Andre Ricardo, Augustin, Goran, Bala, Miklosh, Balogh, Zsolt J., Baraket, Oussema, Bassett, Matteo, Bellanova, Giovanni, Beltran, Marcelo A., Ben-Ishay, Ofir, Biffl, Walter L., Boermeester, Marja A., Brecher, Stephen M., Bueno, Juan, Cainzos, Miguel A., Cairns, Kelly, Camacho-Ortiz, Adrian, Ceresoli, Marco, Chandy, Sujith J., Cherry-Bukowiec, Jill R., Cirocchi, Roberto, Colak, Elif, Corcione, Antonio, Cornely, Oliver A., Cortese, Francesco, Cui, Yunfeng, Curcio, Daniel, Damaskos, Dimitris, Das, Koray, Delibegovic, Samir, Deme-Trashvili, Zaza, De Simone, Belinda, de Souza, Hamilton Petry, De Waele, Jan, Dhingra, Sameer, Diaz, Jose J., Di Carlo, Isidoro, Di Marzo, Francesco, Di Saverio, Salomone, Dogjani, Agron, Dorj, Gereltuya, Dortet, Laurent, Duane, Therese M., Dupont, Herve, Egiev, Valery N., Eid, Hani O., Elmangory, Mutasim, Marei, Hany El-Sayed, Enani, Mushira Abdulaziz, Escandon-Vargas, Kevin, Faro Junior, Mario P., Ferrada, Paula, Foghetti, Domitilla, Foianini, Esteban, Fraga, Gustavo P., Frattima, Sabrina, Gandhi, Chinmay, Gattuso, Gianni, Giamarellou, Eleni, Ghnnam, Wagih, Gkiokas, George, Girardis, Massimo, Goff, Debbie A., Gomes, Carlos Augusto, Gomi, Harumi, Guerra Gronerth, Rosio Isabel, Guirao, Xavier, Guzman-Blanco, Manuel, Haque, Mainul, Hecker, Andreas, Hell, Markus, Herzog, Torsten, Hicks, Lauri, Kafka-Ritsch, Reinhold, Kao, Lillian S., Kanj, Souha S., Kaplan, Lewis J., Kapoor, Garima, Karamarkovic, Aleksandar, Kashuk, Jeffry, Kenig, Jakub, Khamis, Faryal, Khokha, Vladimir, Kiguba, Ronald, Kirkpatrick, Andrew W., Korner, Hartwig, Koike, Kaoru, Kok, Kenneth Y. Y., Kon, Kateryna, Kong, Victor, Inaba, Kenji, Ioannidis, Orestis, Isik, Arda, Iskandar, Katia, Labbate, Maurizio, Labricciosa, Francesco M., Lagrou, Katrien, Lagunes, Leonel, Latifi, Rifat, Lasithiotakis, Kostas, Laxminarayan, Ramanan, Lee, Jae Gil, Leone, Marc, Leppaniemi, Ari, Li, Yousheng, Liang, Stephen Y., Liau, Kui-Hin, Litvin, Andrey, Loho, Tonny, Lowman, Warren, Machain, Gustavo M., Maier, Ronald V., Manzano-Nunez, Ramiro, Marinis, Athanasios, Marmorale, Cristina, Martin-Loeches, Ignacio, Marwah, Sanjay, Maseda, Emilio, McFarlane, Michael, de Melo, Renato Bessa, Melotti, Maria Rita, Memish, Ziad, Mertz, Dominik, Mesina, Cristian, Menichetti, Francesco, Mishra, Shyam Kumar, Montori, Giulia, Moore, Ernest E., Moore, Frederick A., Naidoo, Noel, Napolitano, Lena, Negoi, Ionut, Nicolau, David P., Nikolopoulos, Ioannis, Nord, Carl Erik, Ofori-Asenso, Richard, Olaoye, Iyiade, Omari, Abdelkarim H., Ordonez, Carlos A., Ouadii, Mouaqit, Ouedraogo, Abdoul-Salam, Pagani, Leonardo, Paiva, Jose Artur, Parreira, Jose Gustavo, Pata, Francesco, Pereira, Jorge, Pereira, Nuno R., Petrosillo, Nicola, Picetti, Edoardo, Pintar, Tadeja, Ponce-de-Leon, Alfredo, Popovski, Zagorka, Poulakou, Garyphallia, Preller, Jacobus, Guerrero, Adrian Puello, Pupelis, Guntars, Quiodettis, Martha, Rawson, Timothy M., Reichert, Martin, Reinhart, Konrad, Rems, Miran, Rello, Jordi, Rizoli, Sandro, Roberts, Jason, Rubio-Perez, Ines, Ruppc, Etienne, Sakakushev, Boris, Sall, Ibrahima, Kafil, Hossein Samadi, Sanders, James, Sato, Norio, Sawyer, Robert G., Scalea, Thomas, Scibe, Rodolfo, Scudeller, Luigia, Segovia Lohse, Helmut, Sganga, Gabriele, Shafiq, Nusrat, Shah, Jay N., Spigaglia, Patrizia, Suroowan, Shanoo, Tsioutis, Constantinos, Sifri, Costi D., Siribumrungwong, Boonying, Sugrue, Michael, Talving, Peep, Tan, Boun Kim, Tarasconi, Antonio, Tascini, Carlo, Tilsed, Jonathan, Timsit, Jean-Francois, Tumbarello, Mario, Ulrych, Jan, Uranues, Selman, Velmahos, George, Vereczkei, Andras G., Viale, Pierluigi, Vila Estape, Jordi, Viscoli, Claudio, Wagenlehner, Florian, Wright, Brian J., Xiao, Yonghong, Yuan, Kuo-Ching, Zachariah, Sanoop K., Zahar, Jean Ralph, Mergulhao, Paulo, and Catena, Fausto

Abstract

This declaration, signed by an interdisciplinary task force of 234 experts from 83 different countries with different backgrounds, highlights the threat posed by antimicrobial resistance and the need for appropriate use of antibiotic agents and antifungal agents in hospitals worldwide especially focusing on surgical infections. As such, it is our intent to raise awareness among healthcare workers and improve antimicrobial prescribing. To facilitate its dissemination, the declaration was translated in different languages.

Published
2017

Catalog

Books, media, physical & digital resources
See catalog results