Showing papers in "Japanese Journal of Infection Prevention and Control in 2020"
TL;DR: From a series of examinations, it was inferred that ASP led by the dental ICT contributed to the proper use of oral antibiotics for normal tooth extraction and extraction of impacted mandibular third molars.
Abstract: We investigated the use of oral antibiotics related to normal tooth extraction and extraction of impacted mandibular third molars in the outpatient clinic before and after the start of the Antimicrobial Stewardship Program (ASP) by the dental Infection Control Team (ICT). The medication records were extracted through a retrospective survey using an electronic medical record system from January 2015 to December 2018 (four-year duration). Survey items included the presence or absence of oral antibiotics, type of oral antibiotics, and so on. From the second half of the study period, we conducted an e-learning training, which included questions about antimicrobial stewardship for extraction; at the same time, related information was shared among all the dental staff. As a result, out of all the 12,225 normal tooth extraction cases, 68.1% (4110/6036) in the first half received oral antibiotic medication on the day of tooth extraction and 50.4% (3120/6189) in the second half. The extraction of impacted mandibular third molars had 4740 cases in total, and the cases that received medication on the day of tooth extraction were 90.5% (2130/2354) in the first half and 60.3% (1419/2354) in the second half. According to the guidelines, antibiotics are not required during normal tooth extraction, whereas preoperative administration is recommended for the extraction of impacted mandibular third molars, suggesting that proper medication use with the guideline in mind tends to increase over time. The types of oral antibiotics are shifting from third-generation cephems to penicins. The use of third-generation cephems for normal tooth extraction is 86.9% in the first half of 2015 to 28.3% in the second half of 2018, and the use of third-generation cephems for lower jaw impacted tooth extraction is 87.4% in the first half of 2015 to 8.5% in the second half of 2018. From a series of examinations, it was inferred that ASP led by the dental ICT contributed to the proper use of oral antibiotics for normal tooth extraction and extraction of impacted mandibular third molars.
2 citations
TL;DR: The bundle for candidiasis in Japanese guidelines proposed the following: collecting two sets of blood cultures, measuring β-glucan in suspected cases, removing the central venous catheter within 24 h, starting appropriate initial treatment, checking for the presence or absence of ocular lesions, administration of antifungals for at least two weeks after negative blood culture, and confirmation of candidiasis symptom improvement as mentioned in this paper.
Abstract: Candidemia occurs frequently in bacteremia and has a high mortality rate. This disease requires appropriate diagnosis and treatment. The bundle for candidiasis in Japanese guidelines proposed the following: collecting two sets of blood cultures, measuring β-glucan in suspected cases, removing the central venous catheter within 24 h, starting appropriate initial treatment, checking for the presence or absence of ocular lesions, administration of antifungals for at least two weeks after negative blood culture, and confirmation of candidiasis symptom improvement. It was reported that good prognosis was shown by observing these. Antifungal stewardship that should be practiced for candidemia is required with ophthalmic examination at the early diagnostic stage of candidemia and one week after the detection of candidemia, intervention about appropriate early treatment at the time of positive blood culture of yeast-like fungi, and proposal of step-down treatment for patients with long-term treatment and stable symptoms. This article describes basic information about the bundle and guidelines for candidemia, and candidemia management from a multiprofessional perspective.
2 citations
1 citations
TL;DR: An entire ward was opened as a living place for asymptomatic to mildly symptomatic patients, thereby lessening the number of donning and doffing of PPE and minimizing the workload and risk of healthcare workers of being infected in the hospital.
Abstract: In Japan, patients with coronavirus disease 2019 (COVID-19) need to be hospitalized We admitted patients with mild-to-severe disease as well as asymptomatic carriers at a designated hospital;however, we were also aware of the potential issues of shortage of personal protective equipment (PPE) and nosocomial infections among healthcare workers Therefore, we opened an entire ward as a living place for asymptomatic to mildly symptomatic patients, thereby lessening the number of donning and doffing of PPE and minimizing the workload and risk of healthcare workers of being infected in the hospital For those with severe disease, we considered the corridor of intensive care unit as the so called "orange zone" to use PPE to minimize the workload and risk Here, we have described the details of our strategy