BundlED Up: A Narrative Review of Antimicrobial Stewardship Initiatives and Bundles in the Emergency Department
Antimicrobial stewardship (ASP) is becoming an increasingly high priority worldwide, yet the emergency department (ED) is an area where stewardship is often neglected. Implementing care bundles, guidelines, and protocols appears to be a rational strategy for ED stewardship given the inherently dynam...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2019-11-01
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| Series: | Pharmacy |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2226-4787/7/4/145 |
| _version_ | 1798004044108660736 |
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| author | Maressa Santarossa Emily N. Kilber Eric Wenzler Fritzie S. Albarillo Ethan J. Sterk |
| author_facet | Maressa Santarossa Emily N. Kilber Eric Wenzler Fritzie S. Albarillo Ethan J. Sterk |
| author_sort | Maressa Santarossa |
| collection | DOAJ |
| description | Antimicrobial stewardship (ASP) is becoming an increasingly high priority worldwide, yet the emergency department (ED) is an area where stewardship is often neglected. Implementing care bundles, guidelines, and protocols appears to be a rational strategy for ED stewardship given the inherently dynamic and hectic environment of care. Multiple questions still exist such as whether to target certain disease states, optimal implementation of ASP interventions in the ED, and the benefit of unique ED-specific guidelines and protocols. A narrative review was performed on interventions, guidelines, and bundles implemented in the ED setting, in an effort to improve ASP or management of infectious diseases. This review is meant to serve as a framework for the reader to implement these practices at their own institution. We examined various studies related to ASP interventions or care bundles in the ED which included: CNS infections (one study), skin and soft-tissue infections (one study), respiratory infections (four studies), urinary tract infections and sexually transmitted infections (eight studies), sepsis (two studies), culture follow-up programs (four studies), and stewardship in general or multiple infection types (five studies). The interventions in this review were diverse, yet the majority showed a benefit in clinical outcomes or a decrease in antimicrobial use. Care bundles, guidelines, and antimicrobial stewardship interventions can streamline care and improve the management of common infectious diseases seen in the ED. |
| first_indexed | 2024-04-11T12:17:12Z |
| format | Article |
| id | doaj.art-9179e11d6190469191b4cb3053e7e571 |
| institution | Directory Open Access Journal |
| issn | 2226-4787 |
| language | English |
| last_indexed | 2024-04-11T12:17:12Z |
| publishDate | 2019-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Pharmacy |
| spelling | doaj.art-9179e11d6190469191b4cb3053e7e5712022-12-22T04:24:15ZengMDPI AGPharmacy2226-47872019-11-017414510.3390/pharmacy7040145pharmacy7040145BundlED Up: A Narrative Review of Antimicrobial Stewardship Initiatives and Bundles in the Emergency DepartmentMaressa Santarossa0Emily N. Kilber1Eric Wenzler2Fritzie S. Albarillo3Ethan J. Sterk4Department of Medicine, Division of Infectious Disease, Loyola University Medical Center, Maywood, IL 60153, USADepartment of Pharmacy, Maricopa Medical Center, Phoenix, AZ 85008, USACollege of Pharmacy, University of Illinois at Chicago, Chicago, IL 60612, USADepartment of Medicine, Division of Infectious Disease, Loyola University Medical Center, Maywood, IL 60153, USADepartment of Emergency Medicine, Loyola University Medical Center, Maywood, IL 60153, USAAntimicrobial stewardship (ASP) is becoming an increasingly high priority worldwide, yet the emergency department (ED) is an area where stewardship is often neglected. Implementing care bundles, guidelines, and protocols appears to be a rational strategy for ED stewardship given the inherently dynamic and hectic environment of care. Multiple questions still exist such as whether to target certain disease states, optimal implementation of ASP interventions in the ED, and the benefit of unique ED-specific guidelines and protocols. A narrative review was performed on interventions, guidelines, and bundles implemented in the ED setting, in an effort to improve ASP or management of infectious diseases. This review is meant to serve as a framework for the reader to implement these practices at their own institution. We examined various studies related to ASP interventions or care bundles in the ED which included: CNS infections (one study), skin and soft-tissue infections (one study), respiratory infections (four studies), urinary tract infections and sexually transmitted infections (eight studies), sepsis (two studies), culture follow-up programs (four studies), and stewardship in general or multiple infection types (five studies). The interventions in this review were diverse, yet the majority showed a benefit in clinical outcomes or a decrease in antimicrobial use. Care bundles, guidelines, and antimicrobial stewardship interventions can streamline care and improve the management of common infectious diseases seen in the ED.https://www.mdpi.com/2226-4787/7/4/145antimicrobial stewardshipbundleemergency departmentinfectious diseases |
| spellingShingle | Maressa Santarossa Emily N. Kilber Eric Wenzler Fritzie S. Albarillo Ethan J. Sterk BundlED Up: A Narrative Review of Antimicrobial Stewardship Initiatives and Bundles in the Emergency Department Pharmacy antimicrobial stewardship bundle emergency department infectious diseases |
| title | BundlED Up: A Narrative Review of Antimicrobial Stewardship Initiatives and Bundles in the Emergency Department |
| title_full | BundlED Up: A Narrative Review of Antimicrobial Stewardship Initiatives and Bundles in the Emergency Department |
| title_fullStr | BundlED Up: A Narrative Review of Antimicrobial Stewardship Initiatives and Bundles in the Emergency Department |
| title_full_unstemmed | BundlED Up: A Narrative Review of Antimicrobial Stewardship Initiatives and Bundles in the Emergency Department |
| title_short | BundlED Up: A Narrative Review of Antimicrobial Stewardship Initiatives and Bundles in the Emergency Department |
| title_sort | bundled up a narrative review of antimicrobial stewardship initiatives and bundles in the emergency department |
| topic | antimicrobial stewardship bundle emergency department infectious diseases |
| url | https://www.mdpi.com/2226-4787/7/4/145 |
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