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Diagnosing and Treating Acute Bacterial Rhinosinusitis: New Guidelines from the Infectious Diseases Society of America

Categories: Antimicrobial Resistance

Anthony W. Chow MD, FRCPC, FACP

Anthony W. Chow MD, FRCPC, FACP

Author – Dr. Anthony W. Chow, MD.
University of British Columbia and Vancouver Hospital

Sinus infections cause inflammation of both the sinuses and nasal cavity. The infections can sometimes last for weeks and can be very uncomfortable. They are quite common – in fact, nearly one in seven adults are diagnosed with a sinus infection each year.

My coauthors and I developed the Infectious Diseases Society of America (IDSA)’s Clinical Practice Guideline for Acute Bacterial Rhinosinusitis in Children and Adults to help physicians make sense of how to best diagnose and treat rhinosinusitis.

Our goals for the guideline are to inform physicians regarding the appropriate diagnosis and management of rhinosinusitis and to reduce inappropriate and unnecessary use of antibiotics. Inappropriate use can cause harm by fostering antibiotic resistance, unnecessarily exposing patients to drug side effects and adding cost.

Infection Prevention and Control’s Long and Winding Road

Categories: Healthcare-associated infections

Michelle Farber, RN, CIC

Michelle Farber, RN, CIC, APIC 2012 President

Guest Author – Michelle Farber, RN, CIC
Association for Professionals in Infection Control and Epidemiology (APIC) 2012 President

If you asked healthcare professionals a decade ago to describe the role of the infection control practitioner, “hand washing cop” or “flu shot nurse” may have been the response.  With changing reimbursement, quality measure incentives, and mandated reporting of healthcare-associated infections, a proactive, leadership role for these practitioners was essential. For this reason, APIC now uses the name infection preventionist (IP) to describe this shift in the professional role of these important healthcare professionals.

Until now, the profession lacked a standard definition of competency in the United States. There was no widely accepted way to assess IP knowledge or skills. Because IP skills are in high demand and the role is in transition, APIC developed a model of IP competency that could be applicable to all practice settings. The new APIC Competency Model for the Infection Preventionist appears in a white paper in the May issue of the American Journal of Infection Control (AJIC), in a special topic issue, “The Road to 2020.”  Represented as a circular diagram, with patient safety in the center, it outlines the skills needed and areas of competency that will be especially critical in the next three to five years. 

Antimicrobial Stewardship: New Tools for Action

Categories: Antimicrobial Resistance

Neil Fishman, MD

Neil Fishman, MD

Guest Author – Neil Fishman, M.D.
Associate Chief Medical Officer for the University of Pennsylvania Health System,
Associate Professor of Medicine at the University of Pennsylvania School of Medicine.

I have noticed more conversations at hospitals, in the community, and even among policy makers about the importance of preserving our antibiotic supply in the setting of rapidly emerging resistance, and about the role of antimicrobial stewardship programs in helping to achieve this goal.  Antimicrobial resistance is a critical issue that significantly impacts healthcare quality, patient safety and public health. Most people in the healthcare industry “know” we need to practice stewardship to address the problem.  But, as they say, talk is cheap. 

On one hand, I am thrilled about the growing recognition of the importance of antimicrobial stewardship. Suddenly, it seems, my lifelong commitment to this issue has a receptive audience.  On the other hand, truly effective stewardship means more than just an acknowledgement of its importance.  Healthcare practitioners, administrators, and policymakers need real tools to put effective antimicrobial stewardship strategies into place.

Antimicrobial Stewardship is designed to promote the appropriate use of antibiotics. Antimicrobial Stewardship programs help prescribers choose the optimal antimicrobial drug regimen at the correct dose, and to administer it via the correct route for the correct duration. Therefore, effective stewardship programs not only improve the quality of care but also can reduce wasteful spending.

Clostridium difficile It’s Like Seeing a Train Coming…and You Can’t Get Off of the Tracks

Categories: Antimicrobial Resistance, Clostridium difficile

CDC Vital Signs. Learn vital information about stopping C. difficile infections. Read CDC Vital Signs

CDC Vital Signs. Learn vital information about stopping C. difficile infections. Read CDC Vital Signs

Author – Clifford McDonald MD
Prevention and Response Branch Chief
CDC’s Division of Healthcare Quality Promotion

Looking back now, it is like a movie playing out in my mind. We were at the 2004 IDSA conference in Boston, and my colleagues from the CDC lab, Dr. Dale Gerding’s laboratory, other scientific collaborators, and I were presenting on a new strain of Clostridium difficile called NAP1. I’m not sure everyone understood the implications. Some realized NAP1 could be big; others felt that C. diff wasn’t that big of a deal. For me, it was like seeing a train coming, and you can’t get off the tracks.

Clostridium difficile infections have been an important part of my career. Upon wrapping up the SARS investigations for CDC in Toronto, I turned my attention to C. difficile, as I sensed there was something going on that needed further investigation. Now, here we are 8 years later, and NAP1, which causes severe infection, is still a major issue in the United States.

CDC/CMS Team Up to Provide Consumers Access to Local Hospital Patient Safety Data

Categories: CLABSI, Healthcare-associated infections, NHSN

Daniel Pollock, MD

Daniel Pollock, MD

Author: Dan Pollock
CDC, Division of Healthcare Quality Promotion, Surveillance Branch Chief

CMS announced today that its Hospital Compare website now includes central line-associated bloodstream infection (CLABSI) data reported from hospital ICUs to CDC’s National Healthcare Safety Network (NHSN). In many places, this is the first time consumers can see how well their local hospitals prevent CLABSIs, one of the most deadly and preventable healthcare-associated infections (HAIs).   

These data reflect hospital performance during the first quarter of 2011.  In many cases, there was not enough data to produce a valid score for a specific hospital.  As new data are added each quarter to Hospital Compare, enough information will be available to report accurate measures for more hospitals.  A view of statewide progress is also available, based on data from hospitals that participate in CMS’s Value-Based Purchasing program.

Consumers are encouraged to research their local hospitals on Hospital Compare and use the information as a discussion point with their healthcare providers.  The information should not be used as the sole factor in choice of hospital. 

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