This document updates the 2014 Core Elements for Hospital Antibiotic Stewardship Programs and incorporates new evidence and lessons learned from experience with the Core Elements. The Core Elements are applicable in all hospitals, regardless of size. There are suggestions specific to small and criti...cal access hospitals in Implementation of Antibiotic Stewardship Core Elements at Small and Critical Access Hospitals (12).There is no single template for a program to optimize antibiotic prescribing in hospitals. Implementation of antibiotic stewardship programs requires flexibility due to the complexity of medical decision-making surrounding antibiotic use and the variability in the size and types of care among U.S. hospitals. In some sections, CDC has identified priorities for implementation, based on the experiences of successful stewardship programs and published data. The Core Elements are intended to be an adaptable framework that hospitals can use to guide efforts to improve antibiotic prescribing. The assessment tool that accompanies this document can help hospitals identify gaps to address.
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Molecular methods for antimicrobial resistance (AMR)diagnostics to enhance the Global Antimicrobial Resistance Surveillance System
BACKGROUND: Growing political attention to antimicrobial resistance (AMR) offers a rare opportunity for achieving meaningful action. Many governments have developed national AMR action plans, but most have not yet implemented policy interventions to reduce antimicrobial overuse. A systematic evidenc...e map can support governments in making evidence-informed decisions about implementing programs to reduce AMR, by identifying, describing, and assessing the full range of evaluated government policy options to reduce antimicrobial use in humans.
METHODS AND FINDINGS: Seven databases were searched from inception to January 28, 2019, (MEDLINE, CINAHL, EMBASE, PAIS Index, Cochrane Central Register of Controlled Trials, Web of Science, and PubMed). We identified studies that (1) clearly described a government policy intervention aimed at reducing human antimicrobial use, and (2) applied a quantitative design to measure the impact. We found 69 unique evaluations of government policy interventions carried out across 4 of the 6 WHO regions. These evaluations included randomized controlled trials (n = 4), non-randomized controlled trials (n = 3), controlled before-and-after designs (n = 7), interrupted time series designs (n = 25), uncontrolled before-and-after designs (n = 18), descriptive designs (n = 10), and cohort designs (n = 2). From these we identified 17 unique policy options for governments to reduce the human use of antimicrobials. Many studies evaluated public awareness campaigns (n = 17) and antimicrobial guidelines (n = 13); however, others offered different policy options such as professional regulation, restricted reimbursement, pay for performance, and prescription requirements. Identifying these policies can inform the development of future policies and evaluations in different contexts and health systems. Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review.
CONCLUSIONS: To our knowledge this is the first study to provide policy makers with synthesized evidence on specific government policy interventions addressing AMR. In the future, governments should ensure that AMR policy interventions are evaluated using rigorous study designs and that study results are published.
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Stewardship is defined as “the careful and responsible management of something entrusted to one’s care”. It was originally applied in the health-care setting as a tool for optimizing antimicrobial use, termed “antimicrobial stewardship” (AMS). Stewardship has since be...en applied in the context of governance of the health sector as a whole, taking responsibility for the health and well-being of the population and guiding health systems at the national and global level.
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Purpose of this document: to present eight practical steps that Member States can take at the national and sub-national level to improve WASH in health care facilities
EMCDDA Insights - 11
Accessed: 14.03.2019
Known avoidable environmental risks to health cause at least 12.6 million deaths every year, and account for about one quarter of the global burden of disease (2016 data) (1). Air pollution alone causes about 7 million
deaths a year, placing it among the top global risks to health (2). Global envir...onmental challenges are on the rise, including climate change, rapid urbanization and increased resistance to drugs.
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A Manual for Medical Officer
Developed under the Government of India – WHO Collaborative Programme 2008-2009
Accessed: 11.03.2019
Version 1.1. The WHO protocol has been adapted to resource-limited settings and builds on existing methodologies from the European Centre for Disease Prevention and Control (ECDC), the Global PPS project from University of Antwerp, the US Centers for Disease Control and Prevention (CDC), and the Med...icines Utilisation Research in Africa (MURIA).
Point Prevalence Surveys collects information on prescribing practices of antibiotics and other information relevant to treatment and management of infectious diseases in hospitalized patients, and complements surveillance of antimicrobial consumption.
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Tuberculosis cases, TB deaths
1st edition
This resource provides practical guidance for front line health workers responsible for the diagnosis, management and care of patients with these two diseases. Published in collaboration with the World Diabetes Foundation
Despite Pakistan's progress in reducing the number of wild poliovirus type 1 (WPV1) cases to 8 in 2017 and 12 in 2018, 2019 has seen a significant rise in the number of WPV1 cases (41 cases as of July 8 2019). One of the most intractable challenges the Pakistan Polio Eradication Initiative (PEI) is ...facing is refusals by parents and caregivers to immunise their children with the polio vaccine. In light of this challenge, the Pakistan programme has revisited its strategy and put forward this Extension of the National Emergency Action Plan 2018/2019 (NEAP), which will carry the programme forward from July to December 2019
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Project protocol
Introduction Ready-to-eat food sold in the street represents a global phenomenon, more common in urbanized areas, that constitutes an important dietary source in populations from low- and middle-income countries. However, research on the kind of street food offered and its composit...ion is scarce. The main objective of this study is to characterize the urban street food environment, including vending places, the food offered, its nutritional composition, food purchasing patterns and advertising.
Methods and analysis This protocol provides a framework for a stepwise, standardized characterization of the street food environment; it consists of three steps that are of increasing complexity and demand increasingly great human and technical resources. Step 1 comprises identification of street food vending sites and characterization of the products available; this stage may be complemented with an evaluation of food advertising in the streets. Step 2 comprises description of street food purchasing patterns, by direct observation. Step 3 requires collection of food samples for bromatological analysis. Different levels of data collection may be defined for each step; hereafter, these are presented as core and expanded evaluations. For the most part, data analysis involves descriptive statistics and basic spatial analysis.
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