Antimicrobial Stewardship


26 September 2018

UKM Antimicrobial Stewardship Seminar 2018

We are proudly announce that we are going to launch our own Surgical Prophylaxis Protocol. This is the great work from our dedicated AMS team. We are sure it will be beneficial for our patient.

The protocol can be reach in the following link:

https://www.ppukm.ukm.my/farmasi/wp-content/uploads/2018/09/PPUKM-Surgical-Prophylaxis-26092018.pdf






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13 September 2018

Effect of Piperacillin-Tazobactam vs Meropenem on 30-Day Mortality for Patients With E coli or Klebsiella pneumoniae Bloodstream Infection and Ceftriaxone Resistance - A Randomized Clinical Trial



Question  Can piperacillin-tazobactam be used as carbapenem-sparing therapy in patients with bloodstream infections caused by ceftriaxone-resistant Escherichia coli or Klebsiella pneumoniae?



Findings  In this noninferiority randomized clinical trial that included 391 patients with E coli or K pneumoniae bloodstream infection and ceftriaxone resistance, the 30-day mortality rate for patients treated with piperacillin-tazobactam compared with meropenem was 12.3% vs 3.7%, respectively. The difference did not meet the noninferiority margin of 5%.



Meaning  These findings do not support piperacillin-tazobactam compared with meropenem for these infections.



Link

https://jamanetwork.com/journals/jama/fullarticle/2702145?utm_campaign=articlePDF&utm_medium=articlePDFlink&utm_source=articlePDF&utm_content=jama.2018.12163

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Antibiogram (medical) Universiti Kebangsaan Malaysia Medical Centre (UKMMC) 2017

With all the effort of Antimicrobial Stewardship Committee of UKMMC,  our antibiogram (medical) finally officially launch in 2017. With this protocol, it facilitate our antibiotic prescription decision and slow down the development toward antibiotic resistance. Congratulation to AMS team UKMMC.



#AMSMMalaysia #MAMSIG



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A STUDY ON THE APPROPRIATENESS OF EARLY EMPIRICAL ANTIBIOTIC THERAPY ASSOCIATION WITH 28-DAY MORTALITY AMONG PATIENTS WITH SEPSIS SYNDROME PRESENTED TO EMERGENCY DEPARTMENT IN UKMMC


Mohd Sidqi MS, Toh Leong Tan, 

Department of Emergency Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur.


Abstract

Introduction:
Sepsis have high mortality rate and many research was done to determine the best method for sepsis management. Early and appropriate antibiotic should be used to reduced mortality.

Objective:
To determine the association of early appropriate antibiotic administration and 28-day mortality in sepsis syndrome patient presented in Emergency Department (ED) Universiti Kebangsaan Malaysia Medical Centre (UKMMC).

Methods:
This is a single centred retrospective cross-sectional study in ED UKMMC, with patients aged 18 years and older with signs of systemic inflammatory response syndrome, suspected infection and administered antibiotics. All available culture and sensitivity results were trace. Patients were followed up on 28-day mortality for outcome and were compared on time and appropriateness of antibiotics given. 

Results: 
519 cases were included into the study. There were 472 (90.9%) survivors and 47 (9.1%) non-survivors for 28-day mortality. Early (within 6 hours upon arrival in ED) and late (more than 6 hours) administration of antibiotics have significant associations with 28-day mortality (p <0.001). However, appropriateness (according to culture and sensitivity or UKMMC antibiotic protocol) of antibiotic administered have no associations with 28-day mortality (p = 0.099).

Conclusions: 
Timing of antibiotics given to patients is important. The antibiotic was given early as per protocol. The early administration of empirical antibiotic was significant associate with 28-day mortality. This signifies the administration of early empirical antibiotic could reduce mortality in EDPPUKM. Nevertheless, the study unable to demonstrate the appropriateness of antibiotics given to patient improve 28-day mortality in sepsis patients.

Powerpoint is available, please contact: sebastianttl@sigmaris.org 






Article for Malaysian Public Awareness Regarding the Use of Antibiotic and Antibiotic Resistant 















UNDERSTANDING RABIES AND POSTEXPOSURE PROPHYLAXIS

Our Antimicrobial Stewardship Committee Universiti Kebangsaan Medical Center are hosting a CME on 10 Aug 2018. The CME are highlighting the appropriateness of antibiotic usage and understanding Rabies and Post Exposure Prophylaxis


Topic of interest

10 August 2018
8.30am

A STUDY ON THE APPROPRIATENESS OF EARLY EMPIRICAL ANTIBIOTIC THERAPY ASSOCIATION WITH 28-DAY MORTALITY AMONG PATIENTS WITH SEPSIS SYNDROME PRESENTED TO EMERGENCY DEPARTMENT UKMMC
Speaker: Dr Tan Toh Leong
Senior Lecturer and Emergency Department
AMS UKMMC Committee
SIGMARIS MALAYSIA


9.00am
UNDERSTANDING RABIES AND POST-EXPOSURE PROPHYLAXIS
Speaker: Dr Vickneswaran Muthu
Ketua Penolong Pengarah Kanan
Sektor Zoonosis, Bahagian Kawalan Penyakit, Kementerian Kesihatan Malaysia

Dr Vickneshwaran Muthu is currently a chief assistant director at the Zoonoses Sector, Ministry of Health Malaysia. He extensively does research in Infectious Diseases, Epidemiology and Public Health.

His most recent publication is 'Morphological and molecular detection of Blastocystis in wildlife from Tioman Island, Malaysia'.

He has been giving talks on Rabies in major hospitals and been featured in “TV9 Nasi Lemak Kopi O” back in 2017 to educate public about rabies virus.

 We are humbled and grateful for Dr Vicknes to speak to us  on the topic “Understanding Rabies & PEP”  despite his tight schedule, he has even cancelled his ekosistem kondusif sektor awam (eksa) audit to deliver the talk on 10th Aug 2018



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