The 2011 Wisconsin Health Improvement and Research Partnership Forum Fluno Center, Madison, WI September, 15 2011. Influence of Telephone Communication on Antibiotic Prescribing in Nursing Homes. Christopher J. Crnich, MD MS 1, 2.
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The 2011 Wisconsin Health Improvement and Research Partnership Forum
Fluno Center, Madison, WI September, 15 2011
Christopher J. Crnich, MD MS1, 2
1 University of Wisconsin School of Medicine and Public Health, Madison, WI
2 William S. Middleton Veterans Affairs Hospital, Madison, WI
“We can look forward with confidence to a considerable degree of freedom from infectious diseases at a time not too far in the future. Indeed … it seems reasonable to anticipate that within some measurable time… all the major infections will have disappeared.”
T. Aidan Cockburn, 1963
“Antibiotic therapy, if indiscriminately used, may turn out to be a medicinal flood that temporarily cleans and heals, but ultimately destroys life itself.”
Felix Marti-Ibanez, 1955
“At the beginning of the 21st century, antimicrobial resistance is common, has developed against every class of antimicrobial drug, and appears to be spreading into new clinical niches.”
Stephan Harbarth & Matthew Samore, 2005
Ryback et al. Pharmacotherapy 2005; 24(12 part 2): 203S - 15S
McCaig et al.Emerg Infect Dis 2003; 9(4): 432-7
Tertiary care hospital; Quebec, 2003-2006
Valiquette, et al. Clin Infect Dis 2007; 45:S112.
RR 2.8 (2.1-3.8)
RR 1.7 (1.3-2.1)
RR 0.2 (0.1-0.4)
AMP = Antibiotic Management Program
UP = Usual Practice
Fishman N. Am J Med. 2006;119:S53.
Slide courtesy of Barry Fox, Director of UWHC Antibiotic Stewardship Program
Jarvis WR. Emerg Infect Dis 2001; 7(2): 170-3
Crnich et al. IDSA 2010
Crnich et al. IDSA 2010
Crnich et al. J Am Med Dir Assoc 2011, submitted
No. Subjects = 449
No. Abx(+) = 293 (65%)
N = 92 (21%)
J Am Med Dir Assoc 2005; 6(2): 109-12
Gerontol 1989; 29(4): 502-10
J Patient Saf 2009; 5(3): 145-52
Does the quality of telephone/fax communication between nursing staff and off-site prescribers influence the appropriateness of antibiotic prescriptions in NHs?