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write a formal paper on the topic selected in task 4. The paper must include the following elements:

  • Title page
  • Introduction—this should be revised based on feedback you received for the version you developed in task10.
  • Body of the paper that covers the main and subtopics.
  • Identify any gaps in the research that you think could be a research topic in the future.
  • Conclusion
  • References

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Overview
Over time, antibiotics have significantly changed the medical practice; now, untreatable
lethal infections can be successfully treated using antibiotics. Antibiotics have also made
advancements in cancer treatment and made organ transplants possible (Pollack & Srinivasan,
2019). The benefits of antibiotics are generally suitable for public health; nevertheless, about 30%
of the prescribed antibiotics in hospitals are either unnecessary or suboptimal. This fact has led
patients to have serious effects because, like any other medications, antibiotics can cause harmful
effects if used unnecessarily. The unnecessary use has also led to patients developing antibiotic
resistance, a threat to public health. The reference (Pollack & Srinivasan, 2019) provides
stewardship programs that can help the general clinical outcomes of antibiotics and reduce harm.
Excessive use of antibiotics has also led to other related complications in a patient; this can
be multi-drug resistance bacteria. The article by Labi et al. (2018) evaluated the use of antibiotics
to promote the surveillance of antibiotics as a WHO recommendation to improve antibiotic use
and control resistance.
This next article by Nair et al. (2019) seeks to examine the informal and formal providers
of the antibiotics and their knowledge of the effects and use while evaluating their practices on the
same; antibiotic use. The patients are generally not versed with the correct information concerning
antibiotics. A similar study was done in China to document the overuse and misuse of antibiotics,
why they happen in the pastoral care systems, and the impact that non-degree trained physicians
have on the misuse and overuse of antibiotics (Chang et al., 2019). The following qualitative study
explores the drivers of antibiotic use among health workers, whether formal or informal, to explain
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why they make prescription choices as they provide care. This study will also give an insight into
patient knowledge, attitude, and expectation when seeking care (Nair et al., 2019).
Hospital-acquired infections are on the rise in European countries, America, and other parts
of the world. A study was done in three Swiss acute-care hospitals to reduce the infections and the
role antibiotics play in doing so (Metsni et al., 2018). Inappropriate and unnecessary use of
antibiotics leads to high costs and expenditure. Some antibiotics are prescribed for viral infections,
the inappropriate use of antibiotics, especially in inpatient care, has generally led to high rates of
bacterial resistance culminating in a public health crisis. Suda et al. (2018), Argue that decreasing
the inappropriate use of antibiotics will potentially reduce the cost of medication.
Much efforts have been made to improve antibiotic use without much success, no single
intervention seems to work or have significant results, but a combination of varying interventions
is more effective. The campaign was done to reduce this was targeted at healthcare workers and
patients; the intervention focuses on educational sessions and informative resources for
professionals in the health care and patients from urban and suburban areas in Egypt (Kandeel et
al., 2019). A similar study was carried out in Germany to evaluate the determinants of practice in
antibiotic prescribing patterns. It also evaluates the impact of the complex multi-intervention
program in the hybrid approach (Poss-Doering et al., 202). The study was done on a sample of
health professionals: physicians, medical assistants, and stakeholders. A study targeted the
intervention stewardship program to ICU patients who have extensive use of antibiotics. The ICU
is an appropriate place to measure the validity of antibiotic use, as stated by Kallen et al. (2018).
Previous studies have used hospitalized non-ICU adults to implement the stewardship program,
and most have left some room for improvement.
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References
Chang, Y., Chusri, S., Sangthong, R., McNeil, E., Hu, J., Du, W., … & Tang, L. (2019). Clinical
pattern of antibiotic overuse and misuse in primary healthcare hospitals in the southwest
of China. PLoS One, 14(6), e0214779.
Kallen, M. C., Roos-Blom, M. J., Dongelmans, D. A., Schouten, J. A., Gude, W. T., de Jonge,
E., … & de Keizer, N. F. (2018). Development of actionable quality indicators and an
action implementation toolbox for appropriate antibiotic use at intensive care units: a
modified-RAND Delphi study. PLoS One, 13(11), e0207991.
Kandeel, A., Palms, D. L., Afifi, S., Kandeel, Y., Etman, A., Hicks, L. A., & Talaat, M. (2019).
An educational intervention to promote appropriate antibiotic use for acute respiratory
infections in a district in Egypt-pilot study. BMC Public Health, 19(3), 1-10.
Labi, A. K., Obeng-Nkrumah, N., Nartey, E. T., Bjerrum, S., Adu-Aryee, N. A., Ofori-Adjei, Y.
A., … & Newman, M. J. (2018). Antibiotic use in a tertiary healthcare facility in Ghana: a
point prevalence survey. Antimicrobial Resistance & Infection Control, 7(1), 1-9.
Metsini, A., Vazquez, M., Sommerstein, R., Marschall, J., Voide, C., Troillet, N., … & Zingg, W.
(2018). Point prevalence of healthcare-associated infections and antibiotic use in three
large Swiss acute-care hospitals. Swiss medical weekly, 148, w14617.
Nair, M., Tripathi, S., Mazumdar, S., Mahajan, R., Harshana, A., Pereira, A., … & Burza, S.
(2019). Knowledge, attitudes, and practices related to antibiotic use in Paschim
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Bardhaman District: a survey of healthcare providers in West Bengal, India. PLoS
One, 14(5), e0217818.
Nair, M., Tripathi, S., Mazumdar, S., Mahajan, R., Harshana, A., Pereira, A., … & Burza, S.
(2019). “Without antibiotics, I cannot treat”: A qualitative study of antibiotic use in
Paschim Bardhaman district of West Bengal, India. PLoS One, 14(6), e0219002.
Pollack, L., & Srinivasan, A. (2019). Core Elements of Hospital Antibiotic Stewardship
Programs From the Centers for Disease Control and Prevention. Clinical Infectious
Diseases, 59(suppl_3), S97-S100. https://www.cdc.gov/antibiotic-use/coreelements/hospital.html#_ENREF_1
Poss-Doering, R., Kühn, L., Kamradt, M., Stürmlinger, A., Glassen, K., Andres, E., … &
Wensing, M. (2020). Fostering appropriate antibiotic use in a complex intervention:
Mixed-methods process evaluation alongside the cluster-randomized trial
arena. Antibiotics, 9(12), 878.
Suda, K. J., Hicks, L. A., Roberts, R. M., Hunkler, R. J., Matusiak, L. M., & Schumock, G. T.
(2018). Antibiotic expenditures by medication, class, and healthcare setting in the United
States, 2010–2015. Clinical Infectious Diseases, 66(2), 185-190.

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