@article{ng_clinical_2008,
  abstract = {{BACKGROUND:} Inappropriate use of antibiotics is one of the important factors attributing to emergence of drug-resistant pathogens. Infection with multidrug-resistant pathogens adversely affects quality of medical care. {CONTEXT:} Queen Elizabeth Hospital, an 1800-bed acute service hospital in Hong Kong. Antibiotics are commonly prescribed for treating acute infections. {KEY} {MEASURES} {FOR} {IMPROVEMENT:} Reduce inappropriate prescription of broad-spectrum antibiotics and overall antibiotic prescription through implementation of a multidisciplinary antibiotics stewardship programme {(ASP).} {STRATEGIES} {FOR} {CHANGE:} A multidisciplinary programme involving policy and guideline formulation, education and feedback, monthly antibiotic consumption and cost monitoring, antimicrobial susceptibility pattern reporting and concurrent feedbacks for commonly prescribed broad-spectrum antibiotics was implemented in 2004. Predefined logistics to prescribe "restricted" antibiotics were formulated and implemented with collaborative efforts from clinical and non-clinical departments. The programme was supported by management at department and hospital levels. {EFFECTS} {OF} {CHANGE:} Broad-spectrum antibiotics were prescribed inappropriately in 28.9\% (n = 192) clinical scenarios. The {ASP} reduced the restricted and total antibiotic consumption as well as the antibiotics-related costs. Predefined clinical outcomes were not adversely affected. Economic analysis suggested that the extra human cost in running {ASP} could be offset by savings from antibiotic expenditure. {LESSONS} {LEARNED:} It is cost-effective to implement a multidisciplinary {ASP} in acute service hospitals as the programme reduces antibiotic consumption and results in overall cost savings. The quality of medical care is not jeopardized as the important clinical outcomes are not adversely affected. The generalisability and sustainability of {ASPs} in other clinical contexts warrant further studies to ensure the continuous success of this programme.},
  added-at = {2011-03-11T10:05:34.000+0100},
  author = {Ng, C K and Wu, T C and Chan, W M J and Leung, Y S W and Li, C K P and Tsang, D N C and Leung, G M},
  biburl = {https://www.bibsonomy.org/bibtex/2a6d99362efb23336bcb5c0ff9a72ec0b/jelias},
  doi = {10.1136/qshc.2007.023267},
  interhash = {6ed17f80f9bb1281a62f9ef54f989eb2},
  intrahash = {a6d99362efb23336bcb5c0ff9a72ec0b},
  issn = {1475-3901},
  journal = {Quality \& Safety in Health Care},
  keywords = {500 Aged, Agents, Bed Capacity, Care Comorbidity, Cost Evaluation, Female, Health Hong Hospital Hospitals, Humans, Implementation, Intensive Kong, Length Logistic Male, Management, Models, Patterns, Physician's Plan Practice Procedures Program Public, Risk Savings, Stay, Units, Unnecessary and of over, {Anti-Bacterial}},
  month = oct,
  note = {{PMID:} 18842981},
  number = 5,
  pages = {387--392},
  timestamp = {2011-03-11T10:06:42.000+0100},
  title = {Clinical and economic impact of an antibiotics stewardship programme in a regional hospital in Hong Kong},
  url = {http://www.ncbi.nlm.nih.gov/pubmed/18842981},
  volume = 17,
  year = 2008
}

@article{ofarrell_spinal_2000,
  abstract = {A previously healthy 25-yr-old female developed flaccid areflexic tetraplegia, with intact cranial nerve function, 36 h after the diagnosis of bacterial meningitis. Polymerase chain reaction studies of cerebrospinal fluid and blood were positive for Neisseria meningitidis, serogroup B. Magnetic resonance of the cervicothoracic spine revealed increased signal intensity and expansion in the lower medulla, upper cervical cord and cerebellar tonsils. Neurosurgical consultation recommended hyperventilation, dexamethasone and regular mannitol therapy rather than decompressive intervention. The clinical course over the following 12 days was complicated by the development of progressive central nervous and multisystem organ failure with disseminated intravascular coagulopathy. Autopsy revealed cerebral oedema with cystic infarction extending from the medulla to the upper cervical cord and cerebellar tonsils. Flaccid areflexic tetraplegia with spinal cord infarction has not been reported following bacterial infection in an adult. The clinical implications would suggest complete central nervous system evaluation of patients recovering from meningococcal meningitis, since spinal cord lesions, although uncommon, do occur. In those very rare situations where a patient develops significant peripheral neurological deficits, urgent magnetic resonance imaging is warranted, to rule out an infective focus or an underlying anatomical anomaly.},
  added-at = {2011-03-11T10:05:34.000+0100},
  author = {{O'Farrell}, R and Thornton, J and Brennan, P and Brett, F and Cunningham, A J},
  biburl = {https://www.bibsonomy.org/bibtex/2c0546b95433a0cb420058680b5a50b48/jelias},
  interhash = {6bdc105fb203ff9ae78d0fd0386c611d},
  intrahash = {c0546b95433a0cb420058680b5a50b48},
  issn = {0007-0912},
  journal = {British Journal of Anaesthesia},
  keywords = {Adult, Computed Cord Disease Fatal Female, Humans, Imaging, Ischemia, Magnetic Management, Meningitis, Meningococcal, Outcome, Quadriplegia, Resonance Spinal Tomography, {X-Ray}},
  month = apr,
  note = {{PMID:} 10823108},
  number = 4,
  pages = {514--517},
  timestamp = {2011-03-11T10:06:35.000+0100},
  title = {Spinal cord infarction and tetraplegia--rare complications of meningococcal meningitis},
  url = {http://www.ncbi.nlm.nih.gov/pubmed/10823108},
  volume = 84,
  year = 2000
}

@article{lopalco_is_2008,
  added-at = {2011-03-11T10:05:34.000+0100},
  author = {Lopalco, P L},
  biburl = {https://www.bibsonomy.org/bibtex/24abcc92299773c6ca8f8f16c37f42c6b/jelias},
  doi = {18445442},
  interhash = {4934578124cad0a8f03b4e4ad55659dc},
  intrahash = {4abcc92299773c6ca8f8f16c37f42c6b},
  issn = {1560-7917},
  journal = {Euro Surveillance: Bulletin Européen Sur Les Maladies Transmissibles = European Communicable Disease Bulletin},
  keywords = {Case Contact Disease Europe, European Humans, Infections, Management, Meningococcal Outbreaks, Population Surveillance Tracing, Union,},
  month = mar,
  note = {{PMID:} 18445442},
  number = 10,
  timestamp = {2011-03-11T10:06:31.000+0100},
  title = {Is there room for improving case management for contacts of meningococcal disease in the European Union?},
  volume = 13,
  year = 2008
}

@article{baddour_infective_2005,
  abstract = {{BACKGROUND:} Despite advances in medical, surgical, and critical care interventions, infective endocarditis remains a disease that is associated with considerable morbidity and mortality. The continuing evolution of antimicrobial resistance among common pathogens that cause infective endocarditis creates additional therapeutic issues for physicians to manage in this potentially life-threatening illness. {METHODS} {AND} {RESULTS:} This work represents the third iteration of an infective endocarditis "treatment" document developed by the American Heart Association under the auspices of the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease of the Young. It updates recommendations for diagnosis, treatment, and management of complications of infective endocarditis. A multidisciplinary committee of experts drafted this document to assist physicians in the evolving care of patients with infective endocarditis in the new millennium. This extensive document is accompanied by an executive summary that covers the key points of the diagnosis, antimicrobial therapy, and management of infective endocarditis. For the first time, an evidence-based scoring system that is used by the American College of Cardiology and the American Heart Association was applied to treatment recommendations. Tables also have been included that provide input on the use of echocardiography during diagnosis and treatment of infective endocarditis, evaluation and treatment of culture-negative endocarditis, and short-term and long-term management of patients during and after completion of antimicrobial treatment. To assist physicians who care for children, pediatric dosing was added to each treatment regimen. {CONCLUSIONS:} The recommendations outlined in this update should assist physicians in all aspects of patient care in the diagnosis, medical and surgical treatment, and follow-up of infective endocarditis, as well as management of associated complications. Clinical variability and complexity in infective endocarditis, however, dictate that these guidelines be used to support and not supplant physician-directed decisions in individual patient management.},
  added-at = {2011-03-11T10:05:34.000+0100},
  author = {Baddour, Larry M and Wilson, Walter R and Bayer, Arnold S and Fowler, Vance G and Bolger, Ann F and Levison, Matthew E and Ferrieri, Patricia and Gerber, Michael A and Tani, Lloyd Y and Gewitz, Michael H and Tong, David C and Steckelberg, James M and Baltimore, Robert S and Shulman, Stanford T and Burns, Jane C and Falace, Donald A and Newburger, Jane W and Pallasch, Thomas J and Takahashi, Masato and Taubert, Kathryn A},
  biburl = {https://www.bibsonomy.org/bibtex/2b3197b003d27b693d3c96622e5f1112a/jelias},
  doi = {10.1161/CIRCULATIONAHA.105.165564},
  interhash = {a2e1394b96f392c4caa1f8765c23296f},
  intrahash = {b3197b003d27b693d3c96622e5f1112a},
  issn = {1524-4539},
  journal = {Circulation},
  keywords = {Agents, Ambulatory American Association, Bacteria, Bacterial, Cardiovascular Care, Disease Diseases, Echocardiography, Endocarditis, Heart Humans Management, Medicine, {Anti-Infective} {Evidence-Based}},
  month = jun,
  note = {{PMID:} 15956145},
  number = 23,
  pages = {e394--434},
  shorttitle = {Infective endocarditis},
  timestamp = {2011-03-11T10:06:13.000+0100},
  title = {Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America},
  url = {http://www.ncbi.nlm.nih.gov/pubmed/15956145},
  volume = 111,
  year = 2005
}

@article{pagani_navigating_2009,
  abstract = {Bacterial resistance to antimicrobials has become a public health threat for which coordinated action at the international, national, and local level is needed. Current recommendations for the control of antimicrobial overuse and resistance in hospitals recommend various strategies, including antimicrobial stewardship programs. Several of these integrated and multidisciplinary antimicrobial management programs provide detailed information and recommendations on the Web. We performed a search of the most relevant and authoritative Web sites in English that were available without need for special registration or cost. The search excluded community-based programs, and we present only established programs or those providing expert information useful for building a hospital-based antimicrobial stewardship program. The overview of these Web sites may be useful either for institutions or individuals planning to implement such programs in their own health care institution or for educational purposes targeted at different professionals involved in improving antimicrobial practice.},
  added-at = {2011-03-11T10:05:34.000+0100},
  author = {Pagani, Leonardo and Gyssens, Inge C and Huttner, Benedikt and Nathwani, Dilip and Harbarth, Stephan},
  biburl = {https://www.bibsonomy.org/bibtex/2ebe12f71e1bb222cfbbdc22596f9edc2/jelias},
  doi = {10.1086/596762},
  interhash = {65910f8d6b9b0279c0b26ca00023bbaa},
  intrahash = {ebe12f71e1bb222cfbbdc22596f9edc2},
  issn = {1537-6591},
  journal = {Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America},
  keywords = {Agents, Bacterial Cross Guidelines Health Humans, Infection, Infections, Internet, Management, Medication Practice Resources, Therapy Topic as {Anti-Bacterial}},
  month = mar,
  note = {{PMID:} 19191651},
  number = 5,
  pages = {626--632},
  timestamp = {2011-03-11T10:06:11.000+0100},
  title = {Navigating the Web in search of resources on antimicrobial stewardship in health care institutions},
  url = {http://www.ncbi.nlm.nih.gov/pubmed/19191651},
  volume = 48,
  year = 2009
}

@article{mintzberg_musings_1996,
  abstract = {Henry Mintzberg, a professor of management at {McGill} University in Canada and at {INSEAD} in France, takes aim at the hype surrounding management fads and gurus and dares to suggest that the emperor has no clothes. In order to rile all who care about management and get them thinking creatively, he presents ten contrarian observations on such topics as the meanness of leanness, the folly of {CEOs} who fancy themselves strategists, the disempowering that so-called empowerment creates, the myopia of purely financial measures, and the inadequacy of {M.B.A.} programs. Mintzberg maintains, for example, that it is time to delayer the delayerers. He argues that delayering has created more problems than it has solved be cause it is, in essence, a process by which people who barely know what's going on get rid of those who do--a process ensuring that the real database of the organization, the key to what was its future, lines up at the unemployment office. Too many managers, he says, dream of becoming the next turnaround doctor. They fail to understand that great organizations, once created, don't need great leaders: if a company can't function on its own, a hero won't help. A leader who draws out the knowledge embedded in all parts of an organization is a leader who can help a company function alone--without heroes. Such leaders often practice what Mintzberg calls the craft style of management (as opposed to the professional style or the boss style). It is about inspiring, not empowering. It is based on mutual respect rooted in common experience and offers hope for improving what is now wrong with management.},
  added-at = {2011-03-11T10:05:34.000+0100},
  author = {Mintzberg, H},
  biburl = {https://www.bibsonomy.org/bibtex/2760eae2e1df2b1a239f97aa8d17d08dd/jelias},
  interhash = {644eddd0dff9e009a969c7ff6c5b5409},
  intrahash = {760eae2e1df2b1a239f97aa8d17d08dd},
  issn = {0017-8012},
  journal = {Harvard Business Review},
  keywords = {Administrative Decision Education, Financial Graduate, Humans, Innovation, Leadership, Making, Management, Motivation, Objectives, Organizational Organizational, Personnel Personnel, Power States United {(Psychology),}},
  month = aug,
  note = {{PMID:} 10158474},
  number = 4,
  pages = {61--67},
  timestamp = {2011-03-11T10:06:02.000+0100},
  title = {Musings on management. Ten ideas designed to rile everyone who cares about management},
  url = {http://www.ncbi.nlm.nih.gov/pubmed/10158474},
  volume = 74,
  year = 1996
}