@misc{BednorzOelschlaegerKinnemannetal., author = {Bednorz, Carmen and Oelschlaeger, Kathrin and Kinnemann, Bianca and Hartmann, Susanne and Neumann, Konrad and Pieper, Robert and Bethe, Astrid and Semmler, Torsten and Tedin, Karsten and Schierack, Peter and Wieler, Lothar H. and Guenther, Sebastian}, title = {The broader context of antibiotic resistance: zinc feed supplementation of piglets increases the proportion of multi-resistant Escherichia coli in vivo}, series = {International Journal of Medical Microbiology}, volume = {303}, journal = {International Journal of Medical Microbiology}, number = {6-7}, issn = {1618-0607}, doi = {10.1016/j.ijmm.2013.06.004}, pages = {396 -- 403}, language = {en} } @misc{BednorzGuentherOelschlaegeretal., author = {Bednorz, Carmen and Guenther, Sebastian and Oelschlaeger, Kathrin and Pieper, Robert and Hartmann, Susanne and Tedin, Karsten and Semmler, Torsten and Neumann, Konrad and Schierack, Peter and Bethe, Astrid and Wieler, Lothar H. and Kinnemann, Bianca}, title = {Feeding the Probiotic Enterococcus faecium Strain NCIMB 10415 to Piglets Specifically Reduces the Number of Escherichia coli Pathotypes That Adhere to the Gut Mucosa}, series = {Applied and Environmental Microbiology}, volume = {79}, journal = {Applied and Environmental Microbiology}, number = {24}, issn = {0099-2240}, doi = {10.1128/AEM.03138-13}, pages = {7896 -- 7904}, language = {en} } @misc{PieperPachanovBahnsetal., author = {Pieper, Dawid and Pachanov, Alexander and Bahns, Carolin and Prill, Robert and Kopkow, Christian and Shehu, Eni and Song, Yang and Amer, Yasser Sami and Stein, Airton Tetelbom and Choi, Kyung-Eun Anna}, title = {Locally adapted guidelines: a scoping review}, series = {Systematic Reviews}, volume = {14}, journal = {Systematic Reviews}, number = {1}, publisher = {Springer Science and Business Media LLC}, issn = {2046-4053}, doi = {10.1186/s13643-025-02808-0}, pages = {1 -- 9}, abstract = {Background Clinical practice guidelines (CPGs) often fail to be fully implemented in practice. One barrier to CPG implementation is inconsistency between recommendations and existing practice patterns. This can include patients, personnel, structure, availability of resources, cultural and ethical values. To account for this, it is feasible to tailor national CPGs to a regional or local context (e.g. hospital). Local ownership can be beneficial and help to implement the guideline without affecting guideline validity. This process is also known as guideline adaptation. We aimed to identify randomized controlled trials (RCTs) investigating the effectiveness of locally adapted CPGs. Methods We performed a scoping review, following the JBI guidance. The scoping review was registered with the Open Science Framework (https://osf.io/3ed2w). The intervention had to be a locally adapted guideline (locally meaning adapted to any delineated area and/or entity at subnational and/or transnational level). Co-interventions were accepted. We did not restrict the control group. As we considered locally adapted guidelines as an intervention, and it seems feasible to test locally adapted guidelines in trials, we only considered RCTs, including cluster-RCTs. PubMed and Embase were searched in November 2024. Two reviewers independently screened titles and abstracts, full-text articles, and charted data. Conflicts were resolved by involving a third reviewer. Data were summarized descriptively. The findings were discussed with knowledge users. Results Five cluster RCTs reported in 8 publications and published between 2000 and 2010, were included. The trials originated from the UK, Scotland, Australia, the US, and the Netherlands. The adapted CPGs focused on diabetes, asthma, smoking cessation, mental disorders, and menorrhagia and urinary incontinence. The number of sites (e.g. practices) ranged from 4 to 30. Reporting was mostly insufficient to understand how adaptation was performed. Interventions always included some form of dissemination, such as educational meetings or workshops. Conclusions There is a lack of RCTs investigating the effectiveness of locally adapted guidelines. A systematic review is unwarranted due to the clinical and methodological heterogeneity of these trials. The identified studies were largely conducted over 20 years ago, highlighting a significant knowledge gap. The reasons for the lack of similar studies today are unclear, which is surprising given advances in adaptation frameworks in guideline development. As the importance of contextualization is emphasized, future studies on locally adapted guidelines should be conducted with strong rationale supported by local data. Without a sound rationale, there is a risk that evidence-based, high-quality guidelines could be undermined. In future trials, authors should closely adhere to reporting guidelines. Systematic review registration https://osf.io/3ed2w.}, language = {en} } @misc{PieperBehnkeDumkeetal., author = {Pieper, Dawid and Behnke, Eva-Maria and Dumke, Rieke and Kehr-Fuckel, Christel and Radow, Carolin and Schulze, Nils and Follmann, Markus and Schaefer, Corinna and Prill, Robert and Kopkow, Christian and Bahns, Carolin and Choi, Kyung-Eun (Anna) and Fischer, Lena}, title = {Awareness of adapting clinical practice guidelines to a local context}, series = {Clinical and public health guidelines}, volume = {2}, journal = {Clinical and public health guidelines}, number = {3}, publisher = {Wiley}, address = {Hobken, New Jersey}, issn = {2836-3973}, doi = {10.1002/gin2.70025}, pages = {1 -- 7}, abstract = {Background Guideline recommendations are often not implemented in practice. This can be attributed to factors such as patient preferences and characteristics, structural conditions, personnel or other resources, as well as cultural or ethical aspects. Adaptations to the local context (e.g., regional or hospital) result in so-called locally adapted guidelines (LAGL), which could improve implementation. We aimed to assess the awareness of LAGL among guideline developers in Germany. Methods An online survey was conducted via LimeSurvey in May 2024. The questionnaire, designed based on literature and expert opinions, consisted of 23 items, predominantly with dichotomous response options. Recruitment was conducted via email. Direct contact addresses were identified using the German guideline registry (n = 397). Additionally, a mailing list distribution was conducted through the guidelines working group of the German Network for Evidence-Based Medicine (n = 316). Only fully completed questionnaires were included in the analysis. Data cleaning and descriptive analysis were performed using Excel. Results A total of 63 questionnaires were fully completed. The most represented groups were physicians (65\%) and methodologists (24\%), most frequently in coordination (76\%) or as group members (62\%). The most judicious reasons for developing a LAGL were differences in patient populations (48\%), currency of recommendations (46\%), and patient values and preferences (44\%). The most commonly cited likely reasons for developing a LAGL were economic considerations (32\%), differences in patient populations (30\%), and currency of recommendations (30\%). Many respondents (59\%) were aware of the possibility of adapting existing guidelines to the local context. Among these, approximately half (49\%) had already locally adapted a guideline, with 75\% using an adaptation framework. Discussion LAGLs are known among guideline developers in Germany and are generally developed using adaptation frameworks. Potential reasons for preparing LAGLs are diverse, with some discrepancies between perceived valid and likely reasons. Highlights Over half (59\%) of surveyed clinical practice guideline (CPG) developers in Germany were aware of the possibility of adapting CPGs to local contexts, and nearly half of them had practical experience doing so. Although several adaptation frameworks exist, only 44\% of experienced adaptors were familiar with them, and among users, many found them only partly helpful. Differences in patient populations, outdated recommendations, and patient values were rated as the most valid reasons for local CPG adaptation, while economic factors were seen as the most likely driver in practice. Despite existing awareness, guideline adaptation to local settings remains underutilized and lacks structured implementation, highlighting the need for clearer definitions, better resources, and more practical examples.}, language = {en} }