scholarly journals Proxy indicators for antibiotic consumption; surveillance needed to control antimicrobial resistance

2019 ◽  
Vol 97 (1) ◽  
pp. 3-3A ◽  
Author(s):  
Wenjing Tao ◽  
Verica Ivanovska ◽  
Birgitta Schweickert ◽  
Arno Muller
Keyword(s):  
Antimicrobial Resistance ◽  
Antibiotic Consumption ◽  
Proxy Indicators ◽  
Antibiotic Consumption Surveillance

scholarly journals Antibiotic consumption in Belgian acute care hospitals: analysis of the surveillance methodology, consumption evolution 2003 to 2016 and future perspectives

2019 ◽  
Vol 24 (46) ◽  
Author(s):  
Eline Vandael ◽  
Koen Magerman ◽  
Samuel Coenen ◽  
Herman Goossens ◽  
Boudewijn Catry
Keyword(s):  
Antimicrobial Resistance ◽  
Acute Care ◽  
Action Plan ◽  
Acute Care Hospitals ◽  
Antibiotic Consumption ◽  
Antimicrobial Consumption ◽  
Future Perspectives ◽  
Defined Daily Doses ◽  
Reported Data ◽  
Antibiotic Consumption Surveillance

Background Studies have demonstrated the link between antimicrobial consumption and the development of antimicrobial resistance. Surveillance of antimicrobial consumption is an action point of the European Commission’s ‘One Health Action Plan Against Antimicrobial Resistance’. Aim This study aims to compare two methodologies for antibiotic consumption surveillance, investigate the 14-year evolution of antibiotic consumption in Belgian acute care hospitals and discuss future perspectives. Methods We compared self-reported data (old methodology) and reimbursement data (new methodology) of national antibiotic consumption surveillance in hospitals. Descriptive analyses were performed on the reimbursement data collected per year and per trimester (2003–2016), per hospital and per unit. Antibiotic consumption was compared with European Surveillance of Antimicrobial Consumption Network (ESAC-Net) results. Results The median differences for defined daily doses (DDDs)/1,000 patient days and DDDs/1,000 admissions were 3.09% and 3.94% when comparing the old vs new methodology. Based on reimbursement data, the median antibiotic consumption in 2016 in 102 Belgian acute care hospitals was 577.1 DDDs/1,000 patient days and 3,890.3 DDDs/1,000 admissions with high variation between hospitals (interquartile ranges (IQR): 511.3–655.0 and 3,450.0–4,400.5, respectively), and similar to 2015. Based on DDDs/1,000 patient days, the magnitude of consumption is comparable with the Netherlands, Denmark and Sweden, but is higher when based on DDDs/1,000 admissions. Conclusion Antibiotic consumption in Belgian acute care hospitals has remained overall stable over time. However, the high variation across hospitals should be further investigated. This surveillance data could be used for benchmarking and assessing interventions to improve antibiotic consumption in these hospitals.

scholarly journals Informing the development of a standardised approach to measure antibiotic use in secondary care: a systematic review protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e026792
Author(s):  
Selina Patel ◽  
Arnoupe Jhass ◽  
Susan Hopkins ◽  
Laura Shallcross
Keyword(s):  
Secondary Care ◽  
Scale Up ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Antibiotic Usage ◽  
Prescribing Patterns ◽  
Primary Data ◽  
Antibiotic Prescribing ◽  
Cochrane Central Register ◽  
Antibiotic Consumption Surveillance

IntroductionEcological and individual-level evidence indicates that there is an association between level of antibiotic exposure and the emergence and spread of antibiotic resistance. The Global Point Prevalence Survey in 2015 estimated that 34.4% of hospital inpatients globally received at least one antimicrobial. Antimicrobial stewardship to optimise antibiotic use in secondary care can reduce the high risk of patients acquiring and transmitting drug-resistant infections in this setting. However, differences in the availability of data on antibiotic use in this context make it difficult to develop a consensus of how to comparably monitor antibiotic prescribing patterns across secondary care. This review will aim to document and critically evaluate methods and measures to monitor antibiotic use in secondary care.Methods and analysisWe will search Medline (Ovid), Embase (Ovid), Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials and websites of key organisations for published reports where an attempt to measure antibiotic usage among adult inpatients in high-income hospital settings has been made. Two independent reviewers will screen the studies for eligibility, extract data and assess the study quality using the Newcastle-Ottawa scale. A description of the methods and measures used in antibiotic consumption surveillance will be presented. An adaptation of the Affordability, Practicability, Effectiveness, Acceptability, Side-effects Equity framework will be used to consider the practicality of implementing different approaches to measuring antibiotic usage in secondary care settings. A descriptive comparison of definitions and estimates of (in)appropriate antibiotic usage will also be carried out.Ethics and disseminationEthical approval is not required for this study as no primary data will be collected. The results will be published in relevant peer-reviewed journals and presented at relevant conferences or meetings where possible. This review will inform future approaches to scale up antibiotic consumption surveillance strategies to attempt to maximise impact through standardisation.PROSPERO registration numberCRD42018103375

scholarly journals Preventing and managing antimicrobial resistance in the African region: A scoping review protocol

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254737
Author(s):  
Chinwe Juliana Iwu-Jaja ◽  
Anelisa Jaca ◽  
Ishmael Festus Jaja ◽  
Portia Jordan ◽  
Phelele Bhengu ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Infectious Diseases ◽  
Scoping Review ◽  
Health Care Systems ◽  
Grey Literature ◽  
Antibiotic Consumption ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
African Region ◽  
Care Systems

Introduction Antimicrobial resistance (AMR) constitutes a significant threat to global health and food security, typically associated with high morbidity and mortality rate. The high burden of infectious diseases coupled with the weak health systems in most countries of Africa magnifies the risk of increasing AMR and its consequences thereof. This scoping review will be aimed at mapping the evidence on interventions used to prevent and manage antimicrobial resistance in Africa, guided by the “One Health” concept. Methods We will consider interventions targeting multiple sectors such as health care systems, the agricultural and veterinary sectors. The outcomes to be considered include reduction of AMR decreased morbidity and mortality due to infectious diseases, increased awareness for rational use of antimicrobials and reduced antibiotic consumption. We will include all types of studies regardless of study designs conducted within the context of the WHO African region. Studies will be excluded if they are not conducted in Africa and if they are literature reviews, only describing the concept of AMR without mentioning interventions. We will include studies identified through a comprehensive search of peer-reviewed and grey literature databases. In addition, we will search the reference lists of included studies and relevant reviews. Finally, we plan to do a citation search for included studies. Findings of this review will be narratively synthesized.

Evaluating consumption and expenditure patterns of antibiotics in tablet and capsule dosage forms: Pakistan Antibiotic Consumption Surveillance (PACS)

2020 ◽  
Vol 50 (1) ◽  
pp. 36-41
Author(s):  
Zikria Saleem ◽  
Mohamed Azmi Hassali ◽  
Furqan Khurshid Hashmi ◽  
Shama Qaisar ◽  
Mahnoor Ahmad ◽  
...  
Keyword(s):  
Antibiotic Consumption ◽  
Dosage Forms ◽  
Expenditure Patterns ◽  
Antibiotic Consumption Surveillance

scholarly journals Evaluating antimicrobial appropriateness in a tertiary care pediatric ICU in Saudi Arabia: a retrospective cohort study

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Yasser M. Kazzaz ◽  
Haneen AlTurki ◽  
Lama Aleisa ◽  
Bashaer Alahmadi ◽  
Nora Alfattoh ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Cohort Study ◽  
Intensive Care ◽  
Antimicrobial Resistance ◽  
Retrospective Cohort ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Antibiotic Utilization ◽  
Antibiotic Courses

Abstract Background Inappropriate antibiotic utilization is associated with the emergence of antimicrobial resistance (AMR) and a decline in antibiotic susceptibility in many pathogenic organisms isolated in intensive care units. Antibiotic stewardship programs (ASPs) have been recommended as a strategy to reduce and delay the impact of AMR. A crucial step in ASPs is understanding antibiotic utilization practices and quantifying the problem of inappropriate antibiotic use to support a targeted solution. We aim to characterize antibiotic utilization and determine the appropriateness of antibiotic prescription in a tertiary care pediatric intensive care unit. Methods A retrospective cohort study was conducted at King Abdullah Specialized Children’s Hospital, Riyadh, Saudi Arabia, over a 6-month period. Days of therapy (DOT) and DOT per 1000 patient-days were used as measures of antibiotic consumption. The appropriateness of antibiotic use was assessed by two independent pediatric infectious disease physicians based on the Centers for Disease Control and Prevention 12-step Campaign to prevent antimicrobial resistance among hospitalized children. Results During the study period, 497 patients were admitted to the PICU, accounting for 3009 patient-days. A total of 274 antibiotic courses were administered over 2553 antibiotic days. Forty-eight percent of antibiotic courses were found to be nonadherent to at least 1 CDC step. The top reasons were inappropriate antibiotic choice (empirical or definitive) and inappropriate prophylaxis durations. Cefazolin and vancomycin contributed to the highest percentage of inappropriate DOTs. Conclusions Antibiotic consumption was high with significant inappropriate utilization. These data could inform decision-making in antimicrobial stewardship programs and strategies. The CDC steps provide a more objective tool and limit biases when assessing antibiotic appropriateness

scholarly journals Antimicrobial Resistance in Respiratory Tract Streptococcus pneumoniae Isolates: Results of the Canadian Respiratory Organism Susceptibility Study, 1997 to 2002

2003 ◽  
Vol 47 (6) ◽  
pp. 1867-1874 ◽  
Author(s):  
George G. Zhanel ◽  
Lorraine Palatnick ◽  
Kimberly A. Nichol ◽  
Tracy Bellyou ◽  
Don E. Low ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Antimicrobial Resistance ◽  
Antibiotic Consumption ◽  
Multidrug Resistant ◽  
Medical Centers ◽  
Intermediate Resistance ◽  
Susceptibility Study ◽  
Resistant Strains ◽  
Canadian Provinces ◽  
High Level

ABSTRACT A total of 6,991 unique patient isolates of Streptococcus pneumoniae were collected from October 1997 to June 2002 from 25 medical centers in 9 of the 10 Canadian provinces. Among these isolates, 20.2% were penicillin nonsusceptible, with 14.6% being penicillin intermediate (MIC, 0.12 to 1 μg/ml) and 5.6% being penicillin resistant (MIC, ≥2 μg/ml). The proportion of high-level penicillin-resistant S. pneumoniae isolates increased from 2.4 to 13.8% over the last 3 years of the study, and the proportion of multidrug-resistant S. pneumoniae isolates increased from 2.7 to 8.8% over the 5-year period. Resistant rates (intermediate and resistant) among non-β-lactam agents were as follows: macrolides, 9.6 to 9.9%; clindamycin, 3.8%; doxycycline, 5.5%; chloramphenicol, 3.9%; and trimethoprim-sulfamethoxazole, 19.0%. Rates of resistance to non-β-lactam agents were higher among penicillin-resistant strains than among penicillin-susceptible strains. No resistance to vancomycin or linezolid was observed; however, 0.1% intermediate resistance to quinupristin-dalfopristin was observed. The rate of macrolide resistance (intermediate and resistant) increased from 7.9 to 11.1% over the 5 years. For the fluoroquinolones, the order of activity based on the MICs at which 50% of isolates are inhibited (MIC50s) and the MIC90s was gemifloxacin > clinafloxacin > trovafloxacin > moxifloxacin > grepafloxacin > gatifloxacin > levofloxacin > ciprofloxacin. The investigational compounds ABT-773 (MIC90, 0.008 μg/ml), ABT-492 (MIC90, 0.015 μg/ml), GAR-936 (tigecycline; MIC90, 0.06 μg/ml), and BMS284756 (garenoxacin; MIC90, 0.06 μg/ml) displayed excellent activities. Despite decreases in the rates of antibiotic consumption in Canada over the 5-year period, the rates of both high-level penicillin-resistant and multidrug-resistant S. pneumoniae isolates are increasing in Canada.

scholarly journals Antimicrobial resistance: the next BIG pandemic

2017 ◽  
Vol 4 (8) ◽  
pp. 2632 ◽  
Author(s):  
Divya Chaudhry ◽  
Priyanka Tomar
Keyword(s):  
Antimicrobial Resistance ◽  
Global Health ◽  
Health Systems ◽  
Premature Mortality ◽  
Antibiotic Consumption ◽  
Modern Medicine ◽  
Human History ◽  
Mortality And Morbidity ◽  
Health Community ◽  
The World

Pandemics have indefinitely threatened the resilience of health systems worldwide. Based on the costs inflicted by some of the deadliest pandemics in human history, economists have projected that global pandemics could cost over USD 6 trillion and generate an annual estimated loss of over USD 60 billion. While the global health community is tirelessly trying to curb the burden of premature mortality from several old and new forms of pathogens, it is now faced with the silently emerging antimicrobial resistance (AMR) pandemic that could endanger some of the most significant advances in modern medicine. Owing to rampant antibiotic consumption in India, the article shows why the country may become the ‘AMR capital of the world’. It shows how health systems may be strengthened both at the national and international levels to reduce premature mortality and morbidity attributable to AMR and pandemics. 

scholarly journals Overview of three-year trends of antimicrobial consumption and resistance in Sicilian hospitals

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Barchitta ◽  
A Quattrocchi ◽  
A Maugeri ◽  
M C La Rosa ◽  
C La Mastra ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Antimicrobial Resistance ◽  
Surveillance System ◽  
Action Plan ◽  
Antibiotic Consumption ◽  
Defined Daily Dose ◽  
Antimicrobial Consumption ◽  
Antimicrobial Susceptibility Tests ◽  
Susceptibility Tests ◽  
Resistance Rates

Abstract Background Antimicrobial resistance (AMR) is one of the ten threats identified by the WHO in 2019. In order to face this issue and in the framework of the National Action Plan on Antimicrobial Resistance (PNCAR) 2017-2020, the Sicilian Health Authority has implemented a surveillance system of antibiotic consumption in the hospital sector and in the community and of antibiotic resistance in the Sicilian hospitals. The aim of the present work is to report the results of three-year surveillance. Methods From 2015 to 2017, data on antibiotic consumption have been collected from pharmacies of participating hospitals. AMR data on seven bacterial pathogens isolated in blood and cerebrospinal fluid have been collected from hospital laboratories, using routine clinical antimicrobial susceptibility tests. Antibiotic consumption was expressed as Defined Daily Dose (DDD) per 100 patient-days. Antibiotic resistance rates (RRs) were calculated as the number of non-susceptible isolates divided by the total number of isolates multiplied by 100. Results The most commonly consumed antibiotics in participating hospitals were fluoroquinolones in 2015, penicillins in 2016, and beta-lactams in 2017, respectively. RRs of Klebsiella pneumoniae significantly increased for all antimicrobial classes (p < 0.001), but carbapenems. By contrast, RRs of Escherichia coli resistant to third-generation cephalosporins and carbapenems showed significant decreasing trends (p < 0.001). Conclusions The implementation of the Sicilian surveillance system provides Sicilian reference data to monitor trends and target interventions and policies for reducing the threat of AMR. Recently, using toolkits of the ECDC-EAAD initiative adapted with regional surveillance data, an educational campaign “Obiettivo Antibiotico” - https://www.obiettivoantibiotico.it/ - was designed and launched to raise awareness of prudent use of antibiotics in the general public and in healthcare professionals in Sicily. Key messages Inappropriate antimicrobial consumption observed in Sicilian hospitals contributes to the emergence and selection of AMR. Surveillance system of antimicrobial consumption and AMR can help identify strategies for preventing spread of multi-drug resistant microorganisms.

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