Antibiotics and adverse events: the role of antimicrobial stewardship programs in ‘doing no harm’

Purpose of review Antimicrobial resistance (AMR) is a global threat worldwide, with deaths associated with AMR infections projected to exceed 10 million per year by the year 2050. The overuse and misuse of antibiotics is the primary driver of this resistance, with up to 50% of antibiotics prescribed in the hospital setting being either unnecessary or inappropriate. Antimicrobial stewardship (AMS) programs (ASPs) can mitigate some of this resistance, with the benefits well recognized; however, if we are to truly advance the state of AMS, the principles and practices should align with patient safety. Recent findings In a recent evaluation, among 1488 adult patients receiving systemic antibiotic therapy, 298 (20%) experienced at least one antibiotic-associated adverse drug event (ADE). Fifty-six (20%) nonclinically indicated antibiotic regimens were associated with an ADE. It is also well recognized that besides ADEs, the inappropriate use of antibiotics is associated the development of multidrug-resistant infections and Clostridium difficile infection. Summary Currently, there is a significant gap in ASPs correlating initiatives with patient safety goals, including reductions in antibiotic-associated ADEs and multidrug-resistant infections. Therefore, in this article, we provide the rationale for why ASPs are best suited to lead a collaborative effort to prevent antibiotic-associated ADEs and multidrug-resistant infections.
Source: Current Opinion in Infectious Diseases - Category: Infectious Diseases Tags: ANTIMICROBIAL AGENTS: BACTERIAL/FUNGAL: Edited by Monica Slavin Source Type: research

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ConclusionThis is the first report of the isolation of C. difficile from different governmental hospitals of Iran and indicates that CDI might be an important nosocomial infection in different hospital wards. Moreover, this study provides a comprehensive picture of the MDR phenotype characteristics of C. difficile isolates in Iran.
Source: Journal of Global Antimicrobial Resistance - Category: Infectious Diseases Source Type: research
Abstract PCR ribotyping and antimicrobial susceptibility testing were used to characterize 940 Clostridioides (Clostridium) difficile isolates collected from 26 U.S. hospitals over three time periods from 2011 to 2017. The proportion of ribotype (RT) 027 isolated during the three surveys decreased significantly over time from 31% in 2011-2012, to 22% in 2013-2014, and to 14% in 2015-2017 (p
Source: Anaerobe - Category: Microbiology Authors: Tags: Anaerobe Source Type: research
Conclusion: Some Lactobacillus strains exhibit anti-CRE activity, which suggests potential applications for controlling or preventing CRE colonization or infection. Introduction Although Enterobacteriaceae are normal flora of the human intestinal system, they are also common pathogens causing human infections in the setting of both community-acquired and healthcare-associated infections (Hsueh et al., 2010; Toh et al., 2012; Lai et al., 2014; Jean et al., 2016). In this era of widespread antibiotic resistance, Enterobacteriaceae are no exception. Recently, the emergence of carbapenem-resistant Enterobacteriaceae (C...
Source: Frontiers in Microbiology - Category: Microbiology Source Type: research
In conclusion, we demonstrated that the selective boosting of lung innate immunity is a conceptually advantageous approach for improving the effectiveness of antibiotic treatment and fighting antibiotic-resistant bacteria. Introduction Pneumonia constitutes a major cause of death, morbidity and health resource use worldwide. The main causative agents identified in adult patients hospitalized for community-acquired pneumonia (CAP) are viruses (in 27–30% of cases, the most common being rhinovirus, influenza and coronavirus) and bacteria (14–23% of cases, with a marked predominance of Streptococcus pneumonia...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
ConclusionsThe genome sequence of B. cereus S66 provides a valuable reference to further research on multidrug resistance characteristics and pathogenic system analysis of Bacillus sp. in the clinic.
Source: Journal of Global Antimicrobial Resistance - Category: Infectious Diseases Source Type: research
ConclusionsIn this report, the genome sequences ofB. cereus S66 provide a valuable reference to further research on multidrug resistance characteristics and pathogenic system analysis of Bacillus sp. in medicine.
Source: Journal of Global Antimicrobial Resistance - Category: Infectious Diseases Source Type: research
ConclusionsThis is the first report of the isolation of C. difficile from different governmental hospitals of Iran and indicates that CDI might be an important nosocomial infection in different hospital wards. Moreover, this study provides a good comprehensive picture of the MDR phenotype characteristics of C. difficile isolates in Iran.
Source: Journal of Global Antimicrobial Resistance - Category: Infectious Diseases Source Type: research
Posters: Misuse of antibiotics and risks. Credit: WHOBy Baher KamalROME, Oct 4 2017 (IPS)The world is running out of new antibiotics to combat the growing threat of antimicrobial resistance, a new specialised report warns ahead of this year’s World Antibiotic Awareness Week, adding that most of the drugs currently in the clinical pipeline are modifications of existing classes of antibiotics and are only short-term solutions. The latest World Health Organization (WHO) report on this issue “Antibacterial agents in clinical development – an analysis of the antibacterial clinical development pipeline, includi...
Source: IPS Inter Press Service - Health - Category: International Medicine & Public Health Authors: Tags: Featured Global Headlines Health Human Rights TerraViva United Nations Source Type: news
Conclusion Newer tools capable of informing these early decisions are under development, but integrating an awareness of AMR into both hospital and GP practice is a key component of winning the fight against superbugs. Throughout the development process, discussion between clinicians and researchers will ensure that diagnostic tools are effective, and also meet the needs of frontline staff. In the mean-time, cultivating an AMR aware mind-set is the best defence against over-prescription. Understanding and accepting the systematic, ubiquitous biases which affect our judgement of risk is particularly helpful. For example, do...
Source: Life in the Fast Lane - Category: Emergency Medicine Authors: Tags: Clinical Research Microbiology AMR Antimicrobial resistance ESBL MROs multi-resistant organisms multidrug resistant organisms (MROs) Source Type: blogs
Conclusions: Twitter engaged surgeons in ID and antimicrobial stewardship topics and provided real-time education around antimicrobial resistance. Future studies should evaluate whether engagement and education via tweets impact actual antimicrobial use and the rates of antimicrobial resistance.
Source: Infectious Diseases in Clinical Practice - Category: Infectious Diseases Tags: Invited Original Articles Source Type: research
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