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Stewardship / Resistance Scan for November 16, 2018

Australian data reveals one third of emergency response antibiotics not needed A study in Australia has shown that one third…

Australian data reveals one third of emergency response antibiotics not needed

A study in Australia has shown that one third of the antibiotic treatment in an emergency department (ED) was considered inappropriate, according to a study yesterday in Journal of Antimicrobial Chemotherapy .

Researchers at the Gold Coast University Hospital assessed 1,019 patient presentations that meant an antibiotic description in ED for 4 separate weeks in 2016, each in February, May, August and November. 19659003] They determined that 640 antibiotic prescripts (62.8%) were appropriate, 333 (32.7%) were inappropriate and 46 (4.5%) were not judicious. Adults were more likely to receive an inappropriate antibiotic treatment than children (36.9% vs. 22.9%). Patients likely to have sepsis-related organ failure were also more prone to prescribing incorrect antibiotics (56.7% versus 36.1

%).

The researchers found no difference in inappropriate prescribing rates in ED based on patient sex, status of hospitalization, cause of antibiotic treatment (treatment against prophylaxis) or shift time (day to night).

The authors concluded that “with more than one of three antibiotic prescriptions in ED considered inappropriate, there is a pressure needing to develop initiatives to improve the antibiotic description to prevent antibiotic-related patient and social injuries.”
Nov 15 J Antimicrobial Chemother study

China Hospital Shrinks Antibiotics Significantly After Leadership Initiation

A survey in China reports that the use of antibiotics after initiating an antimicrobial stewardship program is cut by almost two thirds and the amount of methicillin-the latter Staphylococcus aureus (MRSA) fell dramatically according to a study today in Epidemiology & Infection .

Researchers examined the trends and correlations between antibiotic consumption and resistance at S aureus at a tertiary hospital at Jiaotong University in northwestern China from 2010 to 2016. They found that the use of antibiotics dropped from 951.9 to 346, 5 defined daily doses per 1,000 patient days, a decrease of 63.6%. The decrease was statistically significant for several antibiotic classes, including cephalosporins, monobactams, aminoglycosides, imidazole derivatives and macrolides.

The presence of MRSA among S aureus isolates decreased from 73.3% in 2010 to 41.4% in 2017, and the decrease was significantly correlated with lower consumption of several classes of antibiotics. The authors note that since the end of the study, resistance levels for S aureus have been significantly lower and MRSA rates have fallen even further.
16 November Epidemiol Infect study

[10659009]

A decade study shows high antibiotic consumption in Poland

A 10-year study of antibiotic consumption in Poland published yesterday in Antimicrobial resistance and infection control ] discovered a high level of drug use compared with other Europe and consumption has increased by 8% since 2007.

Study investigators used data from the monitoring network for healthcare related infections within the European Center for Disease Prevention and Control in combination with a literature review. They estimated consumption in daily doses per 1,000 inhabitants per day.

They found that antibiotic use across the country increased from 22.2 DID 2007 to 23.9 in 2016, an increase of 8.3%, however, from a maximum of 26.2 years in 2015. It is compared with a low of 10 DID in the Netherlands and a high of 36 DID in Greece, according to ECDC data. The figure places Poland as the 19th highest rate of consumption among 23 European nations.

The report also shows that the frequency of antibiotic description in broad spectrum is also high, at 25.8% of total antibiotics that place Poland in 16 of the 23 countries. However, the degree of broad spectrum writing falls in Poland.

The authors say that although the high rate of antibiotic treatment does not match antibiotic resistance, the increase is 8% much lower than globally 36% increased worldwide over the past decade.

The authors conclude that “Because the limited education activities of doctors and dentists can play an important role in current antibiotic consumption patterns, actions focusing on appropriate pre-and post-antibiotic description are integrated. Nov 15 Antimicrob Resist Infect Control study

Swiss researchers report 7000 AMR cases, nearly 300 AMR deaths a year

Swiss researchers estimate that antibiotic resistant bacteria in the country cause more than 7000 diseases and almost 300 deaths per year, according to a letter in The Lancet’s Disease Diseases .

To duplicate a study with ECDC data 2015 for EU nations, researchers applied the same method for data from ECDC and the Swiss Antibiotics Assistance Center for same year.

They estimated that 7 156 cases of infections with antibiotic resistant bacteria in hit, 2015, of which 276 deaths and 7400 disabled lives (DALY) were lost. This corresponds to 85.0 cases, 3.3 deaths and 87.8 DALY per 100,000 people. The majority of the infections were caused by third-generation cephalosporin resistant Escherichia coli and Klebsiella pneumoniae .
Nov 15 Lancet Infect Dis letter [19659000]]
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