A Crucial Role for Antimicrobial Stewardship in the Midst of COVID-19

Mayi, Bindu; Mainville, Manda; Altaf, Rida; Lanspa, Michelle; Vaniawala, Sheel; Ollerhead, Thomas A.; Raja, Aarti

doi:10.1128/jmbe.v22i1.2285

Cited by 9 publications

(8 citation statements)

References 27 publications

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“…In the event its continued use is warranted, switch to oral therapy early and give short cycles of five days [ 26 ]. It is important to educate healthcare providers in antimicrobial stewardship to prevent the consequences of excessive antimicrobial use such as toxicities, selection for opportunistic pathogens such as Clostridioides difficile (coinfection with SARS-CoV-2 results in a worsening of outcomes) and antimicrobial resistance [ 74 , 75 ].…”

Section: Discussionmentioning

confidence: 99%

Inadequate use of antibiotics in the covid-19 era: effectiveness of antibiotic therapy

et al. 2021

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Background Since December 2019, the COVID-19 pandemic has changed the concept of medicine. This work aims to analyze the use of antibiotics in patients admitted to the hospital due to SARS-CoV-2 infection. Methods This work analyzes the use and effectiveness of antibiotics in hospitalized patients with COVID-19 based on data from the SEMI-COVID-19 registry, an initiative to generate knowledge about this disease using data from electronic medical records. Our primary endpoint was all-cause in-hospital mortality according to antibiotic use. The secondary endpoint was the effect of macrolides on mortality. Results Of 13,932 patients, antibiotics were used in 12,238. The overall death rate was 20.7% and higher among those taking antibiotics (87.8%). Higher mortality was observed with use of all antibiotics (OR 1.40, 95% CI 1.21–1.62; p < .001) except macrolides, which had a higher survival rate (OR 0.70, 95% CI 0.64–0.76; p < .001). The decision to start antibiotics was influenced by presence of increased inflammatory markers and any kind of infiltrate on an x-ray. Patients receiving antibiotics required respiratory support and were transferred to intensive care units more often. Conclusions Bacterial co-infection was uncommon among COVID-19 patients, yet use of antibiotics was high. There is insufficient evidence to support widespread use of empiric antibiotics in these patients. Most may not require empiric treatment and if they do, there is promising evidence regarding azithromycin as a potential COVID-19 treatment.

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Section: Discussionmentioning

confidence: 99%

Inadequate use of antibiotics in the covid-19 era: effectiveness of antibiotic therapy

et al. 2021

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“…ASPs actively monitor patients, identify emerging outbreaks with antibiotic-resistant pathogens, and tailor appropriate antibiotic therapy based on data. 92 They work with clinicians to provide ongoing review of the appropriateness of antibiotics and can weigh the potential harms such as C. difficile infection in the patient and promotion of antibiotic resistance. ASPs provide education and training throughout the institution.…”

Section: Discussionmentioning

confidence: 99%

SHEA statement on antibiotic stewardship in hospitals during public health emergencies

Barlam

Mohajer

Al‐Tawfiq

et al. 2022

Infect. Control Hosp. Epidemiol.

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“…The research shows that awareness in the area of antimicrobial resistance is variable in students of health- (including medicine, pharmacy and veterinary science) and non-health-related majors [ 42 ]. Therefore, there is a pressing need to implement curricula and activities: this educational trajectory should start from pupils in secondary (or high) school, and extend to those studying for bachelor and higher degrees [ 14 ]. We acknowledge that the proposed educational activities are far from the ideal experiments (e.g., the proposed activities do not have equivalent teachers and learner groups, neither do pure control groups exist) and the levels of confidence in the interventions are limited, but the activities can be easily implemented to mitigate the threat of antimicrobial resistance via the One-Health approach.…”

Section: Discussionmentioning

confidence: 99%

“…For example, medical students should be better informed on the mechanisms of microbial evolution to foster an appreciation and awareness of antibiotic resistant development as a result of unnecessary antibiotic prescriptions [ 13 ]. Every medical student, during their professional practice, should aim to resolve the patient’s infection while minimizing the development of antimicrobial resistance [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

“…Education has an important role within antimicrobial stewardship and the One-Health approach. It is clear that education for all type of pupils and students would ultimately lead to either well-informed adults that can appreciate the risk of increased antibiotic resistance and raise concerns about the over-prescription of antibiotics by medical practitioners, or health professionals to limit such practices [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Educational Activities for Students and Citizens Supporting the One-Health Approach on Antimicrobial Resistance

et al. 2021

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Antibiotic resistance is one of the biggest threats to global health, food security and development. Urgent action is needed at all levels of society to reduce the impact and spread of antibiotic resistance. For a more sustaining approach, education in children, college students, citizens and caregivers are essential. The One-Heath approach is a collaborative, multisectoral and transdisciplinary strategy in which, no single organizations or sector can address the issue of antimicrobial resistance at the human–environment interface alone. Within this strategy, education plays a central role. In this scoping review, we highlighted a range of learning activities on antibiotic resistance as part of the One-Health approach. In particular, those applications that can be introduced to a wide audience to help arrest the current crisis for the next generation. The review identifies a high number of teaching opportunities: board and role-play games, round tables, musicals, e-learning and environmental experiments to couple with more curricula and formal education to inform a diverse group of audiences.

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A Crucial Role for Antimicrobial Stewardship in the Midst of COVID-19

Abstract: As the world deals with a pandemic, there remains another global challenge that cannot be ignored. Use of broad-spectrum antibiotics may be justified, as we are trying to treat a novel disease condition, which, in turn, could lead to an increase in antimicrobial resistance.

Cited by 9 publications

References 27 publications

Inadequate use of antibiotics in the covid-19 era: effectiveness of antibiotic therapy

Inadequate use of antibiotics in the covid-19 era: effectiveness of antibiotic therapy

SHEA statement on antibiotic stewardship in hospitals during public health emergencies

Educational Activities for Students and Citizens Supporting the One-Health Approach on Antimicrobial Resistance

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