Antimicrobial ethicists: Making ethics explicit in antimicrobial stewardship

Yen, Christina; Cutrell, James B

doi:10.1017/ash.2021.181

Cited by 7 publications

(4 citation statements)

References 22 publications

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“…The principlist medical ethics approach popularized by Beauchamp and Childress, with its reliance on 4 ethical principles-respect for autonomy, nonmaleficence, beneficence, and justice-has recently been applied specifically to the field of antimicrobial stewardship and can offer assistance in resolving major ethical dilemmas. 22 However, we propose that the complex interplay of clinical decision making, interprofessional communication, and multifaceted motivations at play in daily stewardship activities are best addressed through one of the most ancient ethical frameworks: virtue ethics.…”

Section: Stewardship Interprofessional Interactionsmentioning

confidence: 99%

How Should Clinicians Navigate Interprofessional Tension in Their Roles as Antimicrobial Stewards?

2024

AMA Journal of Ethics

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Pharmacists and physicians play key roles in antimicrobial stewardship. This commentary on a case describes these health professionals' need to collaborate to optimize therapeutic use of antimicrobials in clinical settings. Prescription preauthorization is one antimicrobial stewardship strategy that can meet with some physicians' frustration and generate conflict between pharmacists and prescribing physicians, particularly when pharmacists make alternative treatment recommendations. This commentary considers interprofessional tension concerning prescription preauthorization and suggests strategies for navigating such conflict.

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Section: Stewardship Interprofessional Interactionsmentioning

confidence: 99%

How Should Clinicians Navigate Interprofessional Tension in Their Roles as Antimicrobial Stewards?

2024

AMA Journal of Ethics

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“…This is a significant public health concern because of the increasing burden of AMR, and the paucity of drugs in the research pipeline for newer antimicrobials [1]. Antimicrobials are the only class of drug whose population-level efficacy is reduced with excessive and inappropriate use over time [2]. It is estimated that by 2050, drug-resistant infections will lead to 10 million deaths annually, resulting in an overall loss of US $100 trillion [3].…”

Section: Introductionmentioning

confidence: 99%

Antimicrobial stewardship in low- and middle-income countries: Developing a broader perspective through an ethical analysis

Sinha,

Dayama

2024

IJME

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The increase in the number of cases of antimicrobial resistance has gained attention worldwide. The main drivers of this situation are the misuse and overuse of antimicrobials for human and animal health. The imbalance between ensuring appropriate use of antimicrobials and providing equal access in the community makes this an ethical issue. The antimicrobial stewardship programme was initiated in response to this global crisis. Its framework includes interventions targeting the optimisation of antimicrobials in hospitals. Various countries have adopted stewardship interventions, and many success stories have been published. However, the steering of this programme faces hurdles due to the complexity that surrounds decision making in antimicrobial prescription, and the challenges of health systems in lower and middle income countries like India. Addressing these issues will extend the reach of these programmes, increase their sustainability and promote health-related justice to the community.

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“…However, empirical use of broad-spectrum antibiotics has been associated with increased mortality and the development of antibiotic resistance [ 11 ]. The selective pressure of the unsupervised use of antibiotics has already driven bacteria to develop resistant genes against antibiotics [ 12 ]. The rise of antibiotic resistance is notably one of the biggest threats of the 21st century leading to therapeutic failure in the field of infectious diseases [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Recent Advances in Monoclonal Antibody-Based Approaches in the Management of Bacterial Sepsis

2023

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Sepsis is a life-threatening condition characterized by an uncontrolled inflammatory response to an infectious agent and its antigens. Immune cell activation against the antigens causes severe distress that mediates a strong inflammatory response in vital organs. Sepsis is responsible for a high rate of morbidity and mortality in immunosuppressed patients. Monoclonal antibody (mAb)-based therapeutic strategies are now being explored as a viable therapy option for severe sepsis and septic shock. Monoclonal antibodies may provide benefits through two major strategies: (a) monoclonal antibodies targeting the pathogen and its components, and (b) mAbs targeting inflammatory signaling may directly suppress the production of inflammatory mediators. The major focus of mAb therapies has been bacterial endotoxin (lipopolysaccharide), although other surface antigens are also being investigated for mAb therapy. Several promising candidates for mAbs are undergoing clinical trials at present. Despite several failures and the investigation of novel targets, mAb therapy provides a glimmer of hope for the treatment of severe bacterial sepsis and septic shock. In this review, mAb candidates, their efficacy against controlling infection, with special emphasis on potential roadblocks, and prospects are discussed.

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Antimicrobial ethicists: Making ethics explicit in antimicrobial stewardship

Cited by 7 publications

References 22 publications

How Should Clinicians Navigate Interprofessional Tension in Their Roles as Antimicrobial Stewards?

How Should Clinicians Navigate Interprofessional Tension in Their Roles as Antimicrobial Stewards?

Antimicrobial stewardship in low- and middle-income countries: Developing a broader perspective through an ethical analysis

Recent Advances in Monoclonal Antibody-Based Approaches in the Management of Bacterial Sepsis

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