Antimicrobial resistance: a threat to global health

Jee, Youngmee; Carlson, Johan E.; Rafai, Eric; Musonda, Kunda; Huong, Tran Thi Giang; Daza, Paula; Sattayawuthipong, Wanchai; Yoon, Tae-Ho

doi:10.1016/s1473-3099(18)30471-7

Cited by 89 publications

(58 citation statements)

References 5 publications

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“…Increasing emergence of multi-drug resistant pathogens is considered to be one of the most urgent threats to global health and is directly linked to antibiotic overuse [1]. Patients presenting with symptoms of acute respiratory tract illnesses and systemic inflammatory response syndrome (SIRS) or suspected sepsis are often prescribed antibiotics by default, although more than 40% of respiratory infections are due to viruses [2,3].…”

Section: Introductionmentioning

confidence: 99%

Procalcitonin (PCT)-guided antibiotic stewardship: an international experts consensus on optimized clinical use

Шуц¹,

Beishuizen²,

Бройлс³

et al. 2019

Lab. sluzh.

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Background: Procalcitonin (PCT)-guided antibiotic stewardship (ABS) has been shown to reduce antibiotics (ABxs), with lower side-effects and an improvement in clinical outcomes. The aim of this experts workshop was to derive a PCT algorithm ABS for easier implementation into clinical routine across different clinical settings. Methods: Clinical evidence and practical experience with PCT-guided ABS was analyzed and discussed, with a focus on optimal PCT use in the clinical context and increased adherence to PCT protocols. Using a Delphi process, the experts group reached consensus on different PCT algorithms based on clinical severity of the patient and probability of bacterial infection. Results: The group agreed that there is strong evidence that PCT-guided ABS supports individual decisions on initiation and duration of ABx treatment in patients with acute respiratory infections and sepsis from any source, thereby reducing overall ABx exposure and associated side effects, and improving clinical outcomes. To simplify practical application, the expert group refined the established PCT algorithms by incorporating severity of illness and probability of bacterial infection and reducing the

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Section: Introductionmentioning

confidence: 99%

Procalcitonin (PCT)-guided antibiotic stewardship: an international experts consensus on optimized clinical use

Шуц¹,

Beishuizen²,

Бройлс³

et al. 2019

Lab. sluzh.

View full text Add to dashboard Cite

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“…Recently, it has been recognized that one of the biggest risks to human health comes in the form of antibioticresistant bacteria. Increasing emergence of multidrugresistant pathogens is considered to be one of the most urgent threats to global health [35,36]. This is particularly true for Asia-Pacific countries where antibiotic overuse has been a major problem, with multidrug-resistant pathogens on the rise [31,37].…”

Section: Discussionmentioning

confidence: 99%

Procalcitonin (PCT)-guided antibiotic stewardship in Asia-Pacific countries: adaptation based on an expert consensus meeting

Lee

Kwa

Apisarnthanarak

et al. 2020

Clinical Chemistry and Laboratory Medicine (CCLM)

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IntroductionRecently, an expert consensus on optimal use of procalcitonin (PCT)-guided antibiotic stewardship was published focusing mainly on Europe and the United States. However, for Asia-Pacific countries, recommendations may need adaptation due to differences in types of infections, available resources and standard of clinical care.MethodsPractical experience with PCT-guided antibiotic stewardship was discussed among experts from different countries, reflecting on the applicability of the proposed Berlin consensus algorithms for Asia-Pacific. Using a Delphi process, the group reached consensus on two PCT algorithms for the critically ill and the non-critically ill patient populations.ResultsThe group agreed that the existing evidence for PCT-guided antibiotic stewardship in patients with acute respiratory infections and sepsis is generally valid also for Asia-Pacific countries, in regard to proposed PCT cut-offs, emphasis on diagnosis, prognosis and antibiotic stewardship, overruling criteria and inevitable adaptations to clinical settings. However, the group noted an insufficient database on patients with tropical diseases currently limiting the clinical utility in these patients. Also, due to lower resource availabilities, biomarker levels may be measured less frequently and only when changes in treatment are highly likely.ConclusionsUse of PCT to guide antibiotic stewardship in conjunction with continuous education and regular feedback to all stakeholders has high potential to improve the utilization of antibiotic treatment also in Asia-Pacific countries. However, there is need for adaptations of existing algorithms due to differences in types of infections and routine clinical care. Further research is needed to understand the optimal use of PCT in patients with tropical diseases.

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“…5 In addition, the increasingly complex mechanisms of bacterial resistance, such as bacterial biofilm formation, present greater resistance to antibacterial agents and have been a serious threat to worldwide ocular health. [6][7][8][9] Therefore, ophthalmologists continue to search for other effective adjuvant therapies for the management of bacterial keratitis.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Toluidine Blue-Mediated Photodynamic Therapy for Experimental Bacterial Keratitis in Rabbits

Wei

Wang

et al. 2020

Trans. Vis. Sci. Tech.

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The objective of this study was to evaluate the effect of toluidine bluemediated photodynamic therapy on experimental bacterial keratitis in rabbits. Methods: Bacterial keratitis was induced in rabbits by the injection of 200 μl Staphylococcus aureus (S. aureus) solution into the anterior stroma of the right cornea. Rabbits were randomly divided into four groups: toluidine blue O and red light (TBOR), levofloxacin eye drops (LEV), the combination of TBOR and LEV (TBOR + LEV), and a control group. Clinical manifestations, histopathology, and transmission electron microscopy were analyzed at various time points. Results: Conjunctival injection and surface area of the corneal ulcer in the TBOR group and the TBOR + LEV group showed significant improvement from baseline after 7 days of treatment. Compared to baseline, the depth of corneal infiltration was decreased at day 14 in the TBOR and TBOR + LEV groups. Microscopic analysis of the TBOR and TBOR + LEV groups showed that the structure of each layer was intact, and there were no inflammatory cells in the corneal stroma. Additionally, IL-1β and TNF-α were highly expressed in the LEV and control groups but were lower in the TBOR and TBOR + LEV groups. Under transmission electron microscopy, the corneas in the TBOR and TBOR + LEV groups were intact, whereas in the LEV and control groups, double-walled structures corresponding to S. aureus were found in the superficial stromal layer. Conclusions: TBOR demonstrated in vivo antibacterial efficacy against S. aureus. Translational Relevance: This study found in vivo antibacterial efficacy of toluidine blue-mediated photodynamic therapy on rabbit experimental bacterial keratitis, thus providing an additional new option for clinical treatment of bacterial keratitis.

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Antimicrobial resistance: a threat to global health

Cited by 89 publications

References 5 publications

Procalcitonin (PCT)-guided antibiotic stewardship: an international experts consensus on optimized clinical use

Procalcitonin (PCT)-guided antibiotic stewardship: an international experts consensus on optimized clinical use

Procalcitonin (PCT)-guided antibiotic stewardship in Asia-Pacific countries: adaptation based on an expert consensus meeting

Evaluation of Toluidine Blue-Mediated Photodynamic Therapy for Experimental Bacterial Keratitis in Rabbits

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