Antimicrobial resistance (AMR)

Amann, Steffen; Neef, Kees; Kohl, Stephanie

doi:10.1136/ejhpharm-2018-001820

Cited by 66 publications

(38 citation statements)

References 11 publications

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“…Although the WHO's Global action plan on antimicrobial resistance is being formulated [4]. The current studies have reported dramatic increase of antimicrobial resistance especially in resources limited countries [5]. There is a growing body of literature that accents the significance of resistance to antibiotics that are commonly prescribed in lagging countries [6].…”

Section: Introductionmentioning

confidence: 99%

“…Different studies have associated antimicrobial resistance with the level of knowledge, attitudes and perceptions on antimicrobial use in healthcare provider while others have highlighted patient pressure and failure to complete the full course of treatment as two main factors that contribute to drug resistance [5,17]. Healthcare students as future prescribers and dispensers of antimicrobials may have a different perspective on the matter.…”

Section: Introductionmentioning

confidence: 99%

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Knowledge and attitudes towards antibiotic use and resistance among undergraduate healthcare students at University of Rwanda

Nisabwe

Brice

Umuhire

et al. 2020

J of Pharm Policy and Pract

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Background: Antimicrobial resistance (AMR) is an imminent threat to modern medicine. As the efficacy of treatment regimens is reduced, mortality and morbidity attributed to infectious diseases is expected to rise dramatically across the globe. Antimicrobial stewardship and good prescription practices are critical to conserving available therapeutics; it is appropriate, therefore, to appraise our attitudes and knowledge of antimicrobial resistance, particularly for the future healthcare practitioners. Methods: This is a descriptive cross-sectional study that was conducted among 282 medicals, dental and pharmacy students from the University of Rwanda. Questionnaires were used to collect data from the 4th to 29th March 2017. Results: Students from Level 3 to level 6 have demonstrated a good knowledge on antibiotics and antimicrobial resistance. Generally, 95% (n = 218) agreed that the inappropriate use of antibiotics could lead to antibiotic resistance. It was found that 96% (n = 220) of the respondents had heard about AMR outside their degree courses. 49% (n = 112) of the participants reported that they are able to purchase antibiotics without a prescription. 96% (n = 220) agreed that it was important for healthcare students to be knowledgeable about antimicrobial resistance. Perhaps most surprisingly, it was found that 83% (n = 191) of participants were unfamiliar with the concept of antimicrobial stewardship and 49% (n = 21) had not yet discussed antimicrobial resistance as part of their education, albeit only 1% (n = 3) was completely unfamiliar with the term. Furthermore, 38% (n = 86) did not support that the antibiotics were overused in Rwanda, 23% (n = 10) did not agree that inappropriate antimicrobial use contributed to antimicrobial resistance, and 50% (n = 22) of participants agreed that antibiotics were indicated in the treatment of pain and inflammation.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Knowledge and attitudes towards antibiotic use and resistance among undergraduate healthcare students at University of Rwanda

Nisabwe

Brice

Umuhire

et al. 2020

J of Pharm Policy and Pract

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“…The emergence of antibiotic resistance leads to an increased risk of therapeutic failure, longer hospitalization, relapses, and greater costs for the health care system. The main challenge in the fight against AMR is the poor efficacy of most of the available treatments, which results in limited prevention or control [1]. Therefore, infections, such as pneumonia, tuberculosis, and foodborne disease are becoming harder to treat [2].…”

Section: Introductionmentioning

confidence: 99%

Postbiotic-Enabled Targeting of the Host-Microbiota-Pathogen Interface: Hints of Antibiotic Decline?

et al. 2020

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Mismanagement of bacterial infection therapies has undermined the reliability and efficacy of antibiotic treatments, producing a profound crisis of the antibiotic drug market. It is by now clear that tackling deadly infections demands novel strategies not only based on the mere toxicity of anti-infective compounds. Host-directed therapies have been the first example as novel treatments with alternate success. Nevertheless, recent advances in the human microbiome research have provided evidence that compounds produced by the microbial metabolism, namely postbiotics, can have significant impact on human health. Such compounds target the host-microbe-pathogen interface rescuing biotic and immune unbalances as well as inflammation, thus providing novel therapeutic opportunities. This work discusses critically, through literature review and personal contributions, these novel nonantibiotic treatment strategies for infectious disease management and resistance prevention, which could represent a paradigm change rocking the foundation of current antibiotic therapy tenets.

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“…A major public health crisis is the alarming increase of infections caused by antibioticresistant bacteria, which are responsible for approximately 2.8 million infections in the U.S. alone (1). In 2014, the World Health Organization (WHO) reported that a post-antibiotic era, in which antibiotics are largely ineffective, is a possible fate for the 21 st century (2). The postantibiotic era is described as a period where antibiotics fail to target multidrug-resistant bacteria.…”

Section: Introductionmentioning

confidence: 99%

Phage-Antibiotic Synergy is Driven by a Unique Combination of Antibacterial Mechanism of Action and Stoichiometry

Liu

Green

Min

et al. 2020

Preprint

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The continued rise in antibiotic resistance is precipitating a medical crisis. Bacteriophage (phage) has been hailed as one possible therapeutic option to augment the efficacy of antibiotics.However, only a handful of studies have addressed the synergistic relationship between phage and antibiotics. Here, we report a comprehensive analysis of phage-antibiotic interaction that evaluates synergism, additivism, and antagonism for all classes of antibiotics across clinically achievable stoichiometries. We combined an optically-based real-time microtiter plate readout with a matrix-like heatmap of treatment potencies to measure phage and antibiotic synergy (PAS), a process we term synography. Phage-antibiotic synography was performed against a pandemic drug-resistant clonal group of E. coli (ExPEC) with antibiotic levels blanketing the minimum inhibitor concentration (MIC) across seven orders of viral titers. Our results suggest that, under certain conditions, phages provide an adjuvating effect by lowering the MIC for drugresistant strains. Furthermore, synergistic and antagonistic interactions are highly dependent on the mechanism of bacterial inhibition by the class of antibiotic paired to the phage, and when synergism is observed, it suppresses the emergence of resistant cells. Host conditions that simulate the infection environment, including serum and urine, suppress PAS in a bacterial growth-dependent manner. Lastly, phage burst size seems to be a significant driver of synergism.Collectively, this data suggests lytic phages can resuscitate an ineffective antibiotic for previously resistant bacteria, while also synergize with antibiotics in a class-dependent manner, processes that may be dampened by lower bacterial growth rates found in host environments. Significance StatementBacteriophage (phage) therapy is a promising approach to combat the rise of multi-drug resistant bacteria. Currently, the preferred clinical modality is to pair phage with an antibiotic, a practice thought to improve efficacy. However, antagonism between phage and antibiotics has been reported, the choice of phage and antibiotic is not often empirically determined, and the effect of the host factors on the effectiveness is unknown. Here, we interrogate phage-antibiotic interactions across antibiotics with different mechanisms of action. Our results suggest that phage can lower the working MIC for bacterial strains already resistant to the antibiotic, is dependent on the antibiotic class and stoichiometry of the pairing, and is dramatically influenced by the host microenvironment.

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Antimicrobial resistance (AMR)

Cited by 66 publications

References 11 publications

Knowledge and attitudes towards antibiotic use and resistance among undergraduate healthcare students at University of Rwanda

Knowledge and attitudes towards antibiotic use and resistance among undergraduate healthcare students at University of Rwanda

Postbiotic-Enabled Targeting of the Host-Microbiota-Pathogen Interface: Hints of Antibiotic Decline?

Phage-Antibiotic Synergy is Driven by a Unique Combination of Antibacterial Mechanism of Action and Stoichiometry

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