Managing responsible antimicrobial use: perspectives across the healthcare system

Dyar, Oliver James; Tebano, Gianpiero; Pulcini, Céline

doi:10.1016/j.cmi.2017.04.016

Cited by 35 publications

(32 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Antibiotic stewardship (AS) teams are essential actors for combating antibiotic-resistant bacteria in healthcare and community settings, and are routinely mentioned in national and international guidelines, recommendations and action plans. Usually, AS teams in resource-rich settings are multidisciplinary, made up of different experts, commonly including infectious diseases (ID) specialists, clinical microbiologists and pharmacists, adequately trained in antibiotic prescribing and stewardship [1]. Some studies conducted in low-and middle-income countries have also shown that community health workers, nurses, village women and others have important roles [1].…”

mentioning

confidence: 99%

Human resources estimates and funding for antibiotic stewardship teams are urgently needed

Pulcini

Morel

Tacconelli

et al. 2017

Clinical Microbiology and Infection

Self Cite

View full text Add to dashboard Cite

Antibiotic stewardship (AS) teams are essential actors for combating antibiotic-resistant bacteria in healthcare and community settings, and are routinely mentioned in national and international guidelines, recommendations and action plans. Usually, AS teams in resource-rich settings are multidisciplinary, made up of different experts, commonly including infectious diseases (ID) specialists, clinical microbiologists and pharmacists, adequately trained in antibiotic prescribing and stewardship [1]

show abstract

mentioning

confidence: 99%

Human resources estimates and funding for antibiotic stewardship teams are urgently needed

Pulcini

Morel

Tacconelli

et al. 2017

Clinical Microbiology and Infection

Self Cite

View full text Add to dashboard Cite

show abstract

“… In those locations, such use may be often unavoidable. In regions without susceptibility testing, the rationale for this new once‐a‐day therapy is similar to that used with concomitant therapy (ie, those with infections susceptible to one of the two triple therapies consisting of a PPI, bismuth, and clarithromycin or levofloxacin will be cured). Ideally, therapy for nonrapidly fatal infectious diseases is chosen after the susceptibility results become available.…”

Section: Discussionmentioning

confidence: 99%

Once‐daily rabeprazole, levofloxacin, clarithromycin‐MR, and bismuth for Helicobacter pylori eradication: A randomized study of 7 or 14 days (ONCE study)

et al. 2019

View full text Add to dashboard Cite

Objective Most therapies for Helicobacter pylori eradication utilize multiple drugs given 2‐4 times daily. Patient adherence has been an impediment to reliably achieving high success. This study evaluated a once‐daily dosing H pylori eradication regimen. Methods A prospective randomized pilot study of H pylori eradication compared once‐daily treatment regimen containing levofloxacin (750 mg), clarithromycin‐MR (1 g), rabeprazole (60 mg), and bismuth subsalicylate (1,048 mg) for a 7 or 14 days. CYP2C19 genotype and antibiotic susceptibility tests were performed. Successful eradication was defined as negative 13C‐urea breath test at least 4 weeks after completion of treatment. Results 100 subjects were randomized (40 men, 60 women with mean age =54 years). The eradication rates were as follows: 94% (47/50; 95%CI 0.87‐1.01) and 84% (42/50; 95%CI 0.73‐0.95) with 14‐day and 7‐day therapy (OR 0.34; 95%CI 0.08‐1.35, P = 0.06), respectively. Resistance rates were as follows: 13.0% for clarithromycin, 26.0% for fluoroquinolone, 2.9% for dual clarithromycin‐fluoroquinolone resistance, and 62.8% for metronidazole. The 14‐day regimen provided 100% eradication in patients with levofloxacin susceptible strain irrespective of the presence of clarithromycin resistance. CYP2C19 genotypes had no effect on cure rates. Conclusions The once‐daily 14‐day rabeprazole‐, levofloxacin‐, clarithromycin‐MR‐, and bismuth‐containing therapy provided high eradication rate suggested that triple therapies with a PPI, bismuth, and clarithromycin‐MR or levofloxacin would be highly effective for once‐a‐day tailored therapy or as empiric therapy for first‐line regimen.

show abstract

“…This might be explained by the fact that the role of the AMT is also to manage dosage, side effect, drug interaction, and follow-up. It is well-known that AMT interventions increase the rate of appropriate treatment, decrease the use of broad-spectrum antibiotics, and reduce the costs of antimicrobial treatment without increasing death 1,5,16–18. While the overall positive impact of AMT on mortality is only supported by low level of scientific evidence, it has, nevertheless, been well described for specific drug regimen or infection 8.…”

Section: Discussionmentioning

confidence: 99%

Management and outcome of bloodstream infections: a prospective survey in 121 French hospitals (SPA-BACT survey)

Robineau¹,

Robert²,

Bédos³

et al. 2018

IDR

View full text Add to dashboard Cite

BackgroundBloodstream infections (BSIs) are severe infections that can be community or hospital acquired. Effects of time to appropriate treatment and impact of antimicrobial management team are discussed in terms of outcome of BSI. We sought to evaluate the impact of initial BSI management on short-term mortality.Patients and methodsA prospective, multicenter survey was conducted in 121 French hospitals. Participants declaring BSI during a 1-month period were included consecutively. Data on patient comorbidities, illness severity, BSI management, and resistance profile of bacterial strains were collected. Predictors of 10-day mortality were identified by multivariate regression for overall BSI, health care-related and hospital-acquired BSI.ResultsWe included 1,952 BSIs. More than a third of them were hospital acquired (39%). Multidrug resistance was identified in 10% of cases, mainly in health care-related BSI. Empirical therapy and targeted therapy were appropriate for 61% and 94% of cases, respectively. Increased 10-day mortality was associated with severe sepsis, septic shock, increasing age, and any focus other than the urinary tract. Decreased mortality was associated with receiving at least one active antibiotic within the first 48 hours. Intervention of antimicrobial management team during the acute phase of BSI was associated with a decreased mortality at day 10 in the overall population and in health care-related BSI.ConclusionOptimizing BSI management by increasing rapidity of appropriate treatment initiation may decrease short-term mortality, even in countries with low rate of multidrug-resistant organisms. Early intervention of antimicrobial management team is crucial in terms of mortality.

show abstract

Managing responsible antimicrobial use: perspectives across the healthcare system

Cited by 35 publications

References 37 publications

Human resources estimates and funding for antibiotic stewardship teams are urgently needed

Human resources estimates and funding for antibiotic stewardship teams are urgently needed

Once‐daily rabeprazole, levofloxacin, clarithromycin‐MR, and bismuth for Helicobacter pylori eradication: A randomized study of 7 or 14 days (ONCE study)

Management and outcome of bloodstream infections: a prospective survey in 121 French hospitals (SPA-BACT survey)

Contact Info

Product

Resources

About