Results from the Survey of Antibiotic Resistance (SOAR) 2012–14 in Thailand, India, South Korea and Singapore

Torumkuney, D; Chaiwarith, Romanee; Reechaipichitkul, Wipa; Malatham, K.; Chareonphaibul, V.; Rodrigues, Camilla; Chitins, D. S.; Dias, Mary; Anandan, Shalini; Kanakapura, S.; Park, Y. J.; Lee, Keunwook; Lee, H.; Kim, J. Y.; Lee, Y.; Lee, H. K.; Kim, J. H.; Tan, Thean-Yen; Heng, Ying Xuan; Mukherjee, P.; Morrissey, Ian

doi:10.1093/jac/dkw073

Cited by 39 publications

(30 citation statements)

References 21 publications

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“…Such resistance is still rare in most regions of the world; 13,15,19,20 however, the overall sample size was small in this study and the significance of the finding is unclear. Interestingly, the rate of 3.8% non-susceptibility is almost exactly the same as the rate found in neighbouring Turkey in 2011-13 (3.5%).…”

Section: V40mentioning

confidence: 67%

“…Again, however, ,5% of isolates were susceptible to macrolides by EUCAST breakpoints. 13 As has been shown in other SOAR studies that have systematically compared breakpoints, 18,19 this variability is significant, impacting not only clinicians trying to interpret antimicrobial resistance data but also public health officials, epidemiologists and microbiologists struggling to compare data across studies from different geographic regions and over time using different MIC interpretation criteria. All would be much better served if breakpoints were harmonized.…”

Section: V40mentioning

confidence: 99%

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Results from the Survey of Antibiotic Resistance (SOAR) 2014–16 in Greece

Torumkuney

Papaparaskevas

Morrissey³

2018

Journal of Antimicrobial Chemotherapy

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Objectives: To determine antimicrobial susceptibility in isolates of Streptococcus pneumoniae and Haemophilus influenzae collected in 2014-16 from patients with community-acquired respiratory tract infections in Greece.Methods: MICs were determined by CLSI broth microdilution and susceptibility assessed using CLSI, EUCAST and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints.Results: A total of 99 S. pneumoniae and 52 H. influenzae isolates were collected. Overall, 36.4% of S. pneumoniae were penicillin susceptible by CLSI oral/EUCAST and 88.9% by CLSI intravenous (iv) breakpoints. All were fluoroquinolone susceptible with 94% of isolates also susceptible to amoxicillin, amoxicillin/clavulanic acid and ceftriaxone by CLSI and PK/PD breakpoints. Trimethoprim/sulfamethoxazole, cefuroxime, cefaclor and macrolides were less active, with rates of susceptibility of 83.8%, 69.7%, 50.5% and 49.5%, respectively, by CLSI. Generally susceptibility was the same or slightly lower by EUCAST, but the cefaclor difference was much greater. Among H. influenzae, 15.4% of isolates were b-lactamase positive. Susceptibility to amoxicillin/clavulanic acid, ceftriaxone, cefuroxime and the fluoroquinolones was seen in .95% of isolates by CLSI criteria. Susceptibility to azithromycin was seen in 94.2% of isolates using CLSI breakpoints, but clarithromycin susceptibility was lower (61.5%). However, susceptibility to both macrolides was seen in ,5% of isolates by PK/PD and EUCAST criteria. Susceptibility to trimethoprim/sulfamethoxazole was seen in 71.2% of isolates.Conclusions: Owing to the high prevalence of macrolide resistance among S. pneumoniae and the reduced activity of clarithromycin against H. influenzae, it appears that these agents are not appropriate as monotherapy for community-acquired pneumonia in Greece. Amoxicillin/clavulanic acid, on the other hand, maintained excellent in vitro activity and, as opposed to the similarly effective fluoroquinolones, is safe to use in paediatric patients.

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Section: V40mentioning

confidence: 67%

Section: V40mentioning

confidence: 99%

Results from the Survey of Antibiotic Resistance (SOAR) 2014–16 in Greece

Torumkuney

Papaparaskevas

Morrissey³

2018

Journal of Antimicrobial Chemotherapy

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“… 25 The common use of aminopenicillins (eg, amoxicillin) and macrolides (eg, azithromycin) for respiratory symptoms identified in our study might contribute to resistant strains of common respiratory pathogens such as Streptococcus pneumoniae and Haemophilus influenzae . 26 In addition to potentially delaying tuberculosis diagnosis, unnecessary use of steroids is associated with an increased risk of developing lower respiratory tract infection, cellulitis, herpes zoster, and candidiasis. 27 …”

Section: Discussionmentioning

confidence: 99%

Use of standardised patients to assess antibiotic dispensing for tuberculosis by pharmacies in urban India: a cross-sectional study

Satyanarayana

Kwan

Daniels

et al. 2016

The Lancet Infectious Diseases

106

115

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SummaryBackgroundIndia's total antibiotic use is the highest of any country. Patients often receive prescription-only drugs directly from pharmacies. Here we aimed to assess the medical advice and drug dispensing practices of pharmacies for standardised patients with presumed and confirmed tuberculosis in India.MethodsIn this cross-sectional study in the three Indian cities Delhi, Mumbai, and Patna, we developed two standardised patient cases: first, a patient presenting with 2–3 weeks of pulmonary tuberculosis symptoms (Case 1); and second, a patient with microbiologically confirmed pulmonary tuberculosis (Case 2). Standardised patients were scheduled to present each case once to sampled pharmacies. We defined ideal management for both cases a priori as referral to a health-care provider without dispensing antibiotics or steroids or both.FindingsBetween April 1, 2014, and Nov 29, 2015, we sampled 622 pharmacies in Delhi, Mumbai, and Patna. Standardised patients completed 1200 (96%) of 1244 interactions. We recorded ideal management (defined as referrals without the use of antibiotics or steroids) in 80 (13%) of 599 Case 1 interactions (95% CI 11–16) and 372 (62%) of 601 Case 2 interactions (95% CI 58–66). Antibiotic use was significantly lower in Case 2 interactions (98 [16%] of 601, 95% CI 13–19) than in Case 1 (221 [37%] of 599, 95% CI 33–41). First-line anti-tuberculosis drugs were not dispensed in any city. The differences in antibiotic or steroid use and number of medicines dispensed between Case 1 and Case 2 were almost entirely attributable to the difference in referral behaviour.InterpretationOnly some urban Indian pharmacies correctly managed patients with presumed tuberculosis, but most correctly managed a case of confirmed tuberculosis. No pharmacy dispensed anti-tuberculosis drugs for either case. Absence of a confirmed diagnosis is a key driver of antibiotic misuse and could inform antimicrobial stewardship interventions.FundingGrand Challenges Canada, Bill & Melinda Gates Foundation, Knowledge for Change Program, and World Bank Development Research Group.

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“…Table 4 summarizes the current antibiotic resistance of S. pneumoniae strains isolated in Korea. While then antibiotic resistance against penicillin and ceftriaxone is reported to be low at 10% or below, that against erythromycin and azithromycin are still high at 73-81% [ 18 19 20 21 22 ]. Antibiotic resistance against fluoroquinolones is still quite low, but gradually increasing.…”

Section: Current Status Regarding Causative Bacteria Of Pneumoniamentioning

confidence: 99%

Guideline for Antibiotic Use in Adults with Community-acquired Pneumonia

Lee

Kang

et al. 2018

Infect Chemother

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Community-acquired pneumonia is common and important infectious disease in adults. This work represents an update to 2009 treatment guideline for community-acquired pneumonia in Korea. The present clinical practice guideline provides revised recommendations on the appropriate diagnosis, treatment, and prevention of community-acquired pneumonia in adults aged 19 years or older, taking into account the current situation regarding community-acquired pneumonia in Korea. This guideline may help reduce the difference in the level of treatment between medical institutions and medical staff, and enable efficient treatment. It may also reduce antibiotic resistance by preventing antibiotic misuse against acute lower respiratory tract infection in Korea.

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Results from the Survey of Antibiotic Resistance (SOAR) 2012–14 in Thailand, India, South Korea and Singapore

Cited by 39 publications

References 21 publications

Results from the Survey of Antibiotic Resistance (SOAR) 2014–16 in Greece

Results from the Survey of Antibiotic Resistance (SOAR) 2014–16 in Greece

Use of standardised patients to assess antibiotic dispensing for tuberculosis by pharmacies in urban India: a cross-sectional study

Guideline for Antibiotic Use in Adults with Community-acquired Pneumonia

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