The One Health stewardship of colistin as an antibiotic of last resort for human health in South Africa

Mendelson, Marc; Brink, Adrian; Gouws, Joey; Mbelle, Nontombi Marylucy; Naidoo, Vinny; Pople, Troy; Schellack, Natalie; Vuuren, Moritz Van; Rees, Helen; Banoo, Shabir; Bokaba, Khotso; Collins, Marius; Faure, Kim; Herbst, Maryke; Hoek, Beyers; Lancaster, Ruth; Lotter, Jeanette; Modisane, Mike; Mohlala, Mahlodi; Mokantla, Ernest; Molatuli, Adelaide; Molefe, Margaret; Molewa, Griffith; Mompati, Kefiloe; Moshiga, Lesiba; Munbodh, Shyamli; Nkambule, Portia; Patterson, Camilla; Reddy, Darshana; Sigobondhla, Alice; Suliman, Suraiya; Swan, Gerry E.

doi:10.1016/s1473-3099(18)30119-1

Cited by 70 publications

(69 citation statements)

References 14 publications

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“…Globally, the irrational, indiscriminate, and excessive use of antibiotics, including for self-limiting infections, is a key driver of increasing AMR rates and a considerable public health concern 4,9,17-30 . Such concerns are exacerbated by the spread of AMR from one geographic locality to others resulting in resistance to reserve antibiotics including colistin together with growing resistance to a number of organisms including Klebsiella pneumoniae, Escherichia coli, Salmonella typhi and Neisseria gonorrhoeae growing 18,[31][32][33][34][35][36] . As a result, bacteria causing severe health problems have become resistant to multiple antibiotics during the past 20-30 years 18,37,38 .…”

Section: Introductionmentioning

confidence: 99%

“…Unfortunately, antibiotics can achieve good health outcomes even in patients with viral infections, which runs counter to changing public perceptions of their efficacy [56][57][58][59] . Concerns with rising rates of AMR, coupled with the continued irrational use of antibiotics to treat self-limiting infections such as upper respiratory tract infections (URTIs), have resulted in multiple initiatives internationally, regionally, and nationally aimed at reversing current trends 6,8,21,36,40,[60][61][62][63][64][65][66][67][68][69][70][71][72][73][74] .…”

Section: Introductionmentioning

confidence: 99%

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Ongoing strategies to improve the management of upper respiratory tract infections and reduce inappropriate antibiotic use particularly among lower and middle-income countries: findings and implications for the future

Godman

Haque

McKimm

et al. 2019

Current Medical Research and Opinion

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132

170

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ongoing strategies to improve the management of upper respiratory tract infections and reduce inappropriate antibiotic use particularly among lower and middle-income countries: findings and implications for the future

Godman

Haque

McKimm

et al. 2019

Current Medical Research and Opinion

Self Cite

132

170

View full text Add to dashboard Cite

show abstract

“…Concerns with rising AMR rates and its implications have resulted in a range of activities globally, regionally, and nationally to enhance appropriate antibiotic prescribing including the development and agreement of national action plans [7][8][9][10][11][12][13][14][15][16][17]. This is illustrated by colistin where its increasing use in recent years due the emergence of carbapenem-resistant gram-negative bacteria has resulted in initiatives in sub-Sahara Africa to conserve its use to preserve its effectiveness [18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Point prevalence study of antimicrobial use among hospitals across Botswana; findings and implications

Paramadhas

Tiroyakgosi

Mpinda-Joseph

et al. 2019

Expert Review of Anti-infective Therapy

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Objective: There is an urgent need to undertake Point Prevalence Surveys (PPS) across Africa to document antimicrobial utilisation rates given high rates of infectious diseases and growing resistance rates. This is the case in Botswana along with high empiric use and extended prophylaxis to prevent surgical site infections (SSIs) Method: PPS was conducted among all hospital sectors in Botswana using forms based on Global and European PPS studies adapted for Botswana, including rates of HIV, TB, malaria, and malnutrition. Quantitative study to assess the capacity to promote appropriate antibiotic prescribing. Results: 711 patients were enrolled with high antimicrobial use (70.6%) reflecting an appreciable number transferred from other hospitals (42.9%), high HIV rates (40.04% among those with known HIV) and TB (25.4%), and high use of catheters. Most infections were community acquired (61.7%). Cefotaxime and metronidazole were the most prescribed in public hospitals with ceftriaxone the most prescribed antimicrobial in private hospitals. Concerns with missed antibiotic doses (1.96 per patient), high empiric use, extended use to prevent SSIs, high use of IV antibiotics, and variable infrastructures in hospitals to improve future antibiotic use. Conclusion: High antibiotic use reflects high rates of infectious diseases observed in Botswana. A number of concerns have been identified, which are being addressed.

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“…For example, colistin has re-emerged as a valued antibiotic despite its side-effects because of the emergence of carbapenem-resistant gram-negative bacteria [14,15]. This has resulted in a number of countries, including South Africa, to develop programmes to limit its use to preserve its effectiveness [16], with colistin also now included in the WHO reserve list of antibiotics [17]. According to the Council for Appropriate and Rational Antibiotic Therapy (CARAT), criteria for optimized antibiotic therapy include therapeutic safety and benefits, evidence-based results, cost-effectiveness and the optimal antibiotic for the optimal duration [18].…”

Section: Introductionmentioning

confidence: 99%

A multicenter point prevalence survey of antibiotic use in Punjab, Pakistan: findings and implications

Saleem

Hassali

Versporten

et al. 2019

Expert Review of Anti-infective Therapy

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Objective:In line with the recent global action plan for antimicrobial resistance, the first time such a comprehensive survey has been undertaken in Pakistan, sixth most populous country. Method:This point prevalence survey (PPS) was conducted in 13 hospitals among 7 different cities of Pakistan. The survey included all inpatients receiving an antibiotic on the day of PPS. A web-based application was used for data entry, validation, and reporting as designed by the University of Antwerp. Results:Out of 1954 patients, 1516 (77.6%) were treated with antibiotics. Top three most reported indications for antibiotic use were prophylaxis for obstetrics or gynaecological indications (16.5%) and gastrointestinal indications (12.6%) and lower respiratory tract infections (12.0%). Top three most commonly prescribed antibiotics were ceftriaxone (35.0%), metronidazole (16.0%) and ciprofloxacin (6.0%). Out of total indications, 34.2% of antibiotics were prescribed for community-acquired infections (CAI), 5.9% for healthcare-associated infections (HAI), and 57.4% for either surgical or medical prophylaxis. Of total surgical prophylaxis, 97.4% of antibiotics were given for more than one day. Conclusion:Study concluded that unnecessary prophylactic antibiotic use is extremely high and broad-spectrum prescribing is common. There is a considerable need to work on a national action plan of Pakistan on antibiotic resistance.

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The One Health stewardship of colistin as an antibiotic of last resort for human health in South Africa

Cited by 70 publications

References 14 publications

Ongoing strategies to improve the management of upper respiratory tract infections and reduce inappropriate antibiotic use particularly among lower and middle-income countries: findings and implications for the future

Ongoing strategies to improve the management of upper respiratory tract infections and reduce inappropriate antibiotic use particularly among lower and middle-income countries: findings and implications for the future

Point prevalence study of antimicrobial use among hospitals across Botswana; findings and implications

A multicenter point prevalence survey of antibiotic use in Punjab, Pakistan: findings and implications

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