What is antimicrobial stewardship?

Dyar, Oliver James; Huttner, Benedikt; Schouten, Jeroen; Pulcini, Céline

doi:10.1016/j.cmi.2017.08.026

Cited by 567 publications

(420 citation statements)

References 36 publications

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“…Helicobacter pylori is an infectious disease, and the principles regarding treatment of infectious diseases such as antimicrobial stewardship are relevant to H pylori . Definitions of antimicrobial stewardship include the following: (a) a coherent set of actions which promote using antibiotics responsibly; (b) coordinated interventions designed to improve and measure appropriate use of antimicrobial agents by promoting selection of the optimal drug regime including dosing, duration of therapy, and route of administration; and (c) a coherent set of actions which promote using antimicrobials in ways that ensure sustainable access to effective therapy for all that need them.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness and safety of furazolidone‐containing quadruple regimens in patients with Helicobacter pylori infection in real‐world practice

et al. 2019

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Background & Aims The eradication rate of Helicobacter pylori (H pylori) has decreased largely because of the antibiotic resistance. We aimed to evaluate the effectiveness and safety of furazolidone‐containing quadruple regimens for H pylori eradication. Methods This was an observational study of furazolidone‐containing quadruple regimens for H pylori infection in real‐world settings. Data sets were collected from the medical records and telephone interviews of patients referred to a specialist clinic for suspected H pylori reinfection from January 1, 2015, to January 1, 2018, at the First Affiliated Hospital of Nanchang University. Main outcome measures were the eradication rate and adverse reactions during medication. Results Among 584 patients with H pylori infection that met the inclusion criteria, 561 (96.1%) were treated for the first time, 19 (3.3%) had one, and 4 (0.5%) had two or more prior to furazolidone‐containing quadruple regimens. The eradication rates for 10‐day and 14‐day regimens were 93.7% (95% CI: 91.5%‐95.9%) vs 98.2% (95% CI: 95.6%‐99.3%), respectively (P = 0.098). Adverse drug reactions occurred in 8.2% (48/584) with abdominal discomfort being the most common symptom. Overall adverse events with 10‐day regimens were lower than 14‐day regimens (6.1% vs 17.4%, P < 0.001). Logistic regression analysis indicated that poor adherence (adjusted odds ratio [AOR] = 46.5, 95% CI: 9.7‐222.4) was correlated with failed eradication. Adverse drug reactions during medication were related to smoking and tobacco status, alcohol intake history, regimens combined with tetracycline, and poor adherence (all P < 0.05). Conclusions Furazolidone‐containing quadruple regimens proved both safe and highly effective in a real‐world setting.

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Section: Discussionmentioning

confidence: 99%

Effectiveness and safety of furazolidone‐containing quadruple regimens in patients with Helicobacter pylori infection in real‐world practice

et al. 2019

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“…Given that we have been spoiled by the ease with which conventional antimicrobial agents are administered, as well as their general availability, it is unsurprising that maintaining the status quo is so desirable. Antimicrobial stewardship clearly means a departure from this situation, and given support (and cooperation) from all sides, can at least cause some arrest in the development of resistant microbes [5].…”

Section: Fighting Resistancementioning

confidence: 99%

A New Penicillin?

Wainwright

2020

Antibiotics

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The spectre of antimicrobial resistance looms very large indeed in the 21st century; the supply of efficacious conventional drugs is short and not guaranteed, for various reasons. It is time to look elsewhere for answers and for protocols which might be used in tandem with our diminishing arsenal in order to protect vital drugs. This could bridge the gap before new development in conventional antimicrobial therapy occurs, or might be a longer-term solution, particularly in the area of infectious disease prophylaxis (conventional-sensitive or -resistant). Reliable and safe protocols have been developed for the use of photoantimicrobials in this respect, offering much greater coverage, in terms of the microbial target, than Fleming ever imagined.

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“…The term stewardship has evolved over time [11], and today numerous definitions of stewardship exist (Box 1). All describe a multidisciplinary approach (including pharmacists, physicians, microbiologists and infection control) to the appropriate use of antibiotics to optimize patient outcomes by ensuring the right drug, dose and duration are administered.…”

Section: The Role Of Antimicrobial Stewardshipmentioning

confidence: 99%

Combating Resistance While Maintaining Innovation: The Future of Antimicrobial Stewardship

et al. 2019

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Antimicrobial resistance represents a significant global health threat. However, a commercial model that does not offer a return on investment resulting in a lack of investment in antibiotic R&D, means that the current pipeline of antibiotics lacks sufficient innovation to meet this challenge. Those responsible for defining, promoting and monitoring the rationale use of antibiotics (the antimicrobial stewardship programme) are key to addressing current shortcomings. In this personal perspective, we discuss the future role stewardship can play in stimulating innovation, a need to move away from a pharmacy budget dominated view of antibiotic use, and the impact of the ever-increasing sophistication and interdisciplinary nature of antimicrobial control programs. Changes are needed to optimize clinical outcomes for patients.

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What is antimicrobial stewardship?

Cited by 567 publications

References 36 publications

Effectiveness and safety of furazolidone‐containing quadruple regimens in patients with Helicobacter pylori infection in real‐world practice

Effectiveness and safety of furazolidone‐containing quadruple regimens in patients with Helicobacter pylori infection in real‐world practice

A New Penicillin?

Combating Resistance While Maintaining Innovation: The Future of Antimicrobial Stewardship

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