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Source: http://www.cidrap.umn.edu/news-persp...an-sep-30-2016
Antimicrobial Resistance Scan for Sep 30, 2016
Vaccines and AMR; Stewardship in urgent care; Antibiotic use in small hospitals
Filed Under:
Antimicrobial Stewardship
Paper calls for greater role for vaccines in AMR fight
Vaccines should play a larger role in the battle against antimicrobial resistance (AMR), according to a new paper from British think tank Chatham House.
The paper comes in the wake of last week's United Nations meeting on AMR, which produced a commitment to a broad range of interventions aimed at preserving the effectiveness of the world's antibiotics. While those interventions included the creation of new vaccines to prevent infections, the authors argue that the role of vaccines in minimizing antimicrobial use?and consequentially the selection pressure that drive resistance?is being underrated. If vaccines can prevent people from getting infections in the first place, then antibiotics won't be needed, the authors state.
"Among the proposed solutions for tackling AMR, vaccines are a major tool that eliminates the need for antimicrobials, and therefore the need for other interventions related to conserving the utility of such drugs," write David Heymann, MD, and Abbas Omaar, MSc, of Chatham House's Centre on Global Health Security.
An example they cite is the pneumococcal conjugate vaccine, one of three vaccines against bacteria that have been developed since 1980. The World Health Organization, which has placed the vaccine on its essential medicines list, estimates it could prevent as many as 1.6 million deaths from pneumonia each year. The additional benefit of the vaccine is that it reduces the need for the antibiotics that have become increasingly ineffective against Streptococcus pneumoniae. Vaccines against meningitis and Haemophilus influenzae, they argue, provide similar benefits.
Of course, Heymann and Omaar acknowledge, creating vaccines for every infectious disease is unrealistic, given that vaccine development is technically difficult and expensive. But then again so is antibiotic development, and new antibiotics will do nothing to solve the resistance problem. They argue that more efforts should be made to analyze the costs and benefits of developing new vaccines for AMR control relative to those for investing in stewardship and antibiotic development.
"This may strengthen understanding of the unique and dynamic role that conferring immunity to disease can play in tackling AMR," they write.
Sep 28 Chatham House paper "New vaccines are essential to fighting antimicrobial resistance"
New partnership will focus on antibiotic use in urgent care
A new partnership is aiming to reduce the inappropriate use of antibiotics in outpatient settings.
The Urgent Care Association of America (UCAOA) and the Antibiotic Resistance Action Center (ARAC) at Milken Institute School of Public Health at George Washington University announced this week that they've entered into a 3-year partnership to improve patient and clinician understanding of appropriate antibiotic use in the urgent care sector, which has become an increasingly convenient and affordable option for patients seeking treatment for minor ailments. An estimated 160 million patients visit urgent care sectors each year.
In many cases, urgent care patients are seeking quick treatment for acute, infectious disease?like symptoms such as cough and cold. And too often, the groups say, they are being improperly treated with antibiotics. Patient expectations, and the desire of doctors to keep patients happy, are contributing factors.
UCAOA and ARAC say they will work together to develop patient education programs, implement training and education programs for clinical and non-clinical staff, collect data on antibiotic prescribing, and promote evidence-based stewardship practices.
"We hope to begin by learning the best ways to communicate with patients that improves their understanding of when antibiotics are needed while also ensuring patients feel satisfied with their visits," ARAC Chief Medical Officer Cindy Liu, MD, MPH, said in a press release.
The groups said they hope their efforts will make the urgent care sector a leader in antibiotic stewardship.
Sep 26 Milken Institute School of Public Health press release
Study: Antibiotic use in small hospitals similar to larger facilities
A new study suggests small hospitals should be a target for efforts to improve antibiotic prescribing.
As reported today in Clinical Infectious Diseases, the study looked at antibiotic use in 15 small community hospitals (defined as having fewer than 200 beds) and 4 large community hospitals (200 beds or more) operated by Intermountain Healthcare, a nonprofit healthcare network in Utah and Idaho. Researchers evaluated antibiotic use at the hospitals from 2011 to 2013, using data from the National Healthcare and Safety Network antimicrobial use surveillance system.
Antibiotics were characterized based on spectrum of coverage, and use rates were expressed as days of therapy (DOT) per 1,000 patient days (PD).
Over the 3-year period, total antibiotic use rates at the small community hospitals varied greatly but were similar to rates at the large community hospitals, despite having a less complex patient population than the larger facilities. The researchers observed a median of 436 DOT/1,000 PD at the small hospitals and 509 DOT/1,000 PD at large hospitals. In addition, the proportion of broad-spectrum antibiotic use was similar. Broad-spectrum antibiotics accounted for 26% of total antibiotic use in the small hospitals and 32% in the large hospitals.
The authors say the study is significant because there's been little research done on antibiotic use at small community hospitals, which account for 72.4% of all US hospitals and therefore will play a major role in antibiotic stewardship efforts. And given the high rates of antibiotic use observed and the similar prescribing patterns compared with larger facilities, they conclude that implementing antibiotic stewardship programs (ASPs) at small hospitals is critical.
"With the majority of US hospitals having <200 beds and many without ASPs or infectious diseases support," they write, "helping small community hospitals improve antibiotic prescribing must become a priority for the infectious diseases community."
Sep 30 Clin Infect Dis abstract
Antimicrobial Resistance Scan for Sep 30, 2016
Vaccines and AMR; Stewardship in urgent care; Antibiotic use in small hospitals
Filed Under:
Antimicrobial Stewardship
Paper calls for greater role for vaccines in AMR fight
Vaccines should play a larger role in the battle against antimicrobial resistance (AMR), according to a new paper from British think tank Chatham House.
The paper comes in the wake of last week's United Nations meeting on AMR, which produced a commitment to a broad range of interventions aimed at preserving the effectiveness of the world's antibiotics. While those interventions included the creation of new vaccines to prevent infections, the authors argue that the role of vaccines in minimizing antimicrobial use?and consequentially the selection pressure that drive resistance?is being underrated. If vaccines can prevent people from getting infections in the first place, then antibiotics won't be needed, the authors state.
"Among the proposed solutions for tackling AMR, vaccines are a major tool that eliminates the need for antimicrobials, and therefore the need for other interventions related to conserving the utility of such drugs," write David Heymann, MD, and Abbas Omaar, MSc, of Chatham House's Centre on Global Health Security.
An example they cite is the pneumococcal conjugate vaccine, one of three vaccines against bacteria that have been developed since 1980. The World Health Organization, which has placed the vaccine on its essential medicines list, estimates it could prevent as many as 1.6 million deaths from pneumonia each year. The additional benefit of the vaccine is that it reduces the need for the antibiotics that have become increasingly ineffective against Streptococcus pneumoniae. Vaccines against meningitis and Haemophilus influenzae, they argue, provide similar benefits.
Of course, Heymann and Omaar acknowledge, creating vaccines for every infectious disease is unrealistic, given that vaccine development is technically difficult and expensive. But then again so is antibiotic development, and new antibiotics will do nothing to solve the resistance problem. They argue that more efforts should be made to analyze the costs and benefits of developing new vaccines for AMR control relative to those for investing in stewardship and antibiotic development.
"This may strengthen understanding of the unique and dynamic role that conferring immunity to disease can play in tackling AMR," they write.
Sep 28 Chatham House paper "New vaccines are essential to fighting antimicrobial resistance"
New partnership will focus on antibiotic use in urgent care
A new partnership is aiming to reduce the inappropriate use of antibiotics in outpatient settings.
The Urgent Care Association of America (UCAOA) and the Antibiotic Resistance Action Center (ARAC) at Milken Institute School of Public Health at George Washington University announced this week that they've entered into a 3-year partnership to improve patient and clinician understanding of appropriate antibiotic use in the urgent care sector, which has become an increasingly convenient and affordable option for patients seeking treatment for minor ailments. An estimated 160 million patients visit urgent care sectors each year.
In many cases, urgent care patients are seeking quick treatment for acute, infectious disease?like symptoms such as cough and cold. And too often, the groups say, they are being improperly treated with antibiotics. Patient expectations, and the desire of doctors to keep patients happy, are contributing factors.
UCAOA and ARAC say they will work together to develop patient education programs, implement training and education programs for clinical and non-clinical staff, collect data on antibiotic prescribing, and promote evidence-based stewardship practices.
"We hope to begin by learning the best ways to communicate with patients that improves their understanding of when antibiotics are needed while also ensuring patients feel satisfied with their visits," ARAC Chief Medical Officer Cindy Liu, MD, MPH, said in a press release.
The groups said they hope their efforts will make the urgent care sector a leader in antibiotic stewardship.
Sep 26 Milken Institute School of Public Health press release
Study: Antibiotic use in small hospitals similar to larger facilities
A new study suggests small hospitals should be a target for efforts to improve antibiotic prescribing.
As reported today in Clinical Infectious Diseases, the study looked at antibiotic use in 15 small community hospitals (defined as having fewer than 200 beds) and 4 large community hospitals (200 beds or more) operated by Intermountain Healthcare, a nonprofit healthcare network in Utah and Idaho. Researchers evaluated antibiotic use at the hospitals from 2011 to 2013, using data from the National Healthcare and Safety Network antimicrobial use surveillance system.
Antibiotics were characterized based on spectrum of coverage, and use rates were expressed as days of therapy (DOT) per 1,000 patient days (PD).
Over the 3-year period, total antibiotic use rates at the small community hospitals varied greatly but were similar to rates at the large community hospitals, despite having a less complex patient population than the larger facilities. The researchers observed a median of 436 DOT/1,000 PD at the small hospitals and 509 DOT/1,000 PD at large hospitals. In addition, the proportion of broad-spectrum antibiotic use was similar. Broad-spectrum antibiotics accounted for 26% of total antibiotic use in the small hospitals and 32% in the large hospitals.
The authors say the study is significant because there's been little research done on antibiotic use at small community hospitals, which account for 72.4% of all US hospitals and therefore will play a major role in antibiotic stewardship efforts. And given the high rates of antibiotic use observed and the similar prescribing patterns compared with larger facilities, they conclude that implementing antibiotic stewardship programs (ASPs) at small hospitals is critical.
"With the majority of US hospitals having <200 beds and many without ASPs or infectious diseases support," they write, "helping small community hospitals improve antibiotic prescribing must become a priority for the infectious diseases community."
Sep 30 Clin Infect Dis abstract