Shiloh
Editor, Senior Moderator
Source: https://www.cidrap.umn.edu/news-perspective/2020/05/news-scan-may-14-2020
News Scan for May 14, 2020
Antibiotic use in Indian hospitals; Antibiotic resistance board game
Filed Under:
Antimicrobial Stewardship
Study shows rising use of second-, third-line antibiotics in Indian hospitals
Use of second- and third-line antibiotics and fixed-dose combinations (FDCs) of antibiotics increased over a 10-year period at two Indian hospitals, a team of Swedish researchers reported yesterday in BMC Infectious Diseases.
In the study, researchers from Karolinska Insitutet looked at antibiotic prescribing practices at a teaching hospital and a non-teaching hospital in Madhya Pradesh, a large state in central India. The hospitals were selected because they were representative of most healthcare facilities in low- and middle-income countries, where the infectious disease burden is often high and antibiotic resistance is a common cause of mortality in patients with infectious disease.
Antibiotic prescription data were analyzed using the World Health Organization (WHO) classification system, which categorizes antibiotics under the Access, Watch, and Reserve labels based on the risk of antibiotic resistance. Access antibiotics are first-choice antibiotics that should be widely available, while Watch antibiotics are drugs that should be used only for specific indications, and Reserve antibiotics should be used only when other antibiotics don't work. FDCs, which are not recommended because they have been shown to drive resistance, consist of at least two antibiotics, often from different classes.
The researchers analyzed prescribing data on a total of 3,766 patients with infections—2,504 in the non-teaching hospital and 1,262 in the teaching hospital—and 92% and 98%, respectively, received antibiotics. Sixty-one percent of total prescriptions in the teaching hospital and 40% in the non-teaching hospital were for the Access category of antibiotics, while Watch category antibiotics comprised 29% and 40% of total prescriptions in the teaching and non-teaching hospital, respectively. Prescribing of FDCs of antibiotics was significantly higher in the non-teaching hospital (18%) than in the teaching hospital (8%, P < 0.05).
From 2008 through 2017, prescribing of all categories of antibiotics and FDCs increased significantly in the non-teaching hospital. Although overall antibiotic prescribing at the teaching hospital did not change significantly, prescribing of Watch and Reserve antibiotics increased, as did FDCs. Total antibiotic prescribing among patients with pneumonia, peritonitis, and cellulitis increased in both hospitals.
The authors say the establishment of antibiotic stewardship programs based in the WHO classification system, along with the implementation of routine diagnostics, could improve antibiotic prescribing.
May 13 BMC Infect Dis study
Board game helps improve AMR knowledge, Saudi study find
The results of a study conducted in Saudi Arabia suggest that the use of a board game can significantly increase knowledge of antimicrobial resistance (AMR), with better retention than a conventional lecture, researchers reported yesterday in BMC Public Health.
Using a single-blinded parallel-group randomized controlled design, researchers from the College of Dentistry at Umm-Al Qura University randomized 93 volunteers into two groups. Participants in the study group received information about AMR by playing a board game involving dice and flash cards with questions and information. The control group received the same information but by a conventional lecture. Participants filled out questionnaires to test their knowledge at three different time points: (T1) before the intervention, (T2) immediately after the intervention, and (T3) 1 month after the intervention for follow-up to evaluate their retention of the information.
The results showed significant improvements (P < 0.05) in knowledge scores for T2 and T3 in comparison to the T1 baseline scores in both groups. The knowledge scores also relapsed significantly from T2 to T3 in both groups, but the reduction of total knowledge scores from T2 to T3 was significantly greater in the control group than in the study group (P = 0.002), and the improvements in total knowledge scores from T1 to T3 were significantly higher in the study group than in the control group (P < 0.001). The overall mean knowledge score at T3 was also higher in the study group than the control group.
"Gamification using board games seems to be a promising tool for promotional efforts to improve public health knowledge about AMR in relation to dental treatment, as well as other oral health care topics," the authors wrote. "A board game is easy and affordable for use in middle and low socioeconomic communities, and this game provided good levels of retention of information about AMR. Nevertheless, further studies are needed to generalize this study's results."
May 13 BMC Public Health study
News Scan for May 14, 2020
Antibiotic use in Indian hospitals; Antibiotic resistance board game
Filed Under:
Antimicrobial Stewardship
Study shows rising use of second-, third-line antibiotics in Indian hospitals
Use of second- and third-line antibiotics and fixed-dose combinations (FDCs) of antibiotics increased over a 10-year period at two Indian hospitals, a team of Swedish researchers reported yesterday in BMC Infectious Diseases.
In the study, researchers from Karolinska Insitutet looked at antibiotic prescribing practices at a teaching hospital and a non-teaching hospital in Madhya Pradesh, a large state in central India. The hospitals were selected because they were representative of most healthcare facilities in low- and middle-income countries, where the infectious disease burden is often high and antibiotic resistance is a common cause of mortality in patients with infectious disease.
Antibiotic prescription data were analyzed using the World Health Organization (WHO) classification system, which categorizes antibiotics under the Access, Watch, and Reserve labels based on the risk of antibiotic resistance. Access antibiotics are first-choice antibiotics that should be widely available, while Watch antibiotics are drugs that should be used only for specific indications, and Reserve antibiotics should be used only when other antibiotics don't work. FDCs, which are not recommended because they have been shown to drive resistance, consist of at least two antibiotics, often from different classes.
The researchers analyzed prescribing data on a total of 3,766 patients with infections—2,504 in the non-teaching hospital and 1,262 in the teaching hospital—and 92% and 98%, respectively, received antibiotics. Sixty-one percent of total prescriptions in the teaching hospital and 40% in the non-teaching hospital were for the Access category of antibiotics, while Watch category antibiotics comprised 29% and 40% of total prescriptions in the teaching and non-teaching hospital, respectively. Prescribing of FDCs of antibiotics was significantly higher in the non-teaching hospital (18%) than in the teaching hospital (8%, P < 0.05).
From 2008 through 2017, prescribing of all categories of antibiotics and FDCs increased significantly in the non-teaching hospital. Although overall antibiotic prescribing at the teaching hospital did not change significantly, prescribing of Watch and Reserve antibiotics increased, as did FDCs. Total antibiotic prescribing among patients with pneumonia, peritonitis, and cellulitis increased in both hospitals.
The authors say the establishment of antibiotic stewardship programs based in the WHO classification system, along with the implementation of routine diagnostics, could improve antibiotic prescribing.
May 13 BMC Infect Dis study
Board game helps improve AMR knowledge, Saudi study find
The results of a study conducted in Saudi Arabia suggest that the use of a board game can significantly increase knowledge of antimicrobial resistance (AMR), with better retention than a conventional lecture, researchers reported yesterday in BMC Public Health.
Using a single-blinded parallel-group randomized controlled design, researchers from the College of Dentistry at Umm-Al Qura University randomized 93 volunteers into two groups. Participants in the study group received information about AMR by playing a board game involving dice and flash cards with questions and information. The control group received the same information but by a conventional lecture. Participants filled out questionnaires to test their knowledge at three different time points: (T1) before the intervention, (T2) immediately after the intervention, and (T3) 1 month after the intervention for follow-up to evaluate their retention of the information.
The results showed significant improvements (P < 0.05) in knowledge scores for T2 and T3 in comparison to the T1 baseline scores in both groups. The knowledge scores also relapsed significantly from T2 to T3 in both groups, but the reduction of total knowledge scores from T2 to T3 was significantly greater in the control group than in the study group (P = 0.002), and the improvements in total knowledge scores from T1 to T3 were significantly higher in the study group than in the control group (P < 0.001). The overall mean knowledge score at T3 was also higher in the study group than the control group.
"Gamification using board games seems to be a promising tool for promotional efforts to improve public health knowledge about AMR in relation to dental treatment, as well as other oral health care topics," the authors wrote. "A board game is easy and affordable for use in middle and low socioeconomic communities, and this game provided good levels of retention of information about AMR. Nevertheless, further studies are needed to generalize this study's results."
May 13 BMC Public Health study