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CIDRAP Stewardship/Resistance Scan - CARB-X funds for new CRE antibiotic; NICU antibiotic stewardship

Shiloh

Editor, Senior Moderator
Source: https://www.cidrap.umn.edu/news-perspective/2020/10/stewardship-resistance-scan-oct-14-2020


Stewardship / Resistance Scan for Oct 14, 2020
CARB-X funds for new CRE antibiotic; NICU antibiotic stewardship
Filed Under:
Antimicrobial Stewardship



CARB-X taps Swiss company to develop antibiotic for Enterobacteriaceae

CARB-X announced today that it is awarding up to $2.62 million to Swiss biopharmaceutical company Polyphor AG to develop a new antibiotic to treat infections caused by Enterobacteriaceae, including carbapenem-resistant Enterobacteriaceae (CRE).
The antibiotic being developed by Polyphor is a thanatin-derivative peptide that targets the lipopolysaccharide transport protein in gram-negative bacteria to break down their outer membrane. The company says antibiotics in this class have shown potent and specific activity against Enterobacteriacea, including extremely drug-resistant strains like CRE.
"Polyphor's project enriches the pool of novel approaches to deliver a therapeutic that can treat infections caused by multidrug-resistant Gram-negative pathogens, for which only one new class since 1962 has been approved for use in patients," CARB-X research and development director Erin Duffy, PhD, said in a press release. "It is in the early stages of development, and if successful and approved, it could potentially change the way these life-threatening infections are treated and save lives."
This is the second CARB-X (the Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator) award for Polyphor. For today's award, the company will be eligible for an additional $15.82 million in funding if certain project milestones are met.
Since its launch in 2016, CARB-X has awarded more than $252 million to support early development of 70 antibacterial products.
Oct 14 CARB-X press release

Quality improvement program linked to reduce antibiotics in NICU

An initiative aimed at addressing gaps in antibiotic stewardship was associated with decreased antibiotic use and exposure in the neonatal intensive care unit (NICO) of a New York children's hospital, researchers reported today in Pediatrics.
The quality improvement (QI) initiative begun in 2016 at the Golisano Children's Hospital set out to decrease the antibiotic use rate (AUR) by 20% in the NICU by focusing on addressing gaps in the core elements of antibiotic stewardship programs outlined by the Centers for Disease Control and Prevention.
Strategies for reducing antibiotic use included data collection and analysis, audit and feedback on prescribing patterns, development of written guidelines for common infections, implementation of a sepsis risk calculator (SRC) to determine if evaluation for sepsis was warranted, and a focus on antibiotic use in preterm infants. The primary outcome measure was AUR, and the secondary outcome measure was the percentage of infants discharged without receiving antibiotics while in the NICU.
The monthly AUR decreased from 27.6% at baseline to 15.5%, a 43.8% reduction, and has been sustained for more than 18 months. The authors of the study attribute the decline to implementation of the SRC, adopting a 36-hour rule-out period for sepsis evaluations, a 36-hour antibiotic hard stop, and novel guidelines for early-onset sepsis (EOS) evaluation among infants younger than 35 weeks.
The percentage of infants discharged without antibiotic exposure increased from 15.8% to 35.1%. The percent of infants younger than 36 weeks undergoing evaluation for EOS decreased by 42.3% and for those under 35 weeks by 26.0%.
"We believe our methods for achieving improvement, which involved a rich understanding of our current system, rigorous testing, standardization of practices, and analyzing data over time, are applicable to all teams focused on QI," the authors wrote.
Oct 14 Pediatrics abstract
 
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