Shiloh
Editor, Senior Moderator
Source: https://www.cidrap.umn.edu/news-perspective/2021/11/stewardship-resistance-scan-nov-05-2021
Stewardship / Resistance Scan for Nov 05, 2021
Penicillin allergies in pregnant women; Antibiotic prescribing during COVID
Filed Under:
Antimicrobial Stewardship
Study highlights benefits of penicillin allergy testing in pregnant women
Most pregnant women with a reported history of penicillin allergy who were tested were found not to be allergic and could tolerate penicillin during labor, according to a small retrospective study presented today at the annual scientific meeting of the American College of Allergy, Asthma and Immunology (ACAAI).
Of the 32 women pregnant women evaluated in the study, 25 consented to penicillin skin testing, and all were found to be negative for a penicillin allergy. Eight of the 25 patients had uncomplicated pregnancies and thus were not exposed to penicillin administration throughout the pregnancy. Two received antibiotics prior to completion of a graded-oral challenge as a result of unexpected skin lacerations related to vaginal delivery. Thirteen tested positive for Group B Streptococcus (GBS) and had both skin testing and an oral amoxicillin challenge performed, then received penicillin administration during labor, with no reported issues.
GBS can cause invasive infections in newborns, and intrapartum antibiotic prophylaxis may be administered to prevent transmission during labor and delivery.
Allergist and chair of the ACAAI Task Force on Drug Allergy Mariana Castells, MD, PhD, said penicillin testing and de-labeling ahead of the potential need for penicillin could help avoid unnecessary use of broader-spectrum antibiotics.
"A pregnant woman with GBS may need penicillin for treatment," Castells said in an ACAAI press release. "If she is labelled as allergic, she will be offered a less effective, and possibly more harmful antibiotic."
The study abstract was published in the Annals of Allergy, Asthma & Immunology.
Nov 5 ACAAI press release
Nov 1 Ann Allergy Asthma Immunol abstract
Mayo study adds to data on antibiotic prescribing during pandemic
More than a third of COVID-19 patients treated at the Mayo Clinic in Minnesota over a 9-month period in 2020 received antibiotic therapy, with most receiving antibiotics within 48 hours of admission, researchers reported today in JAC-Antimicrobial Resistance.
Of 654 adult COVID-19 patients treated at Mayo from Mar 1, 2020, through Nov 30, 2020, 248 (37.9%) received antibiotics targeting suspected or confirmed bacterial respiratory infections. The incidence of antibiotic prescribing increased with disease severity, with 16.9%, 29.8%, and 64.6% of patients with mild, moderate, and severe disease, respectively, receiving antibiotics. Of the patients who received antibiotics, 212 (85.5%) received empiric therapy within 48 hours of admission. A specific pathogen was identified in the respiratory cultures of 47.1% of the 104 patients who had cultures collected. Over the study period, antibiotic prescribing rates decreased by 8.7% per month, despite an increase in COVID-19—related admissions.
Multivariable analysis found that intensive care unit admission, obtainment of procalcitonin values within 24 hours of admission, intubation, heart failure, hemodialysis, and nursing home residence were associated with empiric prescribing.
The study authors said antimicrobial stewardship programs (ASPs) should carefully monitor unnecessary antimicrobial use in COVID-19 patients with these patient-specific factors.
"Institutional ASPs should take an active role in intervening on unnecessary antimicrobial use in these patients by specifically understanding their local prescribing patterns, trending these patterns over time and identifying patient populations most likely to derive benefit from programmatic interventions," the team wrote.
Nov 5 JAC-Antimicrob Resist study
Stewardship / Resistance Scan for Nov 05, 2021
Penicillin allergies in pregnant women; Antibiotic prescribing during COVID
Filed Under:
Antimicrobial Stewardship
Study highlights benefits of penicillin allergy testing in pregnant women
Most pregnant women with a reported history of penicillin allergy who were tested were found not to be allergic and could tolerate penicillin during labor, according to a small retrospective study presented today at the annual scientific meeting of the American College of Allergy, Asthma and Immunology (ACAAI).
Of the 32 women pregnant women evaluated in the study, 25 consented to penicillin skin testing, and all were found to be negative for a penicillin allergy. Eight of the 25 patients had uncomplicated pregnancies and thus were not exposed to penicillin administration throughout the pregnancy. Two received antibiotics prior to completion of a graded-oral challenge as a result of unexpected skin lacerations related to vaginal delivery. Thirteen tested positive for Group B Streptococcus (GBS) and had both skin testing and an oral amoxicillin challenge performed, then received penicillin administration during labor, with no reported issues.
GBS can cause invasive infections in newborns, and intrapartum antibiotic prophylaxis may be administered to prevent transmission during labor and delivery.
Allergist and chair of the ACAAI Task Force on Drug Allergy Mariana Castells, MD, PhD, said penicillin testing and de-labeling ahead of the potential need for penicillin could help avoid unnecessary use of broader-spectrum antibiotics.
"A pregnant woman with GBS may need penicillin for treatment," Castells said in an ACAAI press release. "If she is labelled as allergic, she will be offered a less effective, and possibly more harmful antibiotic."
The study abstract was published in the Annals of Allergy, Asthma & Immunology.
Nov 5 ACAAI press release
Nov 1 Ann Allergy Asthma Immunol abstract
Mayo study adds to data on antibiotic prescribing during pandemic
More than a third of COVID-19 patients treated at the Mayo Clinic in Minnesota over a 9-month period in 2020 received antibiotic therapy, with most receiving antibiotics within 48 hours of admission, researchers reported today in JAC-Antimicrobial Resistance.
Of 654 adult COVID-19 patients treated at Mayo from Mar 1, 2020, through Nov 30, 2020, 248 (37.9%) received antibiotics targeting suspected or confirmed bacterial respiratory infections. The incidence of antibiotic prescribing increased with disease severity, with 16.9%, 29.8%, and 64.6% of patients with mild, moderate, and severe disease, respectively, receiving antibiotics. Of the patients who received antibiotics, 212 (85.5%) received empiric therapy within 48 hours of admission. A specific pathogen was identified in the respiratory cultures of 47.1% of the 104 patients who had cultures collected. Over the study period, antibiotic prescribing rates decreased by 8.7% per month, despite an increase in COVID-19—related admissions.
Multivariable analysis found that intensive care unit admission, obtainment of procalcitonin values within 24 hours of admission, intubation, heart failure, hemodialysis, and nursing home residence were associated with empiric prescribing.
The study authors said antimicrobial stewardship programs (ASPs) should carefully monitor unnecessary antimicrobial use in COVID-19 patients with these patient-specific factors.
"Institutional ASPs should take an active role in intervening on unnecessary antimicrobial use in these patients by specifically understanding their local prescribing patterns, trending these patterns over time and identifying patient populations most likely to derive benefit from programmatic interventions," the team wrote.
Nov 5 JAC-Antimicrob Resist study