Shiloh
Editor, Senior Moderator
Source: http://www.cidrap.umn.edu/news-perspective/2018/10/stewardship-resistance-scan-oct-26-2018
Stewardship / Resistance Scan for Oct 26, 2018
Stewardship to reduce C diff; Declining ear infections, antibiotics
Filed Under:
Antimicrobial Stewardship; Clostridium difficile
[h=3]Cephalosporin-sparing stewardship tied to lower hospital C diff rates[/h] A Swedish study has found that a hospital stewardship program that restricted cephalosporin use was tied to reduced rates of Clostridioides difficile infection (CDI).
The retrospective study, published yesterday in the Journal of Antimicrobial Chemotherapy, compared two similar hospitals in the country?which has a high incidence of healthcare facility?associated CDI (HCF-CDI) in spite of relatively low in-hospital use of antibiotics. One of the hospitals instituted a cephalosporin-sparing antimicrobial stewardship program (ASP) after 2007, while the other had no such program.
The researchers found that, at the ASP hospital, cephalosporin use declined by 87% from 2007 to 2015, and the number of CDIs dropped from 2.25 per 1,000 hospital admissions to 1.16 (P = 0.0014). The non-ASP hospital, in contrast, had a slight (but not statistically significant) increase, from 2.09 to 2.38 CDIs per 1,000 hospital admissions. The authors said an increased use at the ASP hospital of other broad-spectrum antibiotics, such as piperacillin/tazobactam, was not associated with offsetting increases in CDI cases.
The investigators conclude, "Decreased use of cephalosporins is an effective strategy to decrease HCF-CDI incidence over time in a setting with high incidence and low antibiotic use."
Oct 25 J Antimicrob Chemother abstract
[h=3]Ear infections?and antibiotics for them?both show decline[/h] Scientists from the drug maker Pfizer report that US pediatric cases of acute otitis media (AOM, or middle ear infection) and antibiotic prescriptions for AOM declined substantially from 2011 to 2016, but the average number of antimicrobial prescriptions written per AOM visit remained stable, according to a study in Vaccine.
The investigators used various data sources to measure outpatient visits, incidence, antimicrobial prescriptions, and medical expenditures for AOM during the study period. They focused on children 9 years old and younger.
The researchers report an estimated 11.5 million AOM episodes in children in that age-group in 2011, with by far the highest incidence rate (IR) in children aged 2 years and younger. All subsequent years had lower IRs, and by 2016, IR was 25.1% lower than in 2011 across the age-group studied. The team also estimated that, from 2012 to 2016, 10.8 million fewer AOM cases and 9.2 million fewer cumulative AOM antimicrobial prescriptions were reported compared with 2011 estimates, which represents about a $5.6 billion drop in direct medical expenses.
The average number of antibiotic prescriptions per AOM visit, however, remained stable, with 0.89 and 0.86 prescriptions per visit in 2011 and 2016, respectively, indicating no change in prescribing practice.
Oct 24 Vaccine abstract
Stewardship / Resistance Scan for Oct 26, 2018
Stewardship to reduce C diff; Declining ear infections, antibiotics
Filed Under:
Antimicrobial Stewardship; Clostridium difficile
[h=3]Cephalosporin-sparing stewardship tied to lower hospital C diff rates[/h] A Swedish study has found that a hospital stewardship program that restricted cephalosporin use was tied to reduced rates of Clostridioides difficile infection (CDI).
The retrospective study, published yesterday in the Journal of Antimicrobial Chemotherapy, compared two similar hospitals in the country?which has a high incidence of healthcare facility?associated CDI (HCF-CDI) in spite of relatively low in-hospital use of antibiotics. One of the hospitals instituted a cephalosporin-sparing antimicrobial stewardship program (ASP) after 2007, while the other had no such program.
The researchers found that, at the ASP hospital, cephalosporin use declined by 87% from 2007 to 2015, and the number of CDIs dropped from 2.25 per 1,000 hospital admissions to 1.16 (P = 0.0014). The non-ASP hospital, in contrast, had a slight (but not statistically significant) increase, from 2.09 to 2.38 CDIs per 1,000 hospital admissions. The authors said an increased use at the ASP hospital of other broad-spectrum antibiotics, such as piperacillin/tazobactam, was not associated with offsetting increases in CDI cases.
The investigators conclude, "Decreased use of cephalosporins is an effective strategy to decrease HCF-CDI incidence over time in a setting with high incidence and low antibiotic use."
Oct 25 J Antimicrob Chemother abstract
[h=3]Ear infections?and antibiotics for them?both show decline[/h] Scientists from the drug maker Pfizer report that US pediatric cases of acute otitis media (AOM, or middle ear infection) and antibiotic prescriptions for AOM declined substantially from 2011 to 2016, but the average number of antimicrobial prescriptions written per AOM visit remained stable, according to a study in Vaccine.
The investigators used various data sources to measure outpatient visits, incidence, antimicrobial prescriptions, and medical expenditures for AOM during the study period. They focused on children 9 years old and younger.
The researchers report an estimated 11.5 million AOM episodes in children in that age-group in 2011, with by far the highest incidence rate (IR) in children aged 2 years and younger. All subsequent years had lower IRs, and by 2016, IR was 25.1% lower than in 2011 across the age-group studied. The team also estimated that, from 2012 to 2016, 10.8 million fewer AOM cases and 9.2 million fewer cumulative AOM antimicrobial prescriptions were reported compared with 2011 estimates, which represents about a $5.6 billion drop in direct medical expenses.
The average number of antibiotic prescriptions per AOM visit, however, remained stable, with 0.89 and 0.86 prescriptions per visit in 2011 and 2016, respectively, indicating no change in prescribing practice.
Oct 24 Vaccine abstract