Shiloh
Editor, Senior Moderator
Source: https://www.cidrap.umn.edu/news-perspective/2021/08/stewardship-resistance-scan-aug-19-2021
Stewardship / Resistance Scan for Aug 19, 2021
Antibiotic use in Australia during COVID; Japanese hospital stewardship
Filed Under:
Antimicrobial Stewardship; COVID-19
COVID-19 restrictions in Australia linked to lower community antibiotic use
COVID-19 restrictions in Australia were associated with a substantial decline in community dispensing of antibiotics for respiratory infections, researchers reported this week in the British Journal of Clinical Pharmacology.
Using national claims data on antibiotic dispensing from November 2015 through October 2020, a team led by researchers at the University of New South Wales (UNSW) Sydney conducted an interrupted time series analysis to investigate monthly trends in antibiotic dispensing and face-to-face and telehealth consultations with general practitioners (GPs). COVID-19 restrictions began in Australia in January 2020 with restrictions on travel from high-risk countries, ramped up in March 2020 with school closure and limits on gatherings, then were relaxed in May 2020.
The researchers observed a 17% increase in the monthly rate of antibiotic dispensing in March 2020, but from April onward there was a sustained 36% decline in the monthly rate of antibiotic dispensing, adjusted for seasonality.
The mean monthly rate of antibiotic dispensing for April through October 2020 fell to 56.8 per 1,000 population, from 91.1 per 1,000 population for the corresponding period in 2019. Dispensing of antibiotics primarily used for respiratory infections (roxithromycin, amoxicillin, and clarithromycin) fell by 51% to 69%, while antibiotics used for non-respiratory infections (flucloxacillin, metronidazole, and trimethoprim) were unchanged.
Antibiotics dispensed by GPs decreased from 63.5 per 1,000 population from April through October 2019 to 37.0 per 1,000 population during the corresponding period in 2020. GP consultation rates remained stable overall, but telehealth consultations accounted for 31% of consultations from April 2020 onward.
The study authors say the findings could inform post-pandemic antimicrobial stewardship practices.
"The 'natural experiment' arising from the public health responses to the COVID-19 pandemic is a unique occasion to inform antimicrobial prescribing guidelines, highlighting the potential reduction in antibiotic prescribing by GPs and specialists for respiratory viral infections," the study authors wrote.
Aug 17 Br J Clin Pharmacol study
Study: Stopping, de-escalating antibiotics didn't worsen patient outcomes
A review of stewardship interventions at a Japanese hospital suggests that the use of carbapenems and anti–methicillin-resistant Staphylococcus aureus (MRSA) antibiotics can be safely reduced without worsening patient outcomes, researchers reported this week in the American Journal of Infection Control.
The antimicrobial stewardship program (ASP) at the hospital reviewed all cases for which carbapenems and anti-MRSA antibiotics were used, focusing on dose, duration of use, therapeutic impact, and adverse effect, then made recommendations to prescribing physicians when the course of therapy was completed. Recommendations included discontinuation, de-escalation, and changes in antibiotic use. Analysis of these interventions focused on clinical and microbiologic outcomes in patients treated from December 2018 through November 2019.
While previous studies have looked at the effects of similar interventions on antibiotic use, the study authors say this is the first to investigate the effect of such interventions on clinical and microbiologic outcomes.
The analysis found that favorable clinical responses were obtained in 165 of 184 cases (89.7%) in which the interventions were accepted, compared with 14 of 19 cases (73.7%) in which the intervention was not accepted. In addition, all-cause 30-day mortality was lower in the accepted group than in the not-accepted group (1.1% vs 10.5%). But there were no significant differences on the infection-related 30-day mortality between the accepted and not-accepted patients (0.5% and 0%, respectively). Microbiologic outcomes w
Stewardship / Resistance Scan for Aug 19, 2021
Antibiotic use in Australia during COVID; Japanese hospital stewardship
Filed Under:
Antimicrobial Stewardship; COVID-19
COVID-19 restrictions in Australia linked to lower community antibiotic use
COVID-19 restrictions in Australia were associated with a substantial decline in community dispensing of antibiotics for respiratory infections, researchers reported this week in the British Journal of Clinical Pharmacology.
Using national claims data on antibiotic dispensing from November 2015 through October 2020, a team led by researchers at the University of New South Wales (UNSW) Sydney conducted an interrupted time series analysis to investigate monthly trends in antibiotic dispensing and face-to-face and telehealth consultations with general practitioners (GPs). COVID-19 restrictions began in Australia in January 2020 with restrictions on travel from high-risk countries, ramped up in March 2020 with school closure and limits on gatherings, then were relaxed in May 2020.
The researchers observed a 17% increase in the monthly rate of antibiotic dispensing in March 2020, but from April onward there was a sustained 36% decline in the monthly rate of antibiotic dispensing, adjusted for seasonality.
The mean monthly rate of antibiotic dispensing for April through October 2020 fell to 56.8 per 1,000 population, from 91.1 per 1,000 population for the corresponding period in 2019. Dispensing of antibiotics primarily used for respiratory infections (roxithromycin, amoxicillin, and clarithromycin) fell by 51% to 69%, while antibiotics used for non-respiratory infections (flucloxacillin, metronidazole, and trimethoprim) were unchanged.
Antibiotics dispensed by GPs decreased from 63.5 per 1,000 population from April through October 2019 to 37.0 per 1,000 population during the corresponding period in 2020. GP consultation rates remained stable overall, but telehealth consultations accounted for 31% of consultations from April 2020 onward.
The study authors say the findings could inform post-pandemic antimicrobial stewardship practices.
"The 'natural experiment' arising from the public health responses to the COVID-19 pandemic is a unique occasion to inform antimicrobial prescribing guidelines, highlighting the potential reduction in antibiotic prescribing by GPs and specialists for respiratory viral infections," the study authors wrote.
Aug 17 Br J Clin Pharmacol study
Study: Stopping, de-escalating antibiotics didn't worsen patient outcomes
A review of stewardship interventions at a Japanese hospital suggests that the use of carbapenems and anti–methicillin-resistant Staphylococcus aureus (MRSA) antibiotics can be safely reduced without worsening patient outcomes, researchers reported this week in the American Journal of Infection Control.
The antimicrobial stewardship program (ASP) at the hospital reviewed all cases for which carbapenems and anti-MRSA antibiotics were used, focusing on dose, duration of use, therapeutic impact, and adverse effect, then made recommendations to prescribing physicians when the course of therapy was completed. Recommendations included discontinuation, de-escalation, and changes in antibiotic use. Analysis of these interventions focused on clinical and microbiologic outcomes in patients treated from December 2018 through November 2019.
While previous studies have looked at the effects of similar interventions on antibiotic use, the study authors say this is the first to investigate the effect of such interventions on clinical and microbiologic outcomes.
The analysis found that favorable clinical responses were obtained in 165 of 184 cases (89.7%) in which the interventions were accepted, compared with 14 of 19 cases (73.7%) in which the intervention was not accepted. In addition, all-cause 30-day mortality was lower in the accepted group than in the not-accepted group (1.1% vs 10.5%). But there were no significant differences on the infection-related 30-day mortality between the accepted and not-accepted patients (0.5% and 0%, respectively). Microbiologic outcomes w