Shiloh
Editor, Senior Moderator
Source: http://www.cidrap.umn.edu/news-perspective/2020/02/stewardship-resistance-scan-feb-26-2020
Stewardship / Resistance Scan for Feb 26, 2020
New AMR surveillance platform; Antibiotic failure in pneumonia patients
Filed Under:
Antimicrobial Stewardship
[h=3]New global AMR surveillance partnership announced[/h] The International Society for Infectious Diseases' (ISID's) Program for Monitoring Emerging Diseases (ProMED) today announced that it is teaming up with Public Health England to boost global antimicrobial resistance (AMR) surveillance efforts.
The organizations will collaborate on a surveillance platform, called ProMED-AMR, that will use digital detection methods and non-traditional sources to collect information on resistance trends, clusters of AMR, and newly identified cases in all World Health Organization regions. The platform will collect data on resistant pathogens in humans, animals, and the environment, and disseminate vetted and analyzed reports to an international audience of subscribers in real time.
"Antimicrobial resistant organisms have become major emerging pathogens of our era and ProMED-AMR will apply the same approaches to this problem as it has used so successfully in detecting and monitoring other emerging disease threats," ISID president Marc Mendelson, MBBS, PhD, said in a news release.
All information from the platform will be available free of charge.
Feb 26 ISID news release
[h=3]Study: Antibiotics fail in 22% of pneumonia outpatients[/h] An analysis of US health insurance claims data has found that antibiotic treatment failure occurs in 22% of adult patients receiving outpatient care for community-acquired pneumonia (CAP), a team of US researchers reported today in Open Forum Infectious Diseases.
For the retrospective cohort analysis, the researchers combed through data from the Marketscan commercial and Medicare supplemental databases to identify adults who were diagnosed and treated for CAP in the outpatient setting from 2011 through 2015 and received an antibiotic within 3 days of diagnosis. The primary outcome was antibiotic treatment failure, and secondary outcomes included 30-day all-cause mortality and CAP-related healthcare costs within the 30-day follow-up period.
A total of 251,947 unique patients met the criteria for the study. Their mean age was 52.2 years old, and 47.7% were men. The majority of patients were prescribed azithromycin (39.5%) or levofloxacin (36.9%). Overall, antibiotic treatment failure occurred in 22.1% of patients, but was higher in patients over 65 (25.7%, compared with 21.2% for adults aged 18 to 64). In both groups, treatment failure most frequently occurred with beta-lactam antibiotics. The most common type of treatment failure was a change to a new prescription.
Overall, all-cause mortality within 30 days of index treatment occurred in 7.6% of patients, but it was significantly higher in the antibiotic failure patients compared with the antibiotic success cohort (18.1% vs 4.6%), and the differences in 30-day mortality between antibiotic failure groups increased as a function of age. Mean 30-day CAP-related healthcare costs were also much higher in the patients who experienced treatment failure relative to those that did not ($2,140 vs. $54, respectively).
The authors of the study call the poor patient outcomes observed in patients who experienced antibiotic treatment failure "both clinically relevant and highly concerning."
"Collectively, our findings indicate significant shortcomings in the current treatment approach to managing patients with CAP in the outpatient setting, especially among those who are not responsive to initial therapy," they write. "The results of this study also identify great opportunities to improve the clinical management plans, including appropriate allocation of healthcare resources to avoid adverse outcomes for patients with CAP."
Feb 26 Open Forum Infect Dis abstract
Stewardship / Resistance Scan for Feb 26, 2020
New AMR surveillance platform; Antibiotic failure in pneumonia patients
Filed Under:
Antimicrobial Stewardship
[h=3]New global AMR surveillance partnership announced[/h] The International Society for Infectious Diseases' (ISID's) Program for Monitoring Emerging Diseases (ProMED) today announced that it is teaming up with Public Health England to boost global antimicrobial resistance (AMR) surveillance efforts.
The organizations will collaborate on a surveillance platform, called ProMED-AMR, that will use digital detection methods and non-traditional sources to collect information on resistance trends, clusters of AMR, and newly identified cases in all World Health Organization regions. The platform will collect data on resistant pathogens in humans, animals, and the environment, and disseminate vetted and analyzed reports to an international audience of subscribers in real time.
"Antimicrobial resistant organisms have become major emerging pathogens of our era and ProMED-AMR will apply the same approaches to this problem as it has used so successfully in detecting and monitoring other emerging disease threats," ISID president Marc Mendelson, MBBS, PhD, said in a news release.
All information from the platform will be available free of charge.
Feb 26 ISID news release
[h=3]Study: Antibiotics fail in 22% of pneumonia outpatients[/h] An analysis of US health insurance claims data has found that antibiotic treatment failure occurs in 22% of adult patients receiving outpatient care for community-acquired pneumonia (CAP), a team of US researchers reported today in Open Forum Infectious Diseases.
For the retrospective cohort analysis, the researchers combed through data from the Marketscan commercial and Medicare supplemental databases to identify adults who were diagnosed and treated for CAP in the outpatient setting from 2011 through 2015 and received an antibiotic within 3 days of diagnosis. The primary outcome was antibiotic treatment failure, and secondary outcomes included 30-day all-cause mortality and CAP-related healthcare costs within the 30-day follow-up period.
A total of 251,947 unique patients met the criteria for the study. Their mean age was 52.2 years old, and 47.7% were men. The majority of patients were prescribed azithromycin (39.5%) or levofloxacin (36.9%). Overall, antibiotic treatment failure occurred in 22.1% of patients, but was higher in patients over 65 (25.7%, compared with 21.2% for adults aged 18 to 64). In both groups, treatment failure most frequently occurred with beta-lactam antibiotics. The most common type of treatment failure was a change to a new prescription.
Overall, all-cause mortality within 30 days of index treatment occurred in 7.6% of patients, but it was significantly higher in the antibiotic failure patients compared with the antibiotic success cohort (18.1% vs 4.6%), and the differences in 30-day mortality between antibiotic failure groups increased as a function of age. Mean 30-day CAP-related healthcare costs were also much higher in the patients who experienced treatment failure relative to those that did not ($2,140 vs. $54, respectively).
The authors of the study call the poor patient outcomes observed in patients who experienced antibiotic treatment failure "both clinically relevant and highly concerning."
"Collectively, our findings indicate significant shortcomings in the current treatment approach to managing patients with CAP in the outpatient setting, especially among those who are not responsive to initial therapy," they write. "The results of this study also identify great opportunities to improve the clinical management plans, including appropriate allocation of healthcare resources to avoid adverse outcomes for patients with CAP."
Feb 26 Open Forum Infect Dis abstract