Shiloh
Editor, Senior Moderator
Source: http://www.cidrap.umn.edu/news-perspective/2019/08/stewardship-resistance-scan-aug-20-2019
Stewardship / Resistance Scan for Aug 20, 2019
Parenteral antibiotics in neonates; Funds for superbug vaccine
Filed Under:
Antimicrobial Stewardship
[h=3]Study supports shorter parenteral antibiotics for infants with bacteremic UTIs[/h] A study of infants who had bacteremic urinary tract infections (UTIs) indicates that short-course parenteral antibiotic therapy may be considered as a treatment option, a team of US researchers reported today in Pediatrics.
In the multicenter retrospective cohort study, conducted at 11 geographically diverse US children's hospitals, researchers with the Febrile Young Infant Research Collaborative examined the association between parenteral antibiotic duration and clinical outcomes in infants younger than 60 days who had a UTI with concomitant bacteremia. UTIs are a common bacterial infection in young infants, and approximately 8% to 10% have bacteremic UTIs. Yet no evidence-based treatment guidelines exist in this population, and infants with bacteremic UTIs frequently receive prolonged courses of parenteral antibiotics, which can lead to complications, prolonged hospitalization, and increased costs.
The primary outcome of the analysis was UTI recurrence resulting in an emergency department visit or hospitalization within 30 days of discharge. Secondary outcomes included length of hospitalization and 30-day all-cause hospital reutilization.
Among the 115 infants treated for bacteremic UTIs from 2011 through 2016, 58 received short-course parenteral antibiotic therapy (defined as 7 days or less) and 57 received long-course antibiotics (7 days or more). Six infants had a recurrent UTI, and no significant difference was found in the rates of recurrent UTI between the two treatment groups (adjusted risk difference, 3%; 95% confidence interval [CI], ?5.8 to 12.7). Fifteen infants had 30-day all-cause reutilization, with no significant difference found in the rates of reutilization between the two groups (adjusted risk difference, 3%; 95% CI, ?14.6 to 20.4). The adjusted mean hospital duration was significantly longer in the long-course group compared with the short-course group (adjusted mean difference, 6 days; 95% CI, 4.0 to 8.8).
The authors of the study conclude, "Our data indicates that ≤7 days of parenteral antibiotic therapy may be safe in this population. Researchers in future prospective studies should seek to establish the bioavailability and optimal dosing of oral antibiotics in young infants and assess if there are particular subpopulations of infants with bacteremic UTI who may benefit from longer courses of parenteral antibiotic therapy."
Aug 20 Pediatrics study
[h=3]CARB-X awards funds for developing vaccine against resistant Klebsiella[/h] CARB-X today said it is awarding Vaxxilon AG of Reinach, Switzerland, up to $1.4 million?and possibly more?to develop a multivalent vaccine to prevent infections caused by carbapenem-resistant Klebsiella pneumoniae, an invasive and deadly gram-negative bacterium.
Arne von Bonin, PhD, chief scientific officer and head of immunology at Vaxxilon, said in a CARB-X news release, "CARB-X's award will support the development of VXN-319, a semi-synthetic conjugate vaccine targeting multiple strains of Klebsiella pneumoniae, one of the top priority critical pathogens identified by the World Health Organization."
Vaxxilon said it expects the vaccine would protect against more than 80% of carbapenem-resistant strains of K pneumoniae. To create VXN-319, Vaxxilon scientists synthesized the carbohydrates that resemble the coating that surrounds each bacterial cell. They then combined the synthetic carbohydrates with other components to create a conjugate vaccine similar to those that have been approved to prevent infections from bacteria such as Streptococcus pneumoniae and Haemophilus influenzae type B.
"Vaccines are vital tools in the fight against disease and drug-resistant bacteria, with the potential to prevent infections and reduce the spread of life-threatening bacteria," said Kevin Outterson, JD, CARB-X executive director and professor of law at Boston University. "Vaxxilon's vaccine, if approved for use in patients, could prevent deadly infections and save the lives of thousands of patients."
Vaxxilon could receive $3.1 million in additional funding if certain project milestones are met, according to CARB-X (the Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator). Since its inception in 2016, CARB-X has announced awards for 46 projects in seven countries exceeding $134 million total.
Aug 20 CARB-X news release
Stewardship / Resistance Scan for Aug 20, 2019
Parenteral antibiotics in neonates; Funds for superbug vaccine
Filed Under:
Antimicrobial Stewardship
[h=3]Study supports shorter parenteral antibiotics for infants with bacteremic UTIs[/h] A study of infants who had bacteremic urinary tract infections (UTIs) indicates that short-course parenteral antibiotic therapy may be considered as a treatment option, a team of US researchers reported today in Pediatrics.
In the multicenter retrospective cohort study, conducted at 11 geographically diverse US children's hospitals, researchers with the Febrile Young Infant Research Collaborative examined the association between parenteral antibiotic duration and clinical outcomes in infants younger than 60 days who had a UTI with concomitant bacteremia. UTIs are a common bacterial infection in young infants, and approximately 8% to 10% have bacteremic UTIs. Yet no evidence-based treatment guidelines exist in this population, and infants with bacteremic UTIs frequently receive prolonged courses of parenteral antibiotics, which can lead to complications, prolonged hospitalization, and increased costs.
The primary outcome of the analysis was UTI recurrence resulting in an emergency department visit or hospitalization within 30 days of discharge. Secondary outcomes included length of hospitalization and 30-day all-cause hospital reutilization.
Among the 115 infants treated for bacteremic UTIs from 2011 through 2016, 58 received short-course parenteral antibiotic therapy (defined as 7 days or less) and 57 received long-course antibiotics (7 days or more). Six infants had a recurrent UTI, and no significant difference was found in the rates of recurrent UTI between the two treatment groups (adjusted risk difference, 3%; 95% confidence interval [CI], ?5.8 to 12.7). Fifteen infants had 30-day all-cause reutilization, with no significant difference found in the rates of reutilization between the two groups (adjusted risk difference, 3%; 95% CI, ?14.6 to 20.4). The adjusted mean hospital duration was significantly longer in the long-course group compared with the short-course group (adjusted mean difference, 6 days; 95% CI, 4.0 to 8.8).
The authors of the study conclude, "Our data indicates that ≤7 days of parenteral antibiotic therapy may be safe in this population. Researchers in future prospective studies should seek to establish the bioavailability and optimal dosing of oral antibiotics in young infants and assess if there are particular subpopulations of infants with bacteremic UTI who may benefit from longer courses of parenteral antibiotic therapy."
Aug 20 Pediatrics study
[h=3]CARB-X awards funds for developing vaccine against resistant Klebsiella[/h] CARB-X today said it is awarding Vaxxilon AG of Reinach, Switzerland, up to $1.4 million?and possibly more?to develop a multivalent vaccine to prevent infections caused by carbapenem-resistant Klebsiella pneumoniae, an invasive and deadly gram-negative bacterium.
Arne von Bonin, PhD, chief scientific officer and head of immunology at Vaxxilon, said in a CARB-X news release, "CARB-X's award will support the development of VXN-319, a semi-synthetic conjugate vaccine targeting multiple strains of Klebsiella pneumoniae, one of the top priority critical pathogens identified by the World Health Organization."
Vaxxilon said it expects the vaccine would protect against more than 80% of carbapenem-resistant strains of K pneumoniae. To create VXN-319, Vaxxilon scientists synthesized the carbohydrates that resemble the coating that surrounds each bacterial cell. They then combined the synthetic carbohydrates with other components to create a conjugate vaccine similar to those that have been approved to prevent infections from bacteria such as Streptococcus pneumoniae and Haemophilus influenzae type B.
"Vaccines are vital tools in the fight against disease and drug-resistant bacteria, with the potential to prevent infections and reduce the spread of life-threatening bacteria," said Kevin Outterson, JD, CARB-X executive director and professor of law at Boston University. "Vaxxilon's vaccine, if approved for use in patients, could prevent deadly infections and save the lives of thousands of patients."
Vaxxilon could receive $3.1 million in additional funding if certain project milestones are met, according to CARB-X (the Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator). Since its inception in 2016, CARB-X has announced awards for 46 projects in seven countries exceeding $134 million total.
Aug 20 CARB-X news release