The Evolving Role of Antimicrobial Stewardship Interventions in Combating Antibiotic Resistance

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotics Use and Antimicrobial Stewardship".

Deadline for manuscript submissions: closed (30 September 2023) | Viewed by 7983

Special Issue Editor


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Guest Editor
Hanyang University College of Medicine, Seoul, Korea
Interests: antimicrobial stewardship; multi-durg resistant pathogen; urinary tract infection

Special Issue Information

Dear Colleagues,

Antimicrobial resistance is a one of the greatest public health threats that affects us all. While overall antibiotic use is decreasing in many countries, inappropriate antibiotic use still represents over 20% of cases in hospitals. As physicians responsible for patient health as well as public health, it is vital to learn about prudent use of antibiotics. Further, it is important that we, as responsible clinicians, policy makers, and researchers, develop methods of encouraging physicians to use antimicrobials appropriately. This Special Issue therefore encourages submissions on research in areas of antimicrobial stewardship interventions.

Dr. Bongyoung Kim
Guest Editor

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Keywords

  • antibiotics
  • antimicrobials
  • stewardship
  • antimicrobial stewardship
  • antimicrobial resistance
  • intervention

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Published Papers (4 papers)

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Research

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15 pages, 516 KiB  
Article
Misconceptions and Knowledge Gaps on Antibiotic Use and Resistance in Four Healthcare Settings and Five European Countries—A Modified Delphi Study
by Athina Chalkidou, Maarten Lambert, Gloria Cordoba, Katja Taxis, Malene Plejdrup Hansen and Lars Bjerrum
Antibiotics 2023, 12(9), 1435; https://doi.org/10.3390/antibiotics12091435 - 11 Sep 2023
Cited by 2 | Viewed by 2308
Abstract
Misconceptions and knowledge gaps about antibiotics contribute to inappropriate antibiotic use and antimicrobial resistance. This study aimed to identify and prioritize misconceptions and knowledge gaps about antibiotic use from a healthcare professionals’ perspective. A modified Delphi study with a predefined list of statements, [...] Read more.
Misconceptions and knowledge gaps about antibiotics contribute to inappropriate antibiotic use and antimicrobial resistance. This study aimed to identify and prioritize misconceptions and knowledge gaps about antibiotic use from a healthcare professionals’ perspective. A modified Delphi study with a predefined list of statements, two questionnaire rounds, and an expert meeting was conducted. The statements were rated by healthcare professionals from France, Greece, Lithuania, Poland, and Spain, and from general practice, out-of-hour services, nursing homes, and pharmacies. A total of 44 pre-defined statements covered the following themes: (1) antimicrobial resistance in general, (2) use of antibiotics in general, (3) use of antibiotics for respiratory tract infections, and (4) use of antibiotics for urinary tract infections. Consensus was defined as ≥80% agreement between the professionals during the second Delphi round. For 30% of the statements, professionals from the four settings together reached consensus. In each setting individually, at least 50% of the statements reached consensus, indicating that there are still many misconceptions and knowledge gaps that need to be addressed. Six educational tools (leaflets, posters, checklists) were developed to address the knowledge gaps and misconceptions. These can be used by patients and healthcare professionals to improve the use of antibiotics in practice. Full article
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10 pages, 802 KiB  
Article
Real-World Data about Commonly Used Antibiotics in Long-Term Care Homes in Australia from 2016 to 2019
by Chloé C. H. Smit, Kris Rogers, Hamish Robertson, Katja Taxis and Lisa G. Pont
Antibiotics 2023, 12(9), 1393; https://doi.org/10.3390/antibiotics12091393 - 31 Aug 2023
Cited by 2 | Viewed by 1662
Abstract
In this study, we use real-world data to explore trends in antibiotic use in a dynamic cohort of long-term care (LTC) residents. A cross-sectional retrospective analysis of pharmacy medication supply records of 3459 LTC residents was conducted from 31 May 2016 to 31 [...] Read more.
In this study, we use real-world data to explore trends in antibiotic use in a dynamic cohort of long-term care (LTC) residents. A cross-sectional retrospective analysis of pharmacy medication supply records of 3459 LTC residents was conducted from 31 May 2016 to 31 May 2019. The primary outcome was the monthly prevalence of residents with an antibiotic episode. Secondary outcomes were the type of antibiotic used and duration of use. Over the three-year study period, residents were supplied 10460 antibiotics. On average, 18.9% of residents received an antibiotic monthly. Antibiotic use decreased slightly over time with a mean of 168/1000 (95% CI 146–177) residents using at least one antibiotic per month in June 2016 to 148/1000 (95% CI 127–156) in May 2019. The total number of antibiotic days per 100 resident days remained relatively constant over the study period: 8.8 days in 2016–2017, 8.4 in 2017–2018 and 6.4 in 2018–2019. Prolonged durations exceeding 100 days were seen for a small percentage of residents. We found extensive antibiotic use, which is a recognized contributor to antimicrobial resistance development, underscoring the necessity for quality treatment guidelines in this vulnerable population. Full article
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10 pages, 721 KiB  
Article
Antibiotic Use during Pregnancy in South Korea Using 2011–2020 National Health Insurance Claims Data
by Jungmi Chae, Jun Yong Choi, Bongyoung Kim and Dong-Sook Kim
Antibiotics 2023, 12(8), 1242; https://doi.org/10.3390/antibiotics12081242 - 28 Jul 2023
Cited by 2 | Viewed by 1703
Abstract
Background: Since antimicrobial overuse and misuse can have substantial impacts on both public health and fetal well-being, it is essential to gain comprehensive insights into antimicrobial consumption patterns in pregnant women. This study aims to demonstrate antimicrobial utilization in pregnant women. Methods: We [...] Read more.
Background: Since antimicrobial overuse and misuse can have substantial impacts on both public health and fetal well-being, it is essential to gain comprehensive insights into antimicrobial consumption patterns in pregnant women. This study aims to demonstrate antimicrobial utilization in pregnant women. Methods: We conducted a population-based cohort study using National Health Insurance claims data from January 2009 to December 2020 in South Korea. The target population was pregnancies in women aged 15–45 years who gave birth between 2011 and 2019. The outcome measure was the percentage of antibiotic prescriptions by trimester, subgroup, diagnostic category, and therapeutic category. Antibiotics were defined as J01 in the WHO ATC/DDD classification. To analyze the factors that influenced antibiotic prescriptions, we conducted multivariate logistic regression analysis. Results: Antibiotics were prescribed at least once in 1,808,588 (50%) of the 3,614,478 pregnancies. The proportion of deliveries with exposure to antibiotic therapy during pregnancy increased from 48% in 2011 to 54.8% in 2020. The prescription rate of antibiotics was highest in mothers younger than 25 years old, and it was lowest in participants aged 30–34 years. Also, antibiotic use was highest in the first trimester (30%) and lowest in the second trimester (18.2%). The most commonly used class was J01D (other beta-lactam antibacterials), which includes cephalosporins, and it accounted for 57% of the prescribed antibiotics. An increased probability of being prescribed antibiotics was associated with those younger than 25 years old, insurance (Medical Aid), hospitalization experience, an increase in physician visits, and comorbidities. For comorbidities, the OR was higher for respiratory tract infection (RTI), sexually transmitted infection, and urinary tract infection compared to those without disease, whereas it was decreased for diabetes and epilepsy. Conclusion: The prescribing rate of antibiotics to pregnant women in South Korea has remained stably high. Also, an increase in the use of broad-spectrum beta-lactam penicillin was noted. It is necessary to monitor antibiotics in pregnant women generally in accordance with recommendations. Full article
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Review

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31 pages, 1456 KiB  
Review
The Role of Adult Vaccines as Part of Antimicrobial Stewardship: A Scoping Review
by Charles Travers Williams, Syed Tabish Razi Zaidi, Bandana Saini and Ronald Castelino
Antibiotics 2023, 12(9), 1429; https://doi.org/10.3390/antibiotics12091429 - 10 Sep 2023
Cited by 1 | Viewed by 1693
Abstract
Background: Antimicrobial resistance (AMR) is a significant global health concern, causing an estimated 700,000 deaths annually. Although immunisation has been shown to significantly reduce AMR, the role of vaccines as part of antimicrobial stewardship (AMS) practices is often overlooked. Objective: To identify and [...] Read more.
Background: Antimicrobial resistance (AMR) is a significant global health concern, causing an estimated 700,000 deaths annually. Although immunisation has been shown to significantly reduce AMR, the role of vaccines as part of antimicrobial stewardship (AMS) practices is often overlooked. Objective: To identify and examine the available literature on the role of vaccines as part of AMS practices. Method: A scoping review was conducted in the following databases: MEDLINE, Embase, Scopus, CINAHL, CCRCT, IPA, and WoS, along with grey literature sources. The review was conducted using the JBI Methodology for Scoping Reviews and reported in line with the PRISMA-SCr checklist. Results: Among the 1711 records identified, 34 met the inclusion criteria; 8 discussed only the concept, while 26 discussed both the concept and the vaccine implementation method in AMS practices. There were eight recommended and/or utilised types of AMS activities identified involving vaccines, under four key themes of vaccine-related AMS strategies: Education, Screening, Vaccination, and Monitoring. Influenza and pneumococcal vaccines had the most evidence for inclusion. Conclusion: Overall, the evidence supports the role of vaccines as part of AMS practices and the value of their inclusion in creating improved and comprehensive AMS strategies to further combat the development of AMR. Full article
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