scholarly journals Surveillance of Antimicrobial Use and Antimicrobial Resistance in United States Hospitals: Project ICARE Phase 2

1999 ◽  
Vol 29 (2) ◽  
pp. 245-252 ◽  
Author(s):  
Scott K. Fridkin ◽  
Christine D. Steward ◽  
Jonathan R. Edwards ◽  
Erica R. Pryor ◽  
John E. McGowan, Jr. ◽  
...  
Keyword(s):  
United States ◽  
Antimicrobial Resistance ◽  
Antimicrobial Use ◽  
Phase 2

Otitis Media—Principles of Judicious Use of Antimicrobial Agents

PEDIATRICS ◽  
1998 ◽  
Vol 101 (Supplement_1) ◽  
pp. 165-171 ◽  
Author(s):  
Scott F. Dowell ◽  
S. Michael Marcy ◽  
William R. Phillips ◽  
Michael A. Gerber ◽  
Benjamin Schwartz
Keyword(s):  
United States ◽  
Antimicrobial Resistance ◽  
Otitis Media ◽  
Antibiotic Treatment ◽  
Antimicrobial Agents ◽  
Otitis Media With Effusion ◽  
Antimicrobial Prophylaxis ◽  
Acute Otitis Media ◽  
The United States ◽  
Antimicrobial Use

Otitis media is the leading indication for outpatient antimicrobial use in the United States. Overdiagnosis of and unnecessary prescribing for this condition has contributed to the spread of antimicrobial resistance. A critical step in reducing unnecessary prescribing is to identify the subset of patients who are unlikely to benefit from antibiotics. Conscientiously distinguishing acute otitis media (AOM) from otitis media with effusion (OME), and deferring antibiotics for OME will accomplish this goal, and will avoid up to 8 million unnecessary courses of antibiotics annually. Criteria for defining these conditions are presented, as well as the evidence supporting deferring antibiotic treatment. Discussions of shortened courses of antibiotics for AOM and restricted indications for antimicrobial prophylaxis are also presented.

scholarly journals 920. Use of the Web by State and Territorial Health Departments to Promote the Dissemination of State Antimicrobial Resistance Surveillance Data, United States

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S494-S495
Author(s):  
Xin Yin ◽  
Keith W Hamilton ◽  
Heather Tate ◽  
Nkuchia M M’ikanatha
Keyword(s):  
Public Health ◽  
United States ◽  
Antimicrobial Resistance ◽  
Health Professionals ◽  
One Health ◽  
Antimicrobial Use ◽  
Web Survey ◽  
Related Information ◽  
Appropriate Antimicrobial Use ◽  
The Web

Abstract Background Antimicrobial resistant (AMR) bacteria pose a serious threat to public health. The national response to this threat includes calls for promoting judicious use of antibiotics in humans and animals and strengthening integrated One Health surveillance of AMR bacteria in humans, animals, and environment. However, the extent to which public health jurisdictions are disseminating surveillance findings to promote judicious use of antimicrobials is unclear. Methods We used a standardized web audit tool to manually review and document the presence of AMR-related information on the websites of all public health jurisdictions that participate in national notifiable disease surveillance in the United States. We also emailed a survey to representatives in the 54 jurisdictions that participate in the National Antimicrobial Resistance Monitoring System (NARMS) activities coordinated by the Centers for Disease Control and Prevention. The survey asked questions about AMR-related information on their public health department website. Results Of the 37 (68.5%) jurisdictions that responded to the email survey, 26 (70.3%) indicated that their websites have information on appropriate antibiotic use for health professionals, veterinarians and general public, compared to 89.3% from the web survey (Figure). Eleven (29.7%) indicated that they have data on antimicrobial susceptibility for pathogens, or antibiograms, on their websites, compared to 48.2% from the web survey. While 11 (29.7%) jurisdictions indicated that they have highlighted appropriate antimicrobial use on the homepage, the web survey found no reference on the homepage. Comparison of results from email and web survey on public health jurisdictions’ website, United States - 2020 Conclusion Public health jurisdictions have begun to use websites to increase awareness about the threat of antimicrobial resistance. However, the limited presence of information on appropriate antimicrobial use for the public, health professionals and veterinarians suggest the need for improvement. Gaps exist between the awareness of the epidemiologists and laboratorians and the information reported on public health jurisdictions’ websites. Websites can be expanded and better leveraged to increase visibility of AMR and appropriate antimicrobial prescribing across One Health domains. Disclosures All Authors: No reported disclosures

Dedicated time for antimicrobial stewardship—How much and why? Lessons learned from South Korea

2020 ◽  
Vol 41 (12) ◽  
pp. 1436-1437
Author(s):  
Payal K. Patel ◽  
Arjun Srinivasan
Keyword(s):  
United States ◽  
Antimicrobial Resistance ◽  
South Korea ◽  
Antimicrobial Stewardship ◽  
Large Scale ◽  
The United States ◽  
Lessons Learned ◽  
Joint Commission ◽  
Antimicrobial Use ◽  
Institutional Level

AbstractAntimicrobial resistance is a global and pressing problem that requires large-scale, federal coordination of efforts and tailored local interventions and surveillance. Given the urgency of the threat, many countries now have national policies to reduce inappropriate antimicrobial use. However, few countries have followed this with resources at the institutional level to support the implementation of practices to achieve this goal. In the United States, accreditation bodies such as Centers for Medicare and Medicaid Services and The Joint Commission have added antimicrobial stewardship standards to encourage uptake of antimicrobial stewardship programs (ASPs).

scholarly journals 408. Impact of the COVID-19 Pandemic on Antimicrobial Use and Resistance in the United States and the Dominican Republic

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S305-S306
Author(s):  
Alfredo J Mena Lora ◽  
Rita Alexandra Rojas-Fermin ◽  
Stephanie L Echeverria ◽  
Katia Castro ◽  
Anel E Guzman ◽  
...  
Keyword(s):  
United States ◽  
Antimicrobial Resistance ◽  
Klebsiella Pneumoniae ◽  
Dominican Republic ◽  
The United States ◽  
Antimicrobial Use ◽  
E Coli ◽  
The Us ◽  
Tract Infections ◽  
The Impact

Abstract Background The disease caused by SARS-CoV-2, COVID-19, has caused a global public health crisis. Lower respiratory tract infections (LRTIs) caused by COVID-19 has led to an increase in hospitalizations. Disease severity and concerns for bacterial co-infections can increase antimicrobial pressure. Our aim is to define and compare the impact of COVID-19 on antimicrobial use (AU) and antimicrobial resistance (AMR) in the Dominican Republic (DR) and the United States (US). Methods We performed a retrospective review of AU and antimicrobial susceptibility patterns from 2019-20 at a hospital in the US (H-US) and the DR (H-DR). Our sites are community teaching hospitals with 151 beds in H-US and 295 beds in H-DR. After AU was tabulated, percent changes between 2019-20 were calculated. Resistance patterns for extended-spectrum beta-lactamase producing (ESBL) E coli, ESBL Klebsiella pneumoniae (ESBL-Kp), carbapenem resistant Pseudomonas aeruginosa (CR-PSAR) and Klebsiella pneumoniae (CR-Kp) were tabulated and percent changes between 2019-20 were calculated. Results AU increased by 10% in H-US and 25% in H-DR, with carbapenem use increasing by 268% and 144% respectively. Ceftriaxone use increased by 30% in H-US and 33% in H-DR. Azithromycin increased 54% in H-US and 338% in the H-DR. Resistance increased from 10% to 28% for ESBL-Kp and from 10% to 12% for ESBL E coli at H-US. CR-PSAR decreased from 20% to 12%, while cefepime and piperacillin resistance increased from 5% to 20% and 3% to 16% respectively (Figure 1). At H-DR, ESBL-Kp resistance decreased from 68% to 64% and increased from 58% to 59% for ESBL E coli. CR-PSAR and cefepime resistance increased from 5% to 19% and from 9% to 29% respectively (Figure 2). Figure 1. Antimicrobial resistance (%) for select organisms at H-US in 2019 and 2020 Figure 2. Antimicrobial resistance (%) for select organisms at H-DR in 2019 and 2020 Conclusion COVID-19 had a major impact on antimicrobial consumption and resistance in the US and DR. A greater impact was seen on ESBL rates in the US whilst a greater impact on carbapenem resistance was seen in the DR. The rise in carbapenem use in H-US reflected a rise in ESBL rates. In the DR, ESBL producing organisms were common prior to COVID-19 and carbapenem use was more widespread. The impact of the COVID-19 pandemic on AU may accelerate AMR worldwide. The scale up of antimicrobial stewardship across the globe is urgently needed to curb AMR. Disclosures All Authors: No reported disclosures

scholarly journals Knowledge, Attitude, and Practices on Antimicrobial Use and Antimicrobial Resistance among Poultry Drug and Feed Sellers in Bangladesh

2021 ◽  
Vol 8 (6) ◽  
pp. 111
Author(s):  
Md. Abul Kalam ◽  
Md. Abdul Alim ◽  
Shahanaj Shano ◽  
Md. Raihan Khan Nayem ◽  
Md. Rahim Badsha ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Current Knowledge ◽  
Rank Order ◽  
Antimicrobial Use ◽  
Poultry Production ◽  
Attitudes And Practices ◽  
12Th Grade ◽  
Study Results ◽  
Knowledge Attitudes And Practices ◽  
Drug Sellers

Poultry production has boomed in Bangladesh in recent years. The poultry sector has contributed significantly to meet the increased demand for animal source proteins in the country. However, increased use of antimicrobials and antibiotics appeared to be a significant threat to food safety in the poultry sector. The poultry drug and feed sellers are at the frontline position involving selecting and delivering the antimicrobials to the poultry farmers. Studies assessing the poultry drug and feed sellers’ knowledge, attitudes, and practices (KAPs) are limited. The current study aimed to assess the community poultry drug and feed sellers’ KAPs of antimicrobial use (AMU) and antimicrobial resistance (AMR) in some selected areas of Bangladesh. We determined the respondents’ (drug and the feed sellers) KAPs of AMU and AMR using a tested and paper-based questionnaire. The study demonstrated that most respondents have insufficient knowledge, less positive attitudes, and inappropriate practices regarding AMU and AMR. The factor score analysis further showed that the type of respondents and their years of experience, level of education, and training on the drug were the significant factors impacting the current knowledge, attitudes, and practices of AMU and AMR. The adjusted logistic regression analysis revealed that the drug sellers who completed their education up to 12th grade and had training on the drug had adequate knowledge of AMU and AMR. The data also showed that the drug sellers belong to the age group 31–35 and 36–40 years and who completed 12th grade had good attitudes on the same. Likewise, the analysis further determined that drug sellers belonging the age category 18–25 and 26–30 years, and interestingly, the respondents who completed education up to 12th grade, had better practices. Spearman’s rank-order correlation revealed a positive association between each pair of the KAPs scores for the respondents. The correlation was fair between knowledge–attitudes, knowledge–practices, and attitudes–practices. Based on the current study results, we recommend educational interventions and appropriate training for the poultry drug and feed sellers to raise awareness and to upgrade their current knowledge on the appropriate use of antimicrobials. This will ultimately lead to reducing the chances of developing AMR in the poultry sectors of the country.

Antimicrobial Use Control Measures to Prevent and Control Antimicrobial Resistance in US Hospitals

2006 ◽  
Vol 27 (10) ◽  
pp. 1088-1095 ◽  
Author(s):  
Alan J. Zillich ◽  
Jason M. Sutherland ◽  
Stephen J. Wilson ◽  
Daniel J. Diekema ◽  
Erika J. Ernst ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Antimicrobial Resistance ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Veterans Affairs ◽  
Control Measures ◽  
Antimicrobial Use ◽  
Cross Sectional ◽  
Term Care ◽  
Recommended Practices

Objective.Clinical practice guidelines and recommended practices to control use of antibiotics have been published, but the effect of these practices on antimicrobial resistance (AMR) rates in hospitals is unknown. The objective of this study was to examine relationships between antimicrobial use control strategies and AMR rates in a national sample of US hospitals.Design.Cross-sectional, stratified study of a nationally representative sample of US hospitals.Methods.A survey instrument was sent to the person responsible for infection control at a sample of 670 US hospitals. The outcome was current prevalences of 4 epidemiologically important, drug-resistant pathogens, considered concurrently: methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci, ceftazidime-resistant Klebsiella species, and quinolone (ciprofloxacin)-resistant Escherichia coli Five independent variables regarding hospital practices were selected from the survey: the extent to which hospitals (1) implement practices recommended in clinical practice guidelines and ensure best practices for antimicrobial use, (2) disseminate information on clinical practice guidelines for antimicrobial use, (3) use antimicrobial-related information technology, (4) use decision support tools, and (5) communicate to prescribers about antimicrobial use. Control variables included the hospitals' number of beds, teaching status, Veterans Affairs status, geographic region, and number of long-term care beds; and the presence of an intensive care unit, a burn unit, or transplant services. A generalized estimating equation modeled all resistance rates simultaneously to identify overall predictors of AMR levels at the facility.Results.Completed survey instruments were returned by 448 hospitals (67%). Four antimicrobial control measures were associated with higher prevalence of AMR. Implementation of recommended practices for antimicrobial use (P< .01) and optimization of the duration of empirical antibiotic prophylaxis (P<.01) were associated with a lower prevalence of AMR. Use of restrictive formularies (P = .05) and dissemination of clinical practice guideline information (P<.01) were associated with higher prevalence of AMR. Number of beds and Veterans Affairs status were also associated with higher AMR rates overall.Conclusions.Implementation of guideline-recommended practices to control antimicrobial use and optimize the duration of empirical therapy appears to help control AMR rates in US hospitals. A longitudinal study would confirm the results of this cross-sectional study. These results highlight the need for systems interventions and reengineering to ensure more-consistent application of guideline-recommended measures for antimicrobial use.

scholarly journals Need for Annual Surveillance of Antimicrobial Resistance in Streptococcus pneumoniae in the United States: 2-Year Longitudinal Analysis

2001 ◽  
Vol 45 (4) ◽  
pp. 1037-1042 ◽  
Author(s):  
Daniel F. Sahm ◽  
James A. Karlowsky ◽  
Laurie J. Kelly ◽  
Ian A. Critchley ◽  
Mark E. Jones ◽  
...  
Keyword(s):  
United States ◽  
Streptococcus Pneumoniae ◽  
Antimicrobial Resistance ◽  
Antimicrobial Agents ◽  
The United States ◽  
Multidrug Resistant ◽  
Fluoroquinolone Resistance ◽  
Resistance Patterns ◽  
Changing Patterns ◽  
Resistance To Penicillin

ABSTRACT Although changing patterns in antimicrobial resistance inStreptococcus pneumoniae have prompted several surveillance initiatives in recent years, the frequency with which these studies are needed has not been addressed. To approach this issue, the extent to which resistance patterns change over a 1-year period was examined. In this study we analyzed S. pneumoniaeantimicrobial susceptibility results produced in our laboratory with isolates obtained over 2 consecutive years (1997–1998 and 1998–1999) from the same 96 institutions distributed throughout the United States. Comparison of results revealed increases in resistant percentages for all antimicrobial agents studied except vancomycin. For four of the agents tested (penicillin, cefuroxime, trimethoprim-sulfamethoxazole, and levofloxacin), the increases were statistically significant (P < 0.05). Resistance to the fluoroquinolone remained low in both years (0.1 and 0.6%, respectively); in contrast, resistance to macrolides was consistently greater than 20%, and resistance to trimethoprim-sulfamethoxazole increased from 13.3 to 27.3%. Multidrug resistance, concurrent resistance to three or more antimicrobials of different chemical classes, also increased significantly between years, from 5.9 to 11%. The most prevalent phenotype was resistance to penicillin, azithromycin (representative macrolide), and trimethoprim-sulfamethoxazole. Multidrug-resistant phenotypes that included fluoroquinolone resistance were uncommon; however, two phenotypes that included fluoroquinolone resistance not found in 1997–1998 were encountered in 1998–1999. This longitudinal surveillance study of resistance inS. pneumoniae revealed that significant changes do occur in just a single year and supports the need for surveillance at least on an annual basis, if not continuously.

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