scholarly journals Comparison of national antimicrobial treatment guidelines, African Union

2022 ◽  
Vol 100 (1) ◽  
pp. 50-5+
Author(s):  
Jessica Craig ◽  
Kayli Hiban ◽  
Isabel Frost ◽  
Geetanjali Kapoor, ◽  
Yewande Alimi ◽  
...  
Keyword(s):  
Treatment Guidelines ◽  
Antimicrobial Treatment ◽  
African Union

scholarly journals Antimicrobial resistance in Neisseria gonorrhoeae isolates and gonorrhoea treatment in the Republic of Belarus, Eastern Europe, 2009–2019

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Aliaksandra Aniskevich ◽  
Iryna Shimanskaya ◽  
Iryna Boiko ◽  
Tatyana Golubovskaya ◽  
Daniel Golparian ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Neisseria Gonorrhoeae ◽  
Eastern Europe ◽  
Treatment Guidelines ◽  
Statistical Significance ◽  
Antimicrobial Treatment ◽  
National Guidelines ◽  
First Line ◽  
Exact Test ◽  
The Republic

Abstract Background Limited antimicrobial resistance (AMR) data for Neisseria gonorrhoeae are available in Eastern Europe. We investigated AMR in N. gonorrhoeae isolates in the Republic of Belarus from 2009 to 2019, antimicrobial treatment recommended nationally, and treatment given to patients with gonorrhoea. Methods N. gonorrhoeae isolates (n = 522) cultured in three regions of Belarus in 2009–2019 were examined. Determination of minimum inhibitory concentrations (MICs) of eight antimicrobials was performed using Etest. Resistance breakpoints from the European Committee on Antimicrobial Susceptibility Testing were applied where available. A Nitrocefin test identified β-lactamase production. Gonorrhoea treatment for 1652 patients was also analysed. Statistical significance was determined by the Z-test, Fisher’s exact test, or Mann-Whitney U test with p-values of < 0.05 indicating significance. Results In total, 27.8% of the N. gonorrhoeae isolates were resistant to tetracycline, 24.7% to ciprofloxacin, 7.0% to benzylpenicillin, 2.7% to cefixime, and 0.8% to azithromycin. No isolates were resistant to ceftriaxone, spectinomycin, or gentamicin. However, 14 (2.7%) isolates had a ceftriaxone MIC of 0.125 mg/L, exactly at the resistance breakpoint (MIC > 0.125 mg/L). Only one (0.2%) isolate, from 2013, produced β-lactamase. From 2009 to 2019, the levels of resistance to ciprofloxacin and tetracycline were relatively high and stable. Resistance to cefixime was not identified before 2013 but peaked at 22.2% in 2017. Only sporadic isolates with resistance to azithromycin were found in 2009 (n = 1), 2012 (n = 1), and 2018–2019 (n = 2). Overall, 862 (52.2%) patients received first-line treatment according to national guidelines (ceftriaxone 1 g). However, 154 (9.3%) patients received a nationally recommended alternative treatment (cefixime 400 mg or ofloxacin 400 mg), and 636 (38.5%) were given non-recommended treatment. Conclusions The gonococcal resistance to ciprofloxacin and tetracycline was high, however, the resistance to azithromycin was low and no resistance to ceftriaxone was identified. Ceftriaxone 1 g can continuously be recommended as empiric first-line gonorrhoea therapy in Belarus. Fluoroquinolones should not be prescribed for treatment if susceptibility has not been confirmed by testing. Timely updating and high compliance with national evidence-based gonorrhoea treatment guidelines based on quality-assured AMR data are imperative. The need for continued, improved and enhanced surveillance of gonococcal AMR in Belarus is evident.

High-dose steroid and heparin: a novel therapy for cerebral vasculitis associated with presumed group A Streptococcus meningitis

2021 ◽  
Vol 14 (2) ◽  
pp. e239618
Author(s):  
Brian Alexander Hummel ◽  
Julie Blackburn ◽  
Anne Pham-Huy ◽  
Katherine Muir
Keyword(s):  
Treatment Guidelines ◽  
Group A Streptococcus ◽  
Oral Prednisone ◽  
Acute Otitis Media ◽  
Antimicrobial Treatment ◽  
Cerebral Vasculitis ◽  
High Dose ◽  
Novel Therapy ◽  
Intravenous Heparin ◽  
Group A

Cerebral vasculitis is a serious complication of bacterial meningitis that can cause significant morbidity and mortality due to stroke. Currently, there are no treatment guidelines or safety and efficacy studies on the management of cerebral vasculitis in this context. Herein, we report a case of a previously well 11-year-old girl who presented with acute otitis media that progressed to mastoiditis and fulminant meningitis. Group A Streptococcus was found in blood and ear-fluid cultures (lumbar puncture was unsuccessful). Her decreased level of consciousness persisted despite appropriate antimicrobial treatment, and repeat MRI revealed extensive large vessel cerebral vasculitis. Based on expert opinion and a presumed inflammatory mechanism, her cerebral vasculitis was treated with 7 days of pulse intravenous methylprednisolone followed by oral prednisone taper. She was also treated with intravenous heparin. Following these therapies, she improved clinically and radiographically with no adverse events. She continues to undergo rehabilitation with improvement.

scholarly journals Non-adherence to antimicrobial treatment guidelines results in more broad-spectrum but not more appropriate therapy

2011 ◽  
Vol 31 (7) ◽  
pp. 1561-1568 ◽  
Author(s):  
L. B. J. van der Velden ◽  
M. Tromp ◽  
C. P. Bleeker-Rovers ◽  
M. Hulscher ◽  
B. J. Kullberg ◽  
...  
Keyword(s):  
Broad Spectrum ◽  
Treatment Guidelines ◽  
Antimicrobial Treatment ◽  
Appropriate Therapy

Antimicrobial prescribing behaviour in dogs and cats by Belgian veterinarians

2017 ◽  
Vol 182 (11) ◽  
pp. 324-324 ◽  
Author(s):  
Alexia Van Cleven ◽  
Steven Sarrazin ◽  
Hilde de Rooster ◽  
Dominique Paepe ◽  
Sofie Van der Meeren ◽  
...  
Keyword(s):  
Primary Care ◽  
Online Survey ◽  
Treatment Guidelines ◽  
Current Treatment ◽  
Antimicrobial Treatment ◽  
Fourth Generation ◽  
National Guidelines ◽  
First Line ◽  
Clinical Scenarios ◽  
Prescribing Behaviour

The objective of this study is to survey general prescribing behaviour by Belgian companion animal veterinarians and to assess agreement of these practices with current treatment guidelines. Therefore an online survey was administered with five realistic and frequently occurring first-line cases to primary-care veterinary practitioners. For each case a predefined pattern of questions were asked about whether or not they would prescribe antimicrobials, if they would prescribe a non-antimicrobial treatment and if they would perform additional diagnostic steps. The responses were compared with recommendations in national guidelines and recent literature. The overall most prescribed antimicrobials were potentiated amoxicillin (43.0 per cent), fluoroquinolones (14.7 per cent), third-generation and fourth-generation cephalosporins (10.9 per cent) and tetracyclines (10.9 per cent). Only 48.3 per cent of the veterinarians complied with the guidelines in nearly all of the clinical scenarios (ie, prescribing antimicrobials when indicated, not prescribing antimicrobials when it is not indicated). Moreover, when prescribing highest priority critically important antimicrobials, susceptibility testing on bacterial cultures was performed in only 12.4 per cent of the prescriptions. The results showed that the prescribing behaviour of antimicrobial compounds by primary-care veterinary practitioners in dogs and cats is often not in agreement with national guidelines. Focus in improvement of this prescribing behaviour should be on performing the appropriate diagnostic steps and decreasing the use of highest priority critically important antimicrobials.

scholarly journals Detection of Extended-Spectrum ß-Lactamases among Acinetobacter Baumannii Isolated from Hospitals of Qazvin, Iran

2021 ◽  
Vol 31 (2) ◽  
Author(s):  
Mina Zarabadi-Pour ◽  
Amir Peymani ◽  
Narges Habibollah-Pourzereshki ◽  
Mohammad Reza Sarookhani ◽  
Ali Akbar Karami ◽  
...  
Keyword(s):  
Acinetobacter Baumannii ◽  
Treatment Guidelines ◽  
Laboratory Data ◽  
Cross Sectional Study ◽  
Antimicrobial Treatment ◽  
Cross Sectional ◽  
Extended Spectrum ◽  
Repetitive Extragenic Palindromic Pcr ◽  
Encoding Genes ◽  
Disk Method

BACKGROUND፡ Acinetobacter baumannii is a major contributor to nosocomial infections. Extended-spectrum ßlactamase (ESBL)-producing A. baumannii is spreading worldwide. We aimed to determine the frequency of ESBLencoding genes in clinical isolates of A. baumannii and to access their clonal relationship by repetitive extragenic palindromic-PCR (rep-PCR).METHODS: In this descriptive cross-sectional study, 203 isolates of A. baumannii were collected from Qazvin hospitals. The Identification of isolates was performed by standard laboratory methods. To verify ESBL production, all isolates were screened by disk agar diffusion and confirmed by the combined disk method. Subsequently, ESBL-encoding genes were detected by PCR and sequencing. Possible clonal association of ESBL-producing isolates was evaluated using rep-PCR.RESULTS: Two hundred (98.5%) isolates showed reduced susceptibility to one of the antibiotics used in the ESBL screening test, of which 127 isolates (62.6%) produced ESBL. PCR results showed blaOXA-1 (20.5%) was the most prevalent gene followed by blaTEM-1 (20%), blaGES-1 (15.7%), blaCTX-M-15 (7.9%), and blaPER-1(1.6%). Rep-PCR results revealed that ESBL-producing isolates belonged to clones A (85%), B (13.4%), and C (1.6%).CONCLUSION: Our study showed the significant presence of blaOXA-1, blaTEM-1, blaGES-1, blaCTX-M-15, and blaPER-1 genes in ESBLproducing A. baumannii isolates in the studied hospitals. This is the first report on the emergence of blaOXA-1 gene in these isolates in Iran. The use of comprehensive antimicrobial treatment guidelines based on laboratory data and appropriate infection control interventions are essential.

scholarly journals A rapid review of the overuse of antibiotics during the COVID-19 pandemic: lessons learned and recommendations for the future

2021 ◽  
Vol 3 ◽  
pp. 17
Author(s):  
Will Cherry ◽  
Marielle Brown ◽  
Colin Garner
Keyword(s):  
Antimicrobial Resistance ◽  
Bacterial Infections ◽  
Treatment Guidelines ◽  
Hospital Setting ◽  
Antibiotic Use ◽  
Healthcare Systems ◽  
Antimicrobial Treatment ◽  
Lessons Learned ◽  
Rapid Review ◽  
Causative Agents

The coronavirus disease 2019 (COVID-19) pandemic has had severe implications on healthcare systems and the patients affected by this infectious disease. To improve outcomes for patients with COVID-19 and limit future antimicrobial resistance, there is continued urgency to improve our understanding of the rates and causative agents of secondary bacterial infections in patients with COVID‑19, and recognise whether antibiotics are being overused in patients prior to and following COVID-19 diagnosis. This article presents the results of a rapid review comparing reported rates of secondary bacterial infections with rates of antibiotic use in patients with COVID-19 predominantly in a hospital setting, within the context of treatment guidelines and recommendations. The review revealed rates of antibiotic use in patients with COVID-19 of 37–100%, far outweighing rates of secondary bacterial infections which were typically below 20%. There was a lack of consistent reporting of causative microorganisms of secondary infections, and the distinction between bacterially- and virally-induced sepsis was rarely made. Early in the pandemic, healthcare agencies published treatment guidelines recognising the importance of antimicrobial stewardship. However, many are yet to provide updated guidance detailing the most appropriate antibiotics to treat patients with concurrent COVID-19 and secondary bacterial infections in a way which limits the emergence of drug-resistant infections and does not negatively impact patient outcomes. Without significant improvements to the testing and reporting of causative organisms and corresponding updates to antimicrobial treatment guidelines, there is a risk of worsened clinical outcomes and increased burden on healthcare systems from antimicrobial resistance during the remainder of the COVID-19 pandemic and beyond.

scholarly journals Adherence Barriers to Antimicrobial Treatment Guidelines in Teaching Hospital, the Netherlands

2004 ◽  
Vol 10 (3) ◽  
pp. 522-525 ◽  
Author(s):  
Peter G.M. Mol ◽  
Willem J.M.J. Rutten ◽  
Rijk O.B. Gans ◽  
John E. Degener ◽  
Flora M. Haaijer-Ruskamp
Keyword(s):  
The Netherlands ◽  
Teaching Hospital ◽  
Treatment Guidelines ◽  
Antimicrobial Treatment

scholarly journals Development of the first edition of African treatment guidelines for common bacterial infections and syndromes

2022 ◽  
Vol 12 (2) ◽  
Author(s):  
Jessica Craig ◽  
Isabel Frost ◽  
Aditi Sriram ◽  
James Nuttall ◽  
Geetanjali Kapoor ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Bacterial Infections ◽  
Treatment Guidelines ◽  
Clinical Care ◽  
Treatment Recommendations ◽  
Antimicrobial Treatment ◽  
Empiric Antibiotic Therapy ◽  
Member States ◽  
Clinical Syndromes ◽  
Empiric Antibiotic

Standard treatment guidelines (STGs) are an important tool for ensuring high quality clinical care and prudent antimicrobial use (AMU) and stewardship (AMS). In 2018, African Union (AU) member state representatives recognized the lack of STGs as a barrier to AMS at national and facility levels. Previous research reported that only 17 of 55 (31%) member states had STGs that provided disease- or pathogen-specific antimicrobial treatment recommendations, excluding those that covered only treatment of HIV, malaria, and tuberculosis). The Africa Centres for Disease Control and Prevention convened expert panels to develop first edition antibiotic treatment guidelines for priority infectious diseases and clinical syndromes for pediatric and adult patient populations in Africa. The purpose of the guidelines is to provide healthcare workers with treatment guidance by harmonising existing national STGs, filling gaps where existing STGs are not available, and serving as a model for future guidelines. Two expert panels of 28 total clinicians, pharmacists, and other relevant stakeholders from 14 AU member states representing each continental region convened to develop consensus treatment recommendations for select priority bacterial infections and clinical syndromes. In developing recommendations, the panels considered treatment recommendations from existing STGs, drug availability, clinical experience, and available antimicrobial resistance data. The guidelines underwent an external review process where clinical stakeholders who did not serve on either panel were invited to submit feedback prior to their publication. The guidelines provide empiric antibiotic therapy guidelines – including drug selection, route of administration, formulation, dosage, and therapy duration – and principles of stewardship for 28 bacterial infections or clinical syndromes. The first edition guidelines for the treatment of common infectious diseases and clinical syndromes in Africa aims to improve clinical treatment and antimicrobial stewardship and will serve as a template for future regional guidelines.

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