scholarly journals A Strategy for Hospital Pharmacists to Control Antimicrobial Resistance (AMR) in Japan

Antibiotics ◽  
2021 ◽  
Vol 10 (11) ◽  
pp. 1284
Author(s):  
Yukihiro Hamada ◽  
Fumiya Ebihara ◽  
Ken Kikuchi
Keyword(s):  
Antibiotic Resistance ◽  
Therapeutic Drug Monitoring ◽  
Antimicrobial Stewardship ◽  
Bacterial Resistance ◽  
Antimicrobial Agents ◽  
Action Plan ◽  
Therapeutic Drug ◽  
Optimal Selection ◽  
Inappropriate Use ◽  
Selection Of

In Japan, there is concern regarding the relation between the inappropriate use of antibiotics and antibiotic resistance (AMR). Increased bacterial resistance is due in part to the inappropriate use of antimicrobial agents. The support of the pharmacist becomes important, and there is growing interest in antimicrobial stewardship to promote the appropriate and safe use of antimicrobials needed for the optimal selection of drugs, doses, durations of therapy, therapeutic drug monitoring (TDM), and implementations of cost containment strategies in Japan. Pharmacists should strive to disseminate the concept of “choosing wisely” in relation to all medicines, implement further interventions, and put them into practice. In this article, we present data for antimicrobial stewardship and Japan’s AMR action plan, focusing on how pharmacists should be involved in enabling physicians to choose antimicrobials wisely.

scholarly journals Antimicrobial stewardship, therapeutic drug monitoring and infection management in the ICU: results from the international A- TEAMICU survey

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Christian Lanckohr ◽  
Christian Boeing ◽  
Jan J. De Waele ◽  
Dylan W. de Lange ◽  
Jeroen Schouten ◽  
...  
Keyword(s):  
Intensive Care ◽  
Therapeutic Drug Monitoring ◽  
Antimicrobial Stewardship ◽  
Antimicrobial Susceptibility ◽  
Drug Monitoring ◽  
Online Survey ◽  
Antimicrobial Agents ◽  
Multidrug Resistant ◽  
Therapeutic Drug ◽  
Middle Income

Abstract Background Severe infections and multidrug-resistant pathogens are common in critically ill patients. Antimicrobial stewardship (AMS) and therapeutic drug monitoring (TDM) are contemporary tools to optimize the use of antimicrobials. The A-TEAMICU survey was initiated to gain contemporary insights into dissemination and structure of AMS programs and TDM practices in intensive care units. Methods This study involved online survey of members of ESICM and six national professional intensive care societies. Results Data of 812 respondents from mostly European high- and middle-income countries were available for analysis. 63% had AMS rounds available in their ICU, where 78% performed rounds weekly or more often. While 82% had local guidelines for treatment of infections, only 70% had cumulative antimicrobial susceptibility reports and 56% monitored the quantity of antimicrobials administered. A restriction of antimicrobials was reported by 62%. TDM of antimicrobial agents was used in 61% of ICUs, mostly glycopeptides (89%), aminoglycosides (77%), carbapenems (32%), penicillins (30%), azole antifungals (27%), cephalosporins (17%), and linezolid (16%). 76% of respondents used prolonged/continuous infusion of antimicrobials. The availability of an AMS had a significant association with the use of TDM. Conclusions Many respondents of the survey have AMS in their ICUs. TDM of antimicrobials and optimized administration of antibiotics are broadly used among respondents. The availability of antimicrobial susceptibility reports and a surveillance of antimicrobial use should be actively sought by intensivists where unavailable. Results of this survey may inform further research and educational activities.

scholarly journals Impact on Antibiotic Resistance, Therapeutic Success, and Control of Side Effects in Therapeutic Drug Monitoring (TDM) of Daptomycin: A Scoping Review

Antibiotics ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 263
Author(s):  
Carolina Osorio ◽  
Laura Garzón ◽  
Diego Jaimes ◽  
Edwin Silva ◽  
Rosa-Helena Bustos
Keyword(s):  
Side Effects ◽  
Therapeutic Drug Monitoring ◽  
Drug Monitoring ◽  
Bacterial Resistance ◽  
Plasma Concentrations ◽  
Resistant Bacteria ◽  
Therapeutic Drug ◽  
Therapeutic Success ◽  
Favorable Clinical Outcome ◽  
And Control

Antimicrobial resistance (AR) is a problem that threatens the search for adequate safe and effective antibiotic therapy against multi-resistant bacteria like methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant Enterococci (VRE) and Clostridium difficile, among others. Daptomycin is the treatment of choice for some infections caused by Gram-positive bacteria, indicated most of the time in patients with special clinical conditions where its high pharmacokinetic variability (PK) does not allow adequate plasma concentrations to be reached. The objective of this review is to describe the data available about the type of therapeutic drug monitoring (TDM) method used and described so far in hospitalized patients with daptomycin and to describe its impact on therapeutic success, suppression of bacterial resistance, and control of side effects. The need to create worldwide strategies for the appropriate use of antibiotics is clear, and one of these is the performance of therapeutic drug monitoring (TDM). TDM helps to achieve a dose adjustment and obtain a favorable clinical outcome for patients by measuring plasma concentrations of an administered drug, making a rational interpretation guided by a predefined concentration range, and, thus, adjusting dosages individually.

The Activity of Alkanna Species in vitro Culture and Intact Plant Extracts Against Antibiotic Resistant Bacteria

2019 ◽  
Vol 25 (16) ◽  
pp. 1861-1865 ◽  
Author(s):  
Naira Sahakyan ◽  
Margarit Petrosyan ◽  
Armen Trchounian
Keyword(s):  
Antibiotic Resistance ◽  
Antibacterial Agents ◽  
Bacterial Resistance ◽  
Antimicrobial Agents ◽  
Resistant Bacteria ◽  
Plant Origin ◽  
Bacterial Strains ◽  
Biotechnological Production ◽  
Antibiotic Resistant

Overcoming the antibiotic resistance is nowadays a challenge. There is still no clear strategy to combat this problem. Therefore, the urgent need to find new sources of antibacterial agents exists. According to some literature, substances of plant origin are able to overcome bacterial resistance against antibiotics. Alkanna species plants are among the valuable producers of these metabolites. But there is a problem of obtaining the standardized product. So, this review is focused on the discussion of the possibilities of biotechnological production of antimicrobial agents from Alkanna genus species against some microorganisms including antibiotic resistant bacterial strains.

Therapeutic Drug Monitoring in Neonates: Problems and Issues

1988 ◽  
Vol 22 (4) ◽  
pp. 317-323 ◽  
Author(s):  
Peter Gal
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Drug Concentration ◽  
Drug Monitoring ◽  
Pharmacokinetic Parameters ◽  
Therapeutic Drug ◽  
Plasma Drug ◽  
Potential Applications ◽  
Intensive Care Nursery ◽  
Effective Use ◽  
Selection Of

Therapeutic drug monitoring has been applied in several patient populations to promote safer, more effective use of drugs. The development of therapeutic ranges allows clinicians to aim for a plasma drug concentration that is usually safe and effective, and calculation of specific pharmacokinetic parameters allows selection of doses that will achieve the desired plasma concentration. This concept certainly holds true in the intensive care nursery; however, the intensity of monitoring in this setting provides opportunities for far broader application of the information obtained from drug concentration monitoring. This review provides an overview of the complexity of and potential applications for therapeutic drug monitoring in neonates based on literature and clinical experience.

scholarly journals 43. Impact of a Five-Year Intervention of an Antimicrobial Stewardship Program on the Optimal Antibiotic Prophylaxis Selection in Surgery in a Hospital without Restrictions on Antibiotics Prescription in Costa Rica

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S143-S143
Author(s):  
José P Díaz-Madriz ◽  
Esteban Zavaleta-Monestel ◽  
Jorge A Villalobos-Madriz ◽  
Alison V Meléndez-Alfaro ◽  
Priscilla Castrillo-Portillo ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Antimicrobial Stewardship ◽  
Bacterial Resistance ◽  
Positive Impact ◽  
Surgical Site Infections ◽  
Antimicrobial Stewardship Program ◽  
Defined Daily Doses ◽  
Stewardship Program ◽  
The Impact ◽  
Selection Of

Abstract Background In a private hospital without restrictions on antibiotic prescription, the success of an Antimicrobial Stewardship Program (ASP) depends mainly on prospective feedback and education. Previously, the ASP of this hospital (PROA-HCB) managed to achieve a positive impact on the antibiotic prophylaxis in cesarean delivery. The purpose of this study is to characterize the impact after implementing the PROA-HCB on the optimal prophylaxis selection of all the procedures included in the clinical guideline for surgical antibiotic prophylaxis in adult patients. Methods A retrospective observational study that compares the selection, duration, antibiotic consumption, bacterial resistance profiles and patient’s safety outcomes regarding antibiotic use for all surgical prophylaxis prescription over six months for the periods before (pre-ASP) and after a five-year intervention of PROA-HCB (post-ASP). Results After a five-year intervention, the percentage of optimal selection of antibiotic prophylaxis in Surgery was 21.0% (N=1598) in the pre-ASP period and 80.0% (N=841) in the post-ASP period (59% absolute improvement, p < 0.001). Percentage of optimal duration was 69,1% (N=1598) in the pre-ASP period and 78.0% (N=841) in the post-ASP period (8.9% absolute improvement, p < 0.001). Mean ceftriaxone utilization was 217.7 defined daily doses (DDD) per 1,000 patient days DDD for the pre-ASP period and 139.8 DDD per 1,000 patient days for the ASP period (35.8% decrease; p = 0.019). Mean cefazolin utilization was 14.9 DDD per 1,000 patient days for the pre-ASP period and 153.3 DDD per 1,000 patient days for the ASP period (928.6% increase; p = 0.021). Regarding percentage of bacterial resistance, there was detected an improvement in some isolates like Escherichia coli with a decrease of ESBL detection (11% decrease; p = 0.007). In addition, no serious adverse reactions or an increase in surgical site infections were detected after the intervention. Conclusion The implementation of an ASP in the surgical ward showed an overall positive impact on selection and duration of antibiotic prophylaxis. Furthermore, this intervention could have had a positive impact on antimicrobial resistance and at the same time had no negative effects on the patients. Disclosures All Authors: No reported disclosures

Principles of antibiotic therapy

2019 ◽  
Vol 98 (4) ◽  
pp. 137-144
Keyword(s):  
Antibiotic Therapy ◽  
Antibiotic Prophylaxis ◽  
Antibiotic Stewardship ◽  
Bacterial Infections ◽  
Bacterial Resistance ◽  
Antimicrobial Agents ◽  
Bacterial Pathogens ◽  
Comprehensive Approach ◽  
Contemporary Medicine ◽  
Selection Of

The paper describes the basic sources and principles of antibiotic therapy in contemporary medicine in which the ability to treat bacterial infections may be lost. The main reason for that is the increasing resistance of bacterial pathogens to antibiotics. A possible solution is to implement a comprehensive program of antibiotic stewardship incorporating adequate consideration of indication and selection of antimicrobial agents including appropriate duration and way of administration. Another important component of the comprehensive approach to bacterial resistance and antibiotic therapy is adequately applied antibiotic prophylaxis in surgery.

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