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Weekly Digest: Human consumption of antibiotics up 65% in fifteen years; Essentials of successful antimicrobial stewardship published.

Weekly Digest: Human consumption of antibiotics up 65% in fifteen years; Essentials of successful antimicrobial stewardship published.

Human consumption of antibiotics up 65% in fifteen years. A CDDEP study describing the increase of antibiotic consumption worldwide between 2000 and 2015 was published last month in the Proceedings of the National Academy of Sciences (PNAS). The findings showed an overall 39% increase in the rate (from 11.3 to 15.7 defined daily doses per 1,000 people) despite growing awareness of antibiotic overuse and inappropriate antibiotic prescribing. Overall consumption and rates of consumption from 76 countries were analyzed and grouped by income level.  High-income countries were found to have the highest rates of consumption, but if trends continue, the rates in poorer countries, where antibiotic use goes up as economies grow, could reach those of high-income countries by 2030.  The study was covered widely in global and national media including CBS News, National Public Radio, TIME Magazine, PBS NewshourThe GuardianEl PaisDaily MailThe Economist, Philadelphia Inquirer, Quartz, The Scientist, and the Times of India. [PNAS]

Essentials of successful antimicrobial stewardship published. Elements of successful antibiotic stewardship in hospitals in resource poor settings has been developed by CDDEP researchers working with fifteen experts from thirteen countries on six continents. The consensus-based process produced seven core elements (leadership commitment, accountability, drug expertise, action, tracking, reporting, and education) as well as 29 checklist items that are relevant in all settings, including those that are resource-limited. [Clinical Microbiology and Infection]

Increase in drug-resistant A. baumannii infections in US children. An epidemiologic study of antibiotic resistant Acinetobacter baumannii infections in children across the US, published by CDDEP researchers working with collaborators at Rush University in Chicago, examined national and regional trends of antibiotic resistance in clinical specimens over a 13-year period. While there was an overall increase between 1999 and 2012 in the proportion of isolates that were resistant to cephalosporin and carbapenem, a slight decline was observed after a peak in 2008. [Journal of the Pediatric Infectious Diseases Society]

CDC announces aggressive tactics to fight new resistance threats. Initial data from a new national containment strategy shows that 221 bacterial infections with “unusual” resistance were detected across the US in 2017. The US Centers for Disease Control and Prevention (CDC) has received US$323 million for its Antibiotic Resistance Solutions Initiative, which includes an Antibiotic Resistance Laboratory Network and resources to act early and aggressively to prevent the spread of new resistance genes.  The CDC campaign to educate the medical community about the initiative uses a “wildfire” metaphor, reminding people to act quickly as resistant germs can “spread like wildfire.”  [Healio, Pew, CDC]

Little-known dangers of fluoroquinolones. Rare but severe side effects of a much-used class of antibiotics are finally receiving attention from regulatory agencies in the US, Canada, and Europe, according to an article in Nature.  The US Food and Drug Administration has received over 60,000 reports of adverse effects from the drugs, from tendon rupture to nerve damage causing disability. Five antibiotics in this class are still on the market, including ciprofloxacin and levofloxacin. [Nature]

Rising costs of treating antibiotic-resistant infections.Treating a single antibiotic resistant infection in the United States costs an average of $1,383, according to research published in the journal Health Affairs. With 23,000 such infections occurring annually, treating resistant infections adds over $2 billion to health care expenditures. [Health Affairs]

Hundreds of Non-Antibiotic Medicines Affect Gut Bacteria. Researchers studied the effects of marketed medications on pathogens that inhabit the human intestine, finding that over one quarter of the 923 substances that target human cells inhibit the growth of one or more microbial species. While the drugs’ antimicrobial mechanisms are mostly unknown, the European Molecular Biology Laboratory scientists called for further research into the clinical effects as well as the long term effects of changes in the microbiome, including the impact on antibiotic resistance. [The Scientist; Nature; CIDRAP]

Too many antibiotics used in pediatric hospital patients. In a study of hospitals in 41 countries, fully one third of antibiotics given to hospitalized children were for prophylaxis rather than for treating an existing infection, according to a study in the Journal of the Pediatric Infectious Diseases Society. Seventy-five percent of prophylactic antibiotics were given to non-surgical patients, three times more than to patients awaiting surgery (25%). And broad-spectrum antibiotics (BSA) were used over half the time, while combinations of two or more antibiotics were used over one third of the time. The data support the need for campaigns to reduce prescriptions of BSA, to reduce prophylactic use of antibiotics in general, and to reduce prolonged use of antibiotics.[CIDRAP, Journal of the Pediatric Infectious Diseases Society]

Taskforce: “Soda, alcohol and tobacco taxes can reduce disease.” In a five-part series, the Lancet Taskforce on non-communicable disease (NCD) and economics laid out strategies related to the Sustainable Development Goal of reducing premature mortality by one-third. The proposed actions include the collection of so-called sin taxes on unhealthy products, which the group says “consistently raise prices, reduce consumption, and save lives, while generating additional revenues to support public services.” When the taxes collected are spent on prevention programs, the benefit is multiplied. [The Hindu, Lancet, The Guardian]

What is holding back “preventable” cholera outbreaks in Kenya.  Measures to prevent yearly flood-related cholera outbreaks are well understood in Kenya, but getting funds committed is not straightforward.  An article from researchers at the African Population and Health Research Center analyzes the political inaction that has prevented public health and infrastructure investments from moving forward. [The Conversation]

PACCARB seeks new nominations by COB on April 30, 2018. The US Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria is seeking nominations of new members. The deadline is April 30. Please see the Call for Nominations and Federal Register Notice for more information.

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