CIDRAP Antimicrobial Stewardship Project Newsletter – Jan 23, 2020


In this week's issue:

  • What's new at CIDRAP-ASP
  • French-German call for AMR One Health consortia
  • AMR comic book
  • Surgical stewardship in Kyrgyzstan
  • Nurses and stewardship TwitterChat
  • Role of teamwork in US healthcare system stewardship
  • Outpatient stewardship literacy and education
  • Philosophical basis of antibiotic R&D reform
  • Pan-African AMR National Action Plan conference
  • Delhi state AMR action plan
  • Staph aureus bacteremia bundle in a US hospital
  • Rapid assays for TB diagnosis and susceptibility testing
  • Antifungal stewardship in Spain
  • Agricultural stewardship in Australia
  • Empirical therapy for pediatric UTIs in Thailand




[Weigh In] Test your memory and take our most popular quiz from 2019 to gauge your knowledge of antimicrobial stewardship pledges from a fast food restaurant and a group of stakeholders in animal agriculture.


[Read] CIDRAP News recently published stories on two World Health Organization (WHO) reports on the inadequacies of the antibiotic pipeline, industry leaders' call for government action on antibiotic development, and much more.


[Research] Please take a moment to visit our recently launched compendium of databases and tools for antimicrobial resistance (AMR) surveillance, our antimicrobial stewardship diagnostics resources, our database containing hundreds of publicly available clinical tools for antimicrobial stewardship programs, and our educational multimedia page. The surveillance and diagnostics pages are updated at least weekly, and we add new clinical and educational tools monthly.


[Stay Current] We recently updated our AMR and antimicrobial stewardship bibliographies with 194 new resources. And if you'd like to stay current on all our news and events, please follow CIDRAP-ASP on Twitter and Facebook, subscribe to our YouTube channel, and subscribe to our antimicrobial stewardship podcasts on iTunes.




[Register] Registration is open for a Jan 30 webinar titled, "CDC Update 2020: Antibiotic Stewardship in US Hospitals," hosted by BD (Becton, Dickinson and Company) and featuring a presentation from Arjun Srinivasan, MD.


[Apply] The French Ministry of Higher Education, Research and Innovation and the German Federal Ministry of Education and Research are calling for consortia proposing innovative research on AMR in environmental reservoirs and on antibiotic-resistant bacteria colonizing humans, farm animals, companion animals, and food products. Each agency has committed up to €3.5 million ($3.9 million US) for the call, each consortia must include one French and one German member, and the application deadline is Feb 28.


[Rethink] In Asian Scientist, Kamila Navarro, MSc, interviews Hsu Li Yang, MBBS, MPH, and Sonny Liew about the comic book they made to fight the echo chamber of AMR and popularize antimicrobial stewardship efforts.


[Learn] The WHO profiles the efforts of Kyrgyzstan's Tokmok Territorial Hospital to implement perioperative antibiotic prophylaxis guidelines and the association of the guidelines with lower rates of surgical-site infections.


[Evaluate] In the Journal of Clinical Nursing, Rebecca Wright, RN, PhD, et al discuss how a TwitterChat on AMR for nursing professionals reached more than 2.6 million accounts after 72 hours and may be a helpful way to build community and communication around antimicrobial stewardship. And in the American Journal of Infection Control, Elizabeth Monsees, RN, PhD, MBA, et al found in a survey of 558 nurses that 408 (73%) said that nurses have an important role to play in antimicrobial stewardship, though less than half said that nursing leaders or prescribers encouraged nurse involvement in antibiotic decision-making.


[Engage] The Pew Charitable Trusts features an interview with Shannon Phillips, MD, about the ways in which US healthcare system Intermountain Healthcare has implemented antibiotic stewardship across its hospitals, clinics, home care services, and telemedicine practices, focusing on the strong role that equitable teamwork and institutional support have played in the initiative's success. And if you missed the #ASPChat on experiences with fluoroquinolones in antimicrobial stewardship last week, highlights are now available.


[Examine] In Advances in Therapy, Elizabeth D. Hermsen, PharmD, MBA, et al describe avenues to increase patient literacy and improve provider-patient communication on antimicrobial stewardship in outpatient settings.


[Assess] On The Hill, Amesh A. Adalja, MD, and Greg Salmieri, PhD, discuss ways in which reforming the antibiotic research and development system must grapple with fundamental philosophical changes in how policymakers, industry professionals, clinicians, and funders value the treatment of infectious diseases. And on DownToEarth, Vibha Varshney, PhD, provides insight into issues leading up to the Pan-Africa Workshop on Effective Implementation of National Action Plans on AMR taking place this week.


[Explore] In The Daily Pioneer, Archana Jyoti reports on how Delhi has become the third Indian state, after Kerala and Madhya Pradesh, to develop an action plan to combat AMR. And in Infectious Disease Special Edition, Thomas Rosenthal describes ways in which US hospitals can plan to meet the Mar 30 deadline to implement an antibiotic stewardship program per the Centers for Medicare and Medicaid Services conditions of participation.


[Analyze] In the Journal of Antimicrobial Chemotherapy, Amy L. Brotherton, PharmD, et al assess a Staphylococcus aureus bacteremia (SAB) bundle dependent on a clinical decision support tool in the electronic health record of a US hospital, finding that the bundle was associated with reductions in 30-day mortality and 90-day SAB-related readmissions without the need for prospective audit and feedback. Elsewhere in the same journal, Mah Laka, MPhil, et al review 57 studies on the effectiveness of clinical decision support systems (CDSS) in improving hospital antibiotic use, finding that appropriate antibiotic therapy was twice as likely to occur following CDSS implementation and that decision support tools were associated with decreases in mortality, length of hospital stay, and duration and cost of therapy.


[Peruse] The WHO released a rapid communication saying that rapid molecular assays should replace smear microscopy and phenotypic testing to diagnose pulmonary and extra-pulmonary tuberculosis and detect rifampicin resistance. And in the Wall Street Journal, Brian Gormley, MS, profiles start-up diagnostics companies that are focusing on developing technology to prevent and reduce AMR.


[Study] In the Journal of Infection, Guillermo Martín-Gutiérrez, PhD, MS, et al assess the impact of an antimicrobial stewardship program on antifungal use in a Spanish hospital, noting that the program was associated with a sustained reduction in antifungal use and decreases in hospital-onset candidemia.


[Discover] In the Medical Journal of Australia's MJA InSight, Arjun Rajkhowa, PhD, Kirsten Bailey, BVSc, Laura Hardefeldt, BVMS, PhD, MPh, Helen Billman-Jacobe, PhD, James Gilkerson, BVSc, and Glenn Browning, BVSc, PhD, discuss misperceptions, regulations, and practice considerations related to antimicrobial use and stewardship in Australian animal agriculture. And Veterinary Practice summarizes research and data on agricultural antibiotic use in the UK presented at the Responsible Use of Medicines in Agriculture conference in October 2019.


[Review] In Intensive Care Medicine, Massimo Antonelli, MD, et al offer an expert statement on the management of Clostridioides difficile infection in critically ill patients. And in the Pediatric Infectious Disease Journal, Worawit Kantamalee, MD, et al found no significant difference in clinical or microbiologic failure, relapse, or time to relief from fever between children receiving inappropriate versus appropriate empirical therapy for community-onset urinary tract infections at a Thai hospital, although inappropriate therapy was associated with a significantly longer hospital stay.

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