Stewardship / Resistance Scan for Mar 01, 2018

Senate antimicrobial resistance bill
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Latest CARB-X funding
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Pathways to lower antibiotics

Two groups laud Senate bill to combat antimicrobial resistance

Two major infectious disease groups voiced strong support of a bill introduced yesterday to strengthen the US government's response to the growing threat of antimicrobial resistance (AMR).

The Infectious Diseases Society of American (IDSA) and the Society for Healthcare Epidemiology of America (SHEA) applaud the Strategies to Address Antimicrobial Resistance (STAAR) Act, introduced by Senator Sherrod Brown, D-Ohio.

The STAAR Act would reauthorize the Interagency Antimicrobial Resistance Task Force and codify sections of the National Action Plan for Combating Antibiotic-Resistant Bacteria to promote prevention and tracking, enact Centers for Disease Control and Prevention (CDC) recommendations to bolster federal AMR efforts, provide research grants to healthcare facilities, and foster partnerships between the CDC and state health departments, among other steps, according to a news release from Brown's office.

"Senator Brown's important bill builds upon bipartisan investments in addressing AMR by reinforcing our public health capacity for prevention, detection, and tracking antibiotic resistance threats," the IDSA said in a news release. "The STAAR Act would also drive the implementation of antimicrobial stewardship programs in health care facilities that have proven to improve patient outcomes while lowering inappropriate antibiotic use that causes the development of resistance. The legislation would also strengthen research on AMR to help ensure the availability of evidence-based techniques and innovative tools to combat AMR."

In a SHEA press release, SHEA President Keith Kaye, MD, MPH, said, "Currently, health care systems in the United States face significant challenges in addressing antibiotic resistant bacteria, which threaten the lives and well-being of millions of people each year." He added that the act "addresses this complex public health issue head-on by providing much needed resources support for developing innovative approaches towards infection surveillance, antimicrobial stewardship, and research that can have a meaningful impact on prevention of antimicrobial resistance and patient safety."
Feb 28 IDSA news release
Mar 1 SHEA
press release
Feb 28 Sen. Brown
news release

 

CARB-X awards $2.4 million for antibiotic candidate to treat serious UTIs

CARB-X, a public-private initiative that supports companies in early-stage antibiotic discovery and development, today announced its latest grant: $2.44 million to Macrolide Pharmaceuticals of Watertown, Mass., to support the development of a novel fully synthetic macrolide antibiotic with gram-negative activity, according to a CARB-X news release. The drug is geared toward treating serious infections, including drug-resistant complicated urinary tract infections (cUTIs).

As an antibiotic class, macrolides are known to be effective against various gram-positive but not gram-negative pathogens. Macrolide is using its proprietary chemistry platform to re-engineer the macrolide scaffold with the aim of developing a fully synthetic macrolide to treat drug-resistant cUTI infections that can be administered intravenously and orally, CARB-X said.

If certain milestones are met, the Macrolide award could grow to $6.81 million, according to the release.

Kevin Outterson, JD, Executive Director of CARB-X, said, "The world urgently needs new antibiotics, rapid diagnostics, vaccines, and entirely new approaches to protect us against drug-resistant bacteria. The projects in the Powered by CARB-X portfolio are in the early stages of development, and there is always a risk of failure. But if successful, these innovative projects, like the Macrolide project, hold great potential to treat life-threatening infections and fight against drug-resistant bacteria."

Since the beginning of last year, CARB-X has announced awards totaling $64.64 million, plus an additional $81.42 million if project milestones are met.
Mar 1 CARB-X news release

 

Clinical pathways tied to lower antibiotic use in Italian pediatric hospital

The introduction of multidisciplinary patient management plans called clinical pathways (CPs) for pneumonia in an Italian pediatric emergency department was associated with impressive reductions in antibiotic prescribing, according to a study yesterday in PLoS One.

Italian pediatric antimicrobial prescription rates are among the highest in Europe, the authors of the study said. As a first step in an antimicrobial stewardship program, on Oct 1, 2015, they implemented a CP for community-acquired pneumonia (CAP) to lower overall prescribing of antibiotics, especially broad-spectrum options.

The researchers analyzed outcomes data on children 3 months to 15 years old who had CAP from Oct 15, 2014, to Apr 15, 2015 (pre-CP) or from Oct 15, 2015, to Apr 15, 2016 (post-CP). They assessed antibiotic prescribing during the two periods, including rates, breadth of spectrum, and duration of therapy. They also compared length of hospital stay.

Based on data from 120 pre-CP and 86 post-CP visits, the investigators determined that broad spectrum regimens for particular macrolides decreased from 50.0% to 26.8% after CP, with an associated increase in amoxicillin prescriptions. Median doses of antibiotics dropped from 10 to 8, and duration of therapy declined from 10 to 8 days.

Among inpatients they found a decrease in broad-spectrum regimens (100% pre-CP vs 66.7% post-CP) and the introduction of narrow-spectrum regimens (0% vs 33.3%). Hospitalized patients received antibiotics for 10 days post-CP compared with 18.5 days pre-CP, but inpatients had no statistical difference in length of therapy after the intervention.

In addition, the researchers reported no difference in treatment failure between the two periods.
Feb 28 PLoS One study

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