Stewardship / Resistance Scan for Jan 17, 2019

Antibiotic overprescribing in tots
Fast track for new C diff drug

Analysis finds antibiotic use still routine in infants with viral lung infections

About one fourth of children younger than age 2 who are seen in US emergency departments (EDs) for bronchiolitis, a common viral lung infection in that age-group, received an antibiotic prescription, despite 2006 recommendations against the treatment in the absence of documented bacterial infection.

Researchers from Canada's McGill University based their findings on data from an annual survey on ED visits by the US Centers for Disease Control and Prevention (CDC), publishing their findings today in the Journal of the Pediatric Infectious Diseases Society.

They found that, from 2007 to 2015, about 25% of children younger than 2 years who were seen in the ED for bronchiolitis received antibiotics, reflecting only a minimal improvement compared with earlier years and no significant changes in antibiotic prescription rates during the 9 years that followed the 2006 American Academy of Pediatrics guidance. Of kids who received antibiotics, 70% didn't have a documented bacterial infection.

Also, the team found an association between increased antibiotic prescribing for the condition and hospitals that weren't teaching hospitals nor pediatric hospitals, suggesting that those facilities might benefit most from efforts to encourage providers to follow the guidelines.

Brett Burstein, MD, PhD, MPH, senior author of the study, said in a Pediatric Infectious Disease Society (PIDS) press release today that targeted interventions to reduce inappropriate prescribing are essential. "But at the same time, informing the lay public about the potential downstream consequences and why it is important not to over-treat viral conditions are equally important," he added.
Jan 17 J Pediatric Infect Dis Soc abstract
Jan 17 PIDS
press release


FDA grants Fast Track status to new C difficile antibiotic

The US Food and Drug Administration (FDA) has granted Fast Track designation to a new investigational antibiotic for Clostridioides difficile infection (CDI), according to a press release yesterday from Acurx Pharmaceuticals.

ACX-362E is a novel, narrow-spectrum oral antibiotic based on inhibition of the enzyme DNA polymerase IIIC, which is required for bacterial replication and pathogenesis in C difficile. The drug is currently being tested in a phase 1 clinical trial. The company expects to launch a phase 2 trial at the end of year.

Under the Fast Track designation, ACX-362E will receive expedited review from the FDA. The agency grants the designation to drugs that treat serious or life-threatening conditions and fulfill an unmet medical need. The CDC has identified C difficile, which sickens nearly 500,000 Americans each year, as an urgent threat.

"If approved, we believe our new antibacterial, ACX-362E, will be an important therapeutic alternative for patients with CDI," Acurx managing partner Robert DeLuccia said in the press release. "The Fast Track designation will allow Acurx to work more closely with the FDA to bring ACX-362E to physicians and patients as soon as possible."
Jan 16 Acurx Pharmaceuticals press release

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