News Scan for Apr 17, 2019

New Saudi MERS case
;
Antibiotic Rx in Italian preschoolers
;
Antibiotic use in UK nursing homes

Saudi health ministry notes another MERS case in Khafji

Saudi Arabia's Ministry of Health (MOH) reported a new MERS-CoV case today in its epidemiologic week 16 report.

A 68-year-old man from Khafji has contracted MERS-CoV (Middle East respiratory syndrome coronavirus) as a secondary case, meaning likely not from another MERS patient. It's unknown if he had camel contact.

This is the 12th case reported from that city since Mar 29, many of them secondary cases, which suggests a hospital or healthcare-related outbreak

Saudi Arabia's total number of MERS cases since the first of the year is now 131, including 57 linked to a large outbreak in Wadi ad-Dawasir.
Apr 17 MOH update

 

Study: Italian overprescribing in preschoolers shows little decline

Significant overprescribing of antibacterial to preschool children in Italy's Emilia-Romagna region hasn't improved much over the past decade, despite stewardship recommendations, according to new research based on data from a regional prescription database. The team reported its findings yesterday in the Journal of Antimicrobial Chemotherapy.

According to European surveillance findings, countries vary widely in antibacterial prescribing among children, who often receive them for viral conditions that don't respond to the drugs. Italy is considered sixth highest in antibiotic consumption, and southern European countries have higher prescribing rates compared with Nordic countries.

The analysis of antibacterial prescribing patterns covered children ages 0 to 5 who were seen in outpatient clinics in Emilia-Romagna from 2007 to 2013 and were prescribed at least one systemic antibiotic. Researchers looked at the data by year, sex, and age to gauge periodic prevalence and the annual prescribing rate.

They found that the percentage of children who received at least one prescription per year varied from 68% in 2007 to 59% in 2013, reflecting a slight decrease. The average prevalence of kids who received five or more prescriptions per year was 6.96%. The overall annual prescription rate ranged from 1,621.26 in 2007 to 1,327.27 in 2013.

Broad-spectrum penicillins were the most frequently prescribed antibacterials, making up 63.9% of all prescriptions in the study. Use of narrow-spectrum agents was negligible, at .02%, much lower than countries such as Sweden (27.7%) or Denmark (27.9%). Co-amoxiclav was prescribed more than amoxicillin alone, despite Italian and European guidelines that recommend extended-spectrum penicillins as the first choice for treating the most common childhood bacterial infections.

Macrolides were the third most frequently prescribed antibacterial group, mainly azithromycin and clarithromycin. Cephalosporin use decreased over the study period, but their use was still considerably higher than in Norway or Denmark.
Apr 16 J Antimicrob Chemother abstract

 

UK survey finds high preventive use of antibiotics in nursing homes

A point-prevalence survey to provide a snapshot of antibiotic use levels in the United Kingdom found high preventive use in long-term care facilities (LTCFs), according to new findings from community pharmacists who conducted the study to identify possible knowledge gaps among caregivers and how pharmacists can provide more support for antimicrobial stewardship efforts. The UK investigators reported their findings yesterday in thesame journal.

For the study, 57 community pharmacists conducted the survey between Nov 13 and Dec 12, 2017, at 644 LTCFs, which included data for 17,909 residents. They found that the mean proportion of residents on the day of their visit was 6.3% for England, 7.6% in Northern Ireland, 8.6% in Wales, and 9.6% in Scotland. Just over a quarter (25.3%) of the antibiotics were prescribed for prophylactic use.

When the researchers asked facilities about antibiotic-related training for staff, they found that it was available at only 6.8% of LTCFs, and only 7.1% of the facilities reported using catheter passports, which are designed to be carried by the patients at all times to help reduce the length of time the catheter is needed and the risk of infection.

Pharmacists intervened during the survey for 9.5% of the antibiotic prescribing events, of which 53.4% were for clinical reasons and 32.2% were for administrative reasons.

The authors concluded that the findings support the role of pharmacy teams in working at LTCFs to provide a greater focus on antimicrobial stewardship, with an eye toward supporting the national goal of reducing inappropriate prescribing 50% by 2021.
Apr 16 J Antimicrob Chemother abstract

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