Stewardship / Resistance Scan for Aug 11, 2020

News brief

CARB-X to fund development of new class of broad-spectrum antibiotics

CARB-X announced today that it is awarding $2.91 million to German drug developer Evotec SE to develop a new class of antibiotics to treat infections caused by multidrug-resistant bacteria.

Under the terms of the agreement, Evotec will in-license an antibiotics development program from US biotechnology company Resolute Therapeutics, and continue preclinical development using its proprietary drug discovery and development programs. The goal of the partnership is to develop a novel class of broad-spectrum antibiotics that cover gram-negative and gram-positive pathogens.

Evotec will be eligible for an additional $5.5 million in funding from CARB-X (the Combating Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator) if certain project milestones are met.

"New antibiotics are urgently needed, particularly those that hold significant promise to overcome antimicrobial resistance," Evotec chief scientific officer Cord Dohrmann said in a CARB-X press release.

Since its launch in 2016, CARB-X has awarded $250 million to 67 projects targeting drug-resistant bacteria.
Aug 11 CARB-X press release

Study: High antibiotic prescribing linked to patients' future receipt of antibiotics

Patients who were treated by a high–antibiotic prescribing physician for an acute respiratory infection (ARI) were more likely to receive antibiotics for an ARI in the subsequent year, according to the results of a study published yesterday in Clinical Infectious Diseases.

In the study, a team led by researchers from Harvard Medical School examined encounter data from a US health insurer, looking specifically for patients under the age of 65 with a visit to an urgent care center for an ARI from January 2013 through Jun 10, 2016 and a prescription for an antibiotic filled the day before, the day of, or the 2 days after the visit. They then categorized clinicians within each urgent care center into quartiles based on their antibiotic prescribing rate and examined the association between the clinicians' antibiotic rate during the index visit and the patients' rate of ARI antibiotic receipt in the subsequent year. They also examined subsequent ARI antibiotic receipt among patients' spouses.

The hypothesis was that patients who saw high-prescribing doctors might be more likely to seek care for ARIs and receive an antibiotic in the subsequent year and that their spouses might be as well.

Across 232,256 visits at 736 urgent care centers, ARI antibiotic prescribing rates were 42.1% in the lowest quartile of clinicians and 80.2% in the highest quartile of clinicians. In the year after the index ARI visit, patients who saw the highest-prescribing clinicians received 3 more antibiotic fills per 100 people, or 14.6% more antibiotic fills, over the subsequent year compared with those who saw the lowest prescribers. The increase was also observed among the patients' spouses. The increase was largely driven by the increased number of ARI visits (+ 5.6 ARI visits per 100 patients) among patients who saw high-prescribing clinicians, rather than a higher prescribing rate during those subsequent visits.

"Our results emphasize the importance of how care in one encounter drives a patient to seek care for subsequent ARIs," the authors of the study wrote. "A reduction in antibiotic prescribing may create a feedback loop such that more judicious antibiotic use in one encounter may result in fewer future antibiotics. Thus, an additional benefit of greater antibiotic stewardship is the establishment of new norms for patients on when antibiotics are needed."
Aug 10 Clin Infect Dis abstract

News Scan for Aug 11, 2020

News brief

NIAID enrolling participants in two COVID-19 monoclonal antibody trials

The National Institute of Allergy and Infectious Diseases (NIAID) yesterday announced that it is enrolling participants for two phase 3 trials of two different monoclonal antibody treatments for COVID-19.

The trials are enrolling healthy adults at risk for infection due to close contact at work or home; the investigations are part of the COVID-19 Prevention Network recently established by NIAID, the group said in a news release. Anthony Fauci, MD, NIAID's director, said the network is designed to conduct large-scale trials rapidly and efficiently.

One of the trials involves a double monoclonal antibody against SARS-CoV-2 developed by Regeneron and has a goal of enrolling about 2,000 asymptomatic adults who are household contacts of people diagnosed with COVID-19. The trial will also assess safety and whether the drug can prevent symptoms in those who are already infected.

The second trial involves a monoclonal antibody from Eli Lilly based on the antibodies of a recovered COVID-19 patient isolated by scientists at AbCellera in Vancouver, British Columbia. The trial will assess whether the drug can prevent infection in people working in skilled nursing or assisted living facilities. The study will enroll up to 2,400 participants and assess if the medication can prevent symptoms in people with confirmed infections.
Aug 10 NIAID press release

Study shows physical distancing in US prevented 600,000 COVID-19 cases

A new modeling study from researchers at Massachusetts General Hospital (MGH) shows that within 3 weeks of implementation, physical distancing helped reduce COVID-19 cases by 600,000 across the United States. The study is published today in PLoS Medicine.

"The results show the timing of government-issued orders correlated strongly with reductions in both cases and deaths," co-author Mark J. Siedner, MD, MPH, an infectious diseases physician at MGH, said in a press release. "These measures work, and policy makers should use them as an arrow in their quivers to get on top of local epidemics where they are not responding to containment measures."

To conduct the study, researchers collected data on the first 5 months of the pandemic in the United States, including government-issued orders on statewide physical distancing measures. They then compared changes in COVID-19 cases and COVID-19–attributed deaths in states that implemented physical distancing measures before and after implementation.

The average daily COVID-19 case growth rate began declining 4 days after implementation of the first statewide physical distancing measures, and the epidemic doubling time increased from approximately 4 days to 8 days within 3 weeks of implementation.

"The case growth rate declined by approximately 1% per day beginning 4 days (about 1 incubation period) after statewide social distancing measures were implemented," the authors wrote.
Aug 11 PLOS Medicine study
Aug 11 MGH press release

Low path H5N2 outbreaks strike turkey farms in Australia

Animal health officials in Australia reported two low-pathogenic H5N2 outbreaks at turkey farms, marking the country's first detection of the strain in poultry, Australian Broadcasting Corporation (ABC) reported today.

The detections occurred in an area of Victoria state that had been under enhanced surveillance due to recent highly pathogenic H7N7 outbreaks at layer farms. The locations include Lethbridge and Bairnsdale. A Victorian agriculture official said infected turkeys were recently transported from Lethbridge to Bairnsdale. Several thousand turkeys will be destroyed to curb the spread of the virus, and other measures include the placement of a restricted zone around the farms and enhanced control of movement of birds, equipment, and other products within and outside of the affected area.
Aug 11 ABC report