Stewardship / Resistance Scan for Jan 16, 2020

Antifungal stewardship
AMR in low-resource nations

Antifungal stewardship tied to drop in antifungal drugs, candidemia

A team of Spanish scientists reports that after they implemented an antimicrobial stewardship program (ASP) focused on antifungal use at their university hospital in Seville, use of antifungal drugs dropped 38%, according to their findings published yesterday in the Journal of Infection.

Over a 9-year period, the team quarterly assessed antifungal consumption, incidence of hospital-acquired candidemia, Candida distribution, antifungal resistance, and crude death rate per 1,000 occupied bed days (OBDs) of hospital-acquired candidemia.

They observed a trend of decreased antifungal consumption throughout the 9 years, with a sustained 0.87% reduction per quarter and a final reduction of 38.4% over the entire study period. Reduced fluconazole use accounted for the lion's share of the drop, with a sustained reduction of 1.37% per quarter.

In addition, hospital acquired candidemia decreased 5.06% cases per 1,000 OBDs per year, and the crude death rate dropped 6.36% per 1,000 OBDs per year (from 0.044 to 0.017).

The authors conclude, "This ASP has succeeded in optimizing the use of antifungal with a long-lasting reduction without increasing the incidence, neither the mortality, of hospital-acquired candidemia."
Jan 15 J Infect abstract


University of Leeds launches website for AMR in lower-resource countries

Yesterday the Community Engagement for Anti-microbial Resistance (CE4AMR) project at the University of Leeds in England launched its website, which showcases the network it's building to champion the use of community engagement and participatory and creative approaches to tackle antibiotic resistance in low- and middle-income countries (LMICs).

"CE4AMR believes that if communities are fully informed and engaged with the concept of antimicrobial resistance (AMR) then subsequent behaviour change will be meaningful and sustainable, allowing global AMR objectives to be met," said Jessica Mitchell, PhD, of the University of Leeds, in a CE4AMR blog post yesterday. "To achieve this vision the CE4AMR website provides a collaborative hub to showcase current research utilising community engagement methods to tackle AMR, plus resources and guidance for those wishing to branch into this area."

The website highlights interventions in LMICs, primarily in Southeast Asia and Africa. Projects range from small-scale programs to established, long-term interventions. The site hosts material to support the methodological development of community engagement projects, background information on AMR, evaluation and monitoring resources, and practical toolkits, infographics, reports, and reflections from CE4AMR's network.

The site will also feature workshops, webinars, and conferences on AMR geared toward LMICs.
Jan 15 CE4AMR blog post
CE4AMR website

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