Stewardship / Resistance Scan for Jan 19, 2021

New Oxford AMR institute
Antibiotic stewardship in an Indian ICU

University of Oxford to launch new AMR research institute

The University of Oxford announced today that it has received £100 million ($136 million USD) from the chemical manufacturing company Ineos to launch a new institute to study antimicrobial resistance (AMR).

The Ineos Oxford Institute for AMR Research will focus primarily on developing new antimicrobial drugs, particularly novel drugs just for animals. Scientists at the institute will also contribute to research on the type and extent of drug-resistant microbes across the world, and promote responsible use of antimicrobials in human and animal medicine.

"Just as the discovery of penicillin and subsequent antibiotics transformed modern medicine, the rapid and relentless growth of antimicrobial resistance poses one of the most serious threats to human life worldwide," Oxford professor of medical microbiology Tim Walsh, PhD, said in a university press release.

"Modern agriculture and healthcare both heavily reliant on antibiotics, which is why it is vital to address this issue as a humanitarian emergency and to bring together national and international expertise across scientific disciplines to develop new drugs and policies to tackle this global problem."

The institute will be based in the University of Oxford's departments of chemistry and zoology.
Jan 19 University of Oxford press release


Intense stewardship, infection control tied to less antibiotic ICU use

Implementation of intensive antimicrobial stewardship strategies and monitoring of infection prevention and control practices were associated with a reduction in antibiotic use in the surgical intensive care unit (ICU) of an Indian hospital, researchers reported yesterday in the Journal of Global Antimicrobial Resistance.

The study, conducted by researchers with the Postgraduate Institute of Medical Education and Research in Chandigarh, India, compared antibiotic use in the hospital's ICU surgical recovery unit from April 2017 to June 2017 (the baseline period) with antibiotic use from July 2017 to December 2017 (the intervention period).

During the baseline period, routine prospective audit and feedback of antibiotic prescribing was conducted, per the hospital's antimicrobial stewardship program. For the intervention period, additional stewardship interventions, including antibiotic timeouts, dose optimization, and small training sessions on rational antibiotic use were implemented, along with a bundle of measures for preventing healthcare-acquired infections.

A total of 337 patients were included in the study, with 94 observed in the baseline phase and 243 in the intervention phase. Comparison of the two periods showed a decrease in the days of therapy per 1,000 patient-days (1,112.3 days in the baseline period vs 1,048.6 days in the intervention period) and the length of therapy per 1,000 patient-days (956 vs 936.3 days). The cumulative defined daily doses per 1,000 patient-days for all antimicrobials also fell (1,326.3 vs 1,313.5). Double cover for gram-negative infections was noted in 9.5% of total patients in the baseline phase, compared with 2.9% of patients in the intervention phase.

The analysis also found that the incidence of ventilator-associated pneumonia per 1,000 ventilator-days declined from 46.4 to 35.4, while central line–associated bloodstream infections per 1,000 central line–days remained the same (14.7 vs 14.8).

The authors of the study say the findings, though limited, could be applicable to ICU surgical recovery units in other developing countries with limited resources.
Jan 18 J Glob Antimicrob Resist study

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