July 22, 2019
The growing burden of drug-resistant UTIs. A new article published in the New York Times last week highlights the growing burden of drug-resistant urinary tract infections (UTIs). Once easily treatable with a single course of antibiotics, UTIs are becoming increasingly resistant. The New York City Department of Health found that one-third of UTIs caused by Escherichia coli were resistant to Bactrim, one of the most commonly used antibiotics for UTI treatment. This growing burden calls for improved tracking systems for drug resistant-UTIs which are currently lacking in the US, as well as quick diagnostic tools for accurate drug prescriptions. [NYTimes]
UK pilots a subscription-style payment model for antibiotics. As a part of its 2040 antimicrobial resistance (AMR) vision, the UK government will pilot a subscription-style payment model, which will pay pharmaceutical companies for producing antimicrobial drugs. The model aims to encourage the pharmaceutical industry to invest in drug development for resistant infections and to address the decades of stagnation in the field. Such an approach seeks to overcome the reluctance of drug companies to devote substantial resources to research associated with bringing new antibiotics to the market. An evaluation will be conducted to serve as a basis for the future introduction of similar systems in other parts of the world. [DHSC]
One in 10 children failed to receive lifesaving vaccines last year. According to a recent estimate from the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF), over 1 in 10 children worldwide failed to receive lifesaving vaccines in 2018. A majority of these unvaccinated children live in the world’s poorest, most conflict-ridden countries and are unlikely to have access to treatment. [WHO/UNICEF]
Malaria prevention in young African children. Researchers in Uganda assessed the effectiveness of treating children with intermittent preventive treatment (IPT) of malaria with dihydroartemisinin–piperaquine every 4 weeks versus every 12 weeks. Findings indicate that the incidence of symptomatic malaria among children treated with dihydroartemisinin–piperaquine every 4 weeks was significantly lower than those treated every 12 weeks (p<0.0001). Following the cessation of IPT, malaria protection continued to be stronger in the 4-week group (p=0.028). [The Lancet Infectious Diseases]
Excess antibiotic use common in pneumonia patients. A study across 43 hospitals in Michigan evaluated excess antibiotic use and associated adverse events in patients with pneumonia. The researchers found that 67.8 percent of the 6,481 patients studied received excess antibiotics, and 93.2 percent of these antibiotics were prescribed at discharge. The overtreatment of pneumonia with antibiotics was also linked to an increase in patient-reported antibiotic-associated adverse events, with 5 percent increase in odds per day of excess antibiotic use. [Annals of Internal Medicine]
Availability of essential and older antibiotics in LMICs. On behalf of the European Society of Clinical Microbiology and Infectious Diseases Study Group for Antimicrobial Stewardship, a group of researchers took inventory of Access and Forgotten antibiotics in 28 low- and middle-income countries (LMICs). All 26 Access antibiotics, which are those defined by WHO as essential to treat common bacterial infections, were approved in more than two-thirds of LMICs surveyed. However, only 1/15 of Forgotten antibiotics, which are often old and off-patent, were approved in more than two-thirds of the countries. These results indicate that Forgotten antibiotics are rarely approved in a majority of LMICs, despite their potential importance in combatting multidrug-resistant bacteria. [International Journal of Antimicrobial Agents]
European countries lack targets for reducing antibiotic use. The Transatlantic Taskforce on Antimicrobial Resistance (TATFAR) evaluated the implementation of national antibiotic use reduction targets in Europe, Canada, and the US. Only nine out of 32 countries that submitted survey responses have established targets to reduce antimicrobial use in humans. Among those without specific targets, 17 nations reported working towards implementing such goals, and many plan on developing national action plans against antimicrobial resistance. [Eurosurveillance]
Valley fever diagnosis delays increase costs and antibiotic use. According to a retrospective study conducted by researchers at the University of Arizona, delayed coccidioidomycosis (valley fever) diagnosis is associated with increased costs and antibiotic use. Valley fever patients in Tucson, Arizona had a median diagnosis delay of 23 days. Nearly 90 percent of patients had a diagnosis delay of more than one day, and 43 percent had a delay of more than one month. These delays were associated with $589,053 in related costs as well as 1,103 antibacterial prescriptions ordered prior to diagnosis. [CDC]
Educational handout associated with more child flu vaccinations. Researchers across the US and the UK measured the association between an intervention on influenza vaccination (an educational handout for parents that was either about local or national flu data) and child flu vaccine receipt. The study found that parents who received an educational handout in the waiting room before their clinic visit had 1.68 times the odds of child flu vaccine receipt by the end of the season compared to parents who received usual care (CI: 1.06–2.67). [Pediatrics]
Causes of death among preterm infants in Ethiopia. According to an observational study across 5 Ethiopian hospitals, the main causes of death in preterm infants born at less than 37 gestational weeks included respiratory distress syndrome, neonatal infections, and asphyxia (45, 30, 14 percent, respectively). Hypothermia contributed to 69 percent of infant deaths among the 1,109 babies in the study who died. Infants born at less than 28 gestational weeks had the highest mortality rate (89 percent), while infants born at 35-36 weeks had the lowest (8 percent). [The Lancet Global Health]
CDDEP Blog: Overcoming Access Barriers to Antibiotics. In a new blog post addressing the Access Barriers to Antibiotics Report, CDDEP researchers highlight why tackling access barriers to antibiotics is the key to combatting antibiotic resistance. [CDDEP]
CDDEP Awards in Antimicrobial Resistance. CDDEP Awards in Antimicrobial Resistance will sponsor two individuals for the best-accepted abstracts addressing AMR in low- or middle-income countries for the 19th International Congress on Infectious Diseases (ICID). The awards consist of reimbursement of travel, accommodation, and registration expenses for the 19th ICID in Kuala Lumpur, February 20-23, 2020. Submit your abstract addressing AMR in LMICs by Oct. 25, 2019. [ICID]
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