Contagion's Top Stories of 2024: Antimicrobial Stewardship

Stewardship remains a key strategy when seeking to reduce antimicrobial resistance (AMR).

of contagion The team continued to cover how AMR is impacting healthcare and why stewardship is a key strategy to combat AMR. Throughout 2024, we spoke with experts from leading institutions, pharmaceutical companies, and federal agencies working together to reduce AMR. We spoke with many key stakeholders at this year's World AMR Conference and have published some of our interviews.

Below is a list of articles that resonated with our audience this year regarding stewardship and how to reduce AMR.

Click on the headings to read more about these articles.

Slow-moving antibiotic resistance train increases morbidity and mortalitymeters

Antimicrobial resistance (AMR) is a slowing train that has everyone in its path fighting bacterial infections. AMR is a multifactorial problem involving many aspects, the biggest of which is potentially a lack of communication and understanding of how it occurs and the consequences of antibiotic misuse. There is no disconnect with the general public.

One disconnect is the lack of public accountability for antibiotic and AMR use. Although the general public understands the potential problems in theory, in practice almost half of those surveyed do not know that their actions can lead to resistance. A poll conducted by the Kaiser Family Foundation found that 67% of respondents recognized the negative effects of antibiotic overuse, meaning patients may have to receive more intensive treatment, and 10 It was found that approximately 6 out of 5 respondents said that the use of antibiotics may be prolonged. Persistent and more dangerous bacterial infections (63%) and increasing numbers of antibiotic-resistant bacteria (62%). However, many believe that the responsibility to protect people from resistant bacteria lies with pharmaceutical companies and healthcare providers. In the same poll, 45% of respondents said they don't take antibiotics as prescribed by a clinician, which can understandably lead to symptoms such as:

IDSA 2024 Guidance: Management of Antimicrobial-Resistant Gram-Negative Infections

The Infectious Diseases Society of America (IDSA) recommends that antimicrobial resistance (AMR) infections, including those caused by extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E), AmpC beta-lactamase-producing Enterobacteria spp. We have published updated guidance for managing ( AmpC-E), carbapenem-resistant Enterobacteriaceae infections (CRE), difficult-to-treat Pseudomonas aeruginosa (DTR) Pseudomonas aeruginosa), carbapenem-resistant Acinetobacter baumannii (CRAB), and Stenotrophomonas maltophilia. This update supersedes previous versions of guidance.

This document outlines preferred and alternative treatments based on the causative organism and antibiotic susceptibility results. We discuss empiric treatment strategies, transition to oral therapy, treatment duration, and other management considerations. This guidance applies to both adults and children, but antibiotic dosages are only provided in the following cases:

Antimicrobial resistance: a devastating (and ignored) biological threat

Before and after the COVID-19 pandemic, the concept of catastrophe, especially biological catastrophe, was limited to the kinds of events you see in movies. Pandemics often come to mind, spreading across the world, wiping out populations and causing mass casualties. That's still a possibility, but if history has shown us anything, it's that pandemics and the biggest biological threats are the least likely to have the highest mortality rates and ultimately lead to catastrophe. That means it can have many meanings. But catastrophes can also burn slowly. It's a neglected issue that we've been fighting for decades, yet we're choosing to drag our feet to take lives…

750,000 AMR-related deaths worldwide could be prevented annually

In the new series starting from lancetResearchers conducted a new modeling analysis that estimates that existing infection prevention methods could prevent up to 750,000 deaths a year related to antibiotic-resistant infections.

Specifically, we analyze that certain strategies could save thousands of lives, including:

Antibiotic de-escalation: Is this the right outcome measure?

The 21st century has brought new ways of thinking about antibiotic prescribing. Clinicians have shifted from a “start low and go slow” mindset to a “go big and go home” mindset. This was in part due to the literature demonstrating that delayed treatment of serious infections worsens outcomes. Based on microbiology results, the empiric use of broad-spectrum antibiotics became commonplace, accompanied by the promise of “later” adjustments to antibiotics. Antibiotic “escalation” (tailoring, narrowing, streamlining, or optimizing empiric treatments) was quickly adopted to reduce consumption of broad-spectrum antibiotics.

Antibiotic de-escalation remains an important antimicrobial stewardship (AMS) strategy, especially in critical care settings where extended-spectrum agents are more frequently used. This is recommended by international guidelines and is generally…

WHO updates list of drug-resistant pathogens

In early May, the World Health Organization (WHO) released an updated document. Bacterial Priority Pathogen List (BPPL) 2024details 24 pathogens across 15 families of antibiotic-resistant bacteria. This list is grouped into critical, high, and moderate categories for prioritization so that public health officials, clinicians, and other stakeholders can recognize and respond accordingly. Additionally, this list provides guidance on the development of new treatments needed to stop the spread of antimicrobial resistance (AMR).

“By mapping the global burden of drug-resistant bacteria and assessing the public health impact, this list is key to guiding investment and addressing the antibiotic pipeline and access crisis,” said WHO Deputy Director-General. said Yukiko Nakatani, MD. for antibacterial resistance Temporary advertisement.

Here’s the breakdown of the pathogens…

The importance of antimicrobial management in dentistry

Traditionally, dental patients undergoing surgery were often prescribed antibiotics for prophylactic purposes. For example, concerns about bacterial endocarditis led to this treatment in patients with heart problems, but new research on the subject has changed the need for antibiotics. “Guidance from the National Institute for Healthcare Excellence (NICE) in England and Wales states that antibiotic prophylaxis against infective endocarditis is not routinely recommended for people undergoing dental procedures.”

Dr. Debra Goff, Professor of Pharmacy Practice at The Ohio State University Wexner Medical Center, has studied the topics of dentistry and antimicrobial stewardship for many years. She became an advocate for the field and taught dentists a thorough understanding of it.

Latest information on the Pasteur method

The Pasteur Act has been in Congress for several years and appears to be here to stay. The bill would authorize the Department of Health and Human Services (HHS) to enter into subscription agreements for urgently needed antibiotics, provide $6 billion in funding for activities under the bill, and include other related provisions. It is. Last year, Sens. Michael Bennet (D-CO) and Todd Young (R-IN), Representatives Drew Ferguson (R-GA) and Scott Peters (D-CA) , Reintroduced the Pasteur Act into Congress. The bill was first introduced in Congress by Bennett and Young in September 2020. Both House members then reintroduced the bill in June 2021, along with Representative Mike Doyle (D-Pennsylvania) and Representative Ferguson.

After the bill was reintroduced last year, five state agencies…

Honoring daughter's legacy after long battle with antimicrobial resistance

Mallory Smith was diagnosed with cystic fibrosis (CF) when she was 3 years old, but it never became a problem until the pathogen was discovered, said her mother, Diane Shader Smith. Burkholderia cepacia It was discovered in his lungs when he was 12 years old.

When a CF patient is colonized with the following bacteria: Burkholderia cepaciathey are often placed in situations that result in a revolving door of medical encounters, including hospitalization, pulmonary treatments, and antibiotic treatment. Unfortunately, the effectiveness of antibiotic treatment can decrease as previously effective treatments become less effective against bacteria and we see an increase in antimicrobial resistance against bacteria.

One Health, One Mission: Fighting AMR with National Antibiotic Awareness Week 2024

November 18-24 is U.S. Antibiotic Awareness Week (USAAW), an important time to raise awareness about antimicrobial resistance (AMR) and promote responsible antibiotic and antifungal use. This annual initiative led by the CDC emphasizes that AMR is a global health crisis that threatens lives around the world.

This year's theme is “The fight against antimicrobial resistance will take all of us.” It highlights the need for a collective and collaborative approach to AMR. This emphasizes the interconnectedness of human, animal, plant, and environmental health, a concept known as the One Health approach. This framework recognizes that human, animal and ecosystem health are inextricably linked and that coordinated action is essential to address them.