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Antibiotics
Special Issues
Antimicrobial Stewardship—from Projects to Standard of Care
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Antimicrobial Stewardship—from Projects to Standard of Care

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotics Use and Antimicrobial Stewardship".

Deadline for manuscript submissions: 31 August 2025 | Viewed by 508

Special Issue Editors

Dr. Gesche Först

E-Mail Website
Guest Editor
1. Clinical Pharmacy, Institute of Pharmaceutical Sciences, Faculty of Chemistry and Pharmacy, Albert-Ludwigs-University, 79085 Freiburg, Germany
2. Division of Infectious Diseases, Department of Medicine II, University Hospital and Medical Centre, and Faculty of Medicine, Albert-Ludwigs-University, 79106 Freiburg, Germany
Interests: antimicrobial stewardship; antimicrobial use; health services research; digitalization of healthcare; medication safety; quality assurance
Dr. Franky Buyle

E-Mail Website
Guest Editor
Department of Pharmacy, Ghent University Hospital, 9000 Ghent, Belgium
Interests: antimicrobial stewardship; OPAT; pharmaceutical service

Special Issue Information

Dear Colleagues,

Antimicrobial stewardship (AMS) remains central for combating antimicrobial resistance ensuring the safe use of antimicrobials. AMS has been shown to be effective and safe; however, its implementation varies widely. Despite successful local and national guidelines, programs and projects, achieving universal integration into standard care remains a challenge. This Special Issue aims to elucidate the gap between current AMS practices and AMS recommendations in different settings. We invite original research, reviews and case reports that address the following topics:

  • Extent of the implementation of AMS recommendations;
  • Feasibility of special AMS measures and programs;
  • Results of AMS interventions;
  • Sustainability of AMS projects;
  • Risk factors, barriers and facilitators of AMS interventions and programs;
  • Quality assurance in AMS;
  • Use and efficacy of digital AMS tools;
  • Innovative AMS projects.

This Special Issue aims to foster a broad dialogue on the evolution of AMS from isolated successes to standard of care, providing insights that can inform policy, practice and future research directions.

Dr. Gesche Först
Dr. Franky Buyle
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • antimicrobial stewardship
  • antimicrobial use
  • antibiotics
  • implementation
  • efficacy
  • quality
  • antimicrobial prescribing

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (1 paper)

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Research

14 pages, 281 KiB  
Article
Optimising Regimen of Co-Amoxiclav (ORCA)—The Safety and Efficacy of Intravenous Co-Amoxiclav at Higher Dosing Frequency in Patients with Diabetic Foot Infection
by Jun Jie Tan, Peijun Yvonne Zhou, Jia Le Lim, Fang Liu and Lay Hoon Andrea Kwa
Antibiotics 2025, 14(8), 758; https://doi.org/10.3390/antibiotics14080758 - 28 Jul 2025
Viewed by 235
Abstract
Background: With increasing pharmacokinetic evidence suggesting the inadequacy of conventional dose intravenous co-amoxiclav (IVCA) 1.2 g Q8H in targeting Enterobacterales, our institution antibiotic guidelines optimised dosing recommendations for diabetic foot infection (DFI) management to 1.2 g Q6H in August 2023. In [...] Read more.
Background: With increasing pharmacokinetic evidence suggesting the inadequacy of conventional dose intravenous co-amoxiclav (IVCA) 1.2 g Q8H in targeting Enterobacterales, our institution antibiotic guidelines optimised dosing recommendations for diabetic foot infection (DFI) management to 1.2 g Q6H in August 2023. In this study, we aim to evaluate the efficacy and safety of the optimised dose IVCA in DFI treatment. Methods: In this single-centre cohort study, patients ≥ 21 years with DFI, creatinine clearance ≥ 50 mL/min, and weight > 50 kg, who were prescribed IVCA 1.2 g Q8H (standard group (SG)), were compared with those prescribed IVCA 1.2 g Q6H (optimised group (OG)). Patients who were pregnant, immunocompromised, had nosocomial exposure in last 3 months, or received < 72 h of IVCA were excluded. The primary efficacy outcome was clinical deterioration at end of IVCA monotherapy. The secondary efficacy outcomes include 30-day readmission and mortality, empiric escalation of antibiotics, lower limb amputation, and length of hospitalisation. The safety outcomes include hepatotoxicity, renal toxicity, and diarrhoea. Results: There were 189 patients (94 in SG; 95 in OG) included. Patients in SG (31.9%) were twice as likely to experience clinical deterioration compared to OG (16.8%) (odds ratio: 2.31, 95% confidence interval: 1.16–4.62, p < 0.05). There were statistically more patients who had 30-day all-cause mortality in SG (5.3%) compared to OG (0%) (p < 0.05). Furthermore, 30-day readmission due to DFI in SG (26.6%) was higher compared to OG (11.6%) (p < 0.05). Empiric escalation of IV antibiotics was required for 14.9% patients in SG and 6.3% patients in OG (p = 0.06). There was no statistical difference for lower limb amputation (p = 0.72), length of hospitalisation (p = 0.13), and the occurrence of safety outcomes in both groups. Conclusions: This study suggests IVCA 1.2 g Q6H is associated with the decreased likelihood of clinical deterioration and is likely as safe as IVCA 1.2 g Q8H. The optimised dose of IVCA may help reduce the use of broad-spectrum antibiotics due to clinical deterioration. Full article
(This article belongs to the Special Issue Antimicrobial Stewardship—from Projects to Standard of Care)
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