Rational Use of Antibiotics

A special issue of Antibiotics (ISSN 2079-6382).

Deadline for manuscript submissions: closed (30 June 2013) | Viewed by 20248

Special Issue Editor


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Guest Editor
Department of Medical Microbiology, University Hospital of Maastricht, PO Box 5800 6202 AZ Maastricht, The Netherlands
Interests: resistance epidemiology; extramural/ non-hospital settings; commensal flora; guidelines

Special Issue Information

Dear Colleagues,

The increasing prevalence of resistance underscores the relevance to optimalize the use of antibiotics. To control the increasing resistance problem rational use of antibiotics is essential not only for patients in the hospital but in all health care sectors, both intra- and extramural, and also in the veterinary sector. As the resistance problem is a global problem, we also have to pay attention to the other continents not only in Europe.
This issue of the Journal will address the different tools and approaches to implement a rational antibiotic policy. The focus is not only the hospital situation but also nursing homes and general practices, as the majority of the human antibiotic prescription is used outside the hospital. Next to that, optimalisation of the veterinary use will get attention as well.

Dr. Ellen E. Stobberingh
Guest Editor

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Keywords

  • antibiotic use
  • intramural
  • extramural
  • veterinary use
  • implementation
  • antibiotic policy
  • antibiotic stewardship

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Published Papers (2 papers)

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Research

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Article
Exploratory Spatial Mapping of the Occurrence of Antimicrobial Resistance in E. coli in the Community
by Sandra Galvin, Niall Bergin, Ronan Hennessy, Belinda Hanahoe, Andrew W. Murphy, Martin Cormican and Akke Vellinga
Antibiotics 2013, 2(3), 328-338; https://doi.org/10.3390/antibiotics2030328 - 1 Jul 2013
Cited by 19 | Viewed by 9859
Abstract
The use of antimicrobials over the past six decades has been associated with the emergence and dissemination of antimicrobial-resistant bacteria. To explore local geographical patterns in the occurrence of acquired antimicrobial resistance (AMR), AMR of E. coli causing urinary tract infections (UTI) in [...] Read more.
The use of antimicrobials over the past six decades has been associated with the emergence and dissemination of antimicrobial-resistant bacteria. To explore local geographical patterns in the occurrence of acquired antimicrobial resistance (AMR), AMR of E. coli causing urinary tract infections (UTI) in the community in the West of Ireland was mapped. All adult patients consulting with a suspected UTI in 22 general practices in the West of Ireland over a nine-month study period were requested to supply a urine sample. Those with a laboratory confirmed E. coli infection were included (n = 752) in the study. Antimicrobial susceptibility testing was performed by standardized disc diffusion. Patient addresses were geocoded. The diameters of the zone of inhibition of growth for trimethoprim (5 μg) and ciprofloxacin (5 μg) for the relevant isolate was mapped against the patient address using ArcGIS software. A series of maps illustrating spatial distribution of AMR in the West of Ireland were generated. The spatial data demonstrated a higher proportion of isolates with AMR from urban areas. Some rural areas also showed high levels of resistant E. coli. Our study is the first to demonstrate the feasibility of using a geographical information system (GIS) platform for routine visual geographical analysis of AMR data in Ireland. Routine presentation of AMR data in this format may be valuable in understanding AMR trends at a local level. Full article
(This article belongs to the Special Issue Rational Use of Antibiotics)
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Review

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Review
Antimicrobial Stewardship: The Need to Cover All Bases
by N. Deborah Friedman
Antibiotics 2013, 2(3), 400-418; https://doi.org/10.3390/antibiotics2030400 - 27 Aug 2013
Cited by 14 | Viewed by 9544
Abstract
Increasing antimicrobial resistance has necessitated an approach to guide the use of antibiotics. The necessity to guide antimicrobial use via stewardship has never been more urgent. The decline in anti-infective innovation and the failure of currently available antimicrobials to treat some serious infections [...] Read more.
Increasing antimicrobial resistance has necessitated an approach to guide the use of antibiotics. The necessity to guide antimicrobial use via stewardship has never been more urgent. The decline in anti-infective innovation and the failure of currently available antimicrobials to treat some serious infections forces clinicians to change those behaviors that drive antimicrobial resistance. The majority of antimicrobial stewardship (AMS) programs function in acute-care hospitals, however, hospitals are only one setting where antibiotics are prescribed. Antimicrobial use is also high in residential aged care facilities and in the community. Prescribing in aged care is influenced by the fact that elderly residents have lowered immunity, are susceptible to infection and are frequently colonized with multi-resistant organisms. While in the community, prescribers are faced with public misconceptions about the effectiveness of antibiotics for many upper respiratory tract illnesses. AMS programs in all of these locations must be sustainable over a long period of time in order to be effective. A future with effective antimicrobials to treat bacterial infection will depend on AMS covering all of these bases. This review discusses AMS in acute care hospitals, aged care and the community and emphasizes that AMS is critical to patient safety and relies on government, clinician and community engagement. Full article
(This article belongs to the Special Issue Rational Use of Antibiotics)
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