National Strategy for Combating Antibiotic-Resistant Bacteria” – White House – September 2014

Posted on September 22, 2014. Filed under: Infectious Diseases | Tags: , |

National Strategy for Combating Antibiotic-Resistant Bacteria” – White House – September 2014

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Technological Challenges in Antibiotic Discovery and Development: A Workshop Summary – National Research Council [US] – 2014

Posted on January 29, 2014. Filed under: Infectious Diseases | Tags: , , |

Technological Challenges in Antibiotic Discovery and Development: A Workshop Summary – National Research Council [US] – 2014

Authors: Douglas Friedman and Joe Alper, Rapporteurs; Chemical Sciences Roundtable; Board on Chemical Sciences and Technology; Division on Earth and Life Studies; National Research Council

“Description

Technological Challenges in Antibiotic Discovery and Development is the summary of a workshop convened by the Chemical Sciences Roundtable in September 2013 to explore the current state of antibiotic discovery and examine the technology available to facilitate development. Through formal presentations and panel discussions, participants from academia, industry, federal research agencies discussed the technical challenges present and the incentives and disincentives industry faces in antibiotic development, and identified novel approaches to antibiotic discovery.

Antibiotic resistance is a serious and growing problem in modern medicine and it is emerging as a pre-eminent public health threat. Each year in the United States alone, at least two million acquire serious infections with bacteria that are resistant to one or more antibiotics, and at least 23,000 people die annually as a direct result of these antibiotic-resistant infections. In addition to the toll on human life, antibiotic-resistant infections add considerable and avoidable costs to the already overburdened U.S. health care system. This report explores the challenges in overcoming antibiotic resistance, screening for new antibiotics, and delivering them to the sites of infection in the body. The report also discusses a path forward to develop the next generation of potent antimicrobial compounds capable of once again tilting the battle against microbial pathogens in favor of humans. Technological Challenges in Antibiotic Discovery and Development gives a broad view of the landscape of antibiotic development and the technological challenges and barriers to be overcome.”

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Antibiotic resistance threats in the United States, 2013 – CDC – 16 September 2013

Posted on September 17, 2013. Filed under: Infection Control, Infectious Diseases | Tags: , , |

Antibiotic resistance threats in the United States, 2013 – CDC – 16 September 2013

“This report, Antibiotic resistance threats in the United States, 2013 gives a first-ever snapshot of the burden and threats posed by the antibiotic-resistant germs having the most impact on human health.

Each year in the United States, at least 2 million people become infected with bacteria that are resistant to antibiotics and at least 23,000 people die each year as a direct result of these infections. Many more people die from other conditions that were complicated by an antibiotic-resistant infection.

Antibiotic-resistant infections can happen anywhere. Data show that most happen in the general community; however, most deaths related to antibiotic resistance happen in healthcare settings such as hospitals and nursing homes.”

Press release: Untreatable: Report by CDC details today’s drug-resistant health threats Landmark report ranks threats, outlines four core actions to halt resistance

Digital Press Kit: Untreatable: Today’s Drug-Resistant Health Threats

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Global Risks 2013 – Eighth Edition – World Economic Forum – January 2013

Posted on January 23, 2013. Filed under: Aged Care / Geriatrics, Infectious Diseases | Tags: , , , |

Global Risks 2013 – Eighth Edition – World Economic Forum – January 2013

Includes a section on – The Dangers of Hubris on Human Health

“Health is a critical system that is constantly being challenged, be it by emerging pandemics or chronic illnesses. Scientific discoveries and emerging technologies allow us to face such challenges, but the medical successes of the past century may also be creating a false sense of security. Arguably, one of the most effective and common means to protect human life – the use of antibacterial and antimicrobial compounds (antibiotics) – may no longer be readily available in the near future. Every dose of antibiotics creates selective evolutionary pressures, as some bacteria survive to pass on the genetic mutations that enabled them to do so. Until now, new antibiotics have been developed to replace older, increasingly ineffective ones. However, human innovation may no longer be outpacing bacterial mutation. None of the new drugs currently in the development pipeline may be effective against certain new mutations of killer bacteria that could turn into a pandemic. Are there ways to stimulate the development of new antibiotics as well as align incentives to prevent their overuse, or are we in danger of returning to a pre-antibiotic era in which a scratch could be potentially fatal?”

and on the  Costs of Living Longer

“We are getting better at keeping people alive for longer. Are we setting up a future society struggling to cope with a mass of arthritic, demented and, above all, expensive, elderly who are in need of long term care and palliative solutions?”

ISBN: 92-95044-50-9
978-92-95044-50-0

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Procalcitonin-Guided Antibiotic Therapy – AHRQ [US] – 5 October 2012

Posted on November 2, 2012. Filed under: Infectious Diseases, Pharmacy | Tags: , , |

Procalcitonin-Guided Antibiotic Therapy – AHRQ [US] – 5 October 2012

Full text

Soni NJ, Samson DJ, Galaydick JL, Vats V, Pitrak DL, Aronson N. Procalcitonin-Guided Antibiotic Therapy. Comparative Effectiveness Review No. 78. (Prepared by the Blue Cross and Blue Shield Association Technology Evaluation Center Evidence-based Practice Center under Contract No. 290-2007-10058-I.) AHRQ Publication No. 12(13)-EHC124-EF. Rockville, MD: Agency for Healthcare Research and Quality. October 2012.

“Structured Abstract

Objectives. To systematically review comparative studies of the use of procalcitonin in the clinical management of adult and pediatric patients with suspected local or systemic infection.

Data sources. MEDLINE®, Embase®, the Cochrane Database of Systematic Reviews, National Institute for Clinical Excellence, the National Guideline Clearinghouse, and the Health Technology Assessment Programme were searched from January 1, 1990, to December 16, 2011; the MEDLINE, Embase, and Cochrane searches were updated in December 2011. A search of the gray literature included databases with regulatory information, clinical trial registries, abstracts and conference papers, grants and federally funded research, and information from manufacturers.

Review methods. We sought studies that compared procalcitonin-guided versus clinical-criteria-guided initiation, discontinuation, or change of antibiotic therapy. Outcomes were antibiotic use, mortality, morbidity, and adverse drug events of antibiotic therapy. Data were abstracted by a single reviewer and fact-checked by a second reviewer. Study quality was assessed using the U.S. Preventive Services Task Force framework. A meta-analysis on short-term mortality in intensive care unit (ICU) patients was performed using a random-effects model. Strength of the body of evidence was assessed according to the AHRQ Methods Guide.

Results. There were 18 randomized, controlled trials that addressed five patient populations. Procalcitonin guidance reduces antibiotic use when used to discontinue antibiotics in adult ICU patients and to initiate or discontinue antibiotics in patients with respiratory tract infections (high evidence), without increasing morbidity (moderate evidence) and mortality (low evidence). In contrast, procalcitonin-guided intensification of antibiotics in adult ICU patients increases morbidity (moderate evidence). There is moderate evidence from a single good quality study that procalcitonin guidance reduces antibiotic use for suspected early neonatal sepsis, but insufficient evidence on morbidity and mortality outcomes was found. Evidence is insufficient to draw conclusions on outcomes of procalcitonin guidance for: (1) fever of unknown source in children 1–36 months of age; and (2) preemptive antibiotics after surgery.
Immunocompromised hosts and other special populations were generally excluded from procalcitonin guidance studies. Thus, findings from this review should not be extrapolated to patients with the following conditions: pregnancy; absolute neutropenia; immunocompromised states; chronic infections, and infections for which prolonged antibiotic therapy is standard of care (e.g., infective endocarditis).

Conclusions. Procalcitonin guidance reduces antibiotic use when used to discontinue antibiotics in adult ICU patients and to initiate or discontinue antibiotics in patients with respiratory tract infections. Populations for future research include immunocompromised patients, patients with other conditions (e.g., pregnancy, cystic fibrosis), and pediatric patients. Future research should compare procalcitonin guidance with antibiotic stewardship programs and to implementation of guidelines. Outcomes of high interest for future research are the consequences of reduction in antibiotic use for antibiotic resistance and for adverse events of antibiotic therapy.”

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CDC now tracking antibiotic use in hospitals – 14 November 2011

Posted on November 15, 2011. Filed under: Health Informatics, Infectious Diseases | Tags: , |

CDC now tracking antibiotic use in hospitals – 14 November 2011

“Get Smart About Antibiotics Week 2011 spotlights importance of appropriate antibiotic use

The Centers for Disease Control and Prevention is launching a new antibiotic tracking system allowing hospitals to monitor antibiotic use electronically, make better decisions about how to improve use, and compare themselves to other hospitals. Before now, CDC was only able to track antibiotic use in doctors′ offices.

Each year, millions of Americans take antibiotics to fight infections. But overuse and misuse of antibiotics can change germs, allowing them to evolve resistance to antibiotics, which increases the risk of an infection for which there are limited or no treatment options. Patients who receive antibiotics can experience side effects, including allergic reactions and may be at increased risk for Clostridium difficile infection, a potentially deadly diarrheal infection.

“Antibiotic use leads to antibiotic resistance, which is a major public health problem,” said CDC Director Thomas R. Frieden, M.D., M.P.H. “Hospitals and other health care facilities should monitor the antibiotics used in their facilities. This new system is a powerful tool that will enhance providers′ ability to monitor and improve patterns of antibiotic use so that these essential drugs will still be effective in the years to come.”

The antibiotic use tracking system is part of CDC′s National Healthcare Safety Network, the nation′s premier tool for monitoring infections in health care facilities, which includes over 4,800 hospitals. CDC has funded four health departments and their academic partners to implement the tracking system in 70 hospitals. In addition, any hospital that participates in the National Healthcare Safety Network can utilize this tool by working directly with its pharmacy software vendor to transmit data electronically from drug administration or barcoding records. There is no manual entry of data, thus saving a facility time and money.”

… continues on the site

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Antibiotic Resistance: Implications for Global Health and Novel Intervention Strategies – Institute of Medicine – 7 September 2010

Posted on September 8, 2010. Filed under: Infectious Diseases | Tags: , , |

Antibiotic Resistance: Implications for Global Health and Novel Intervention Strategies – Institute of Medicine – 7 September 2010

Full text online

Type: Workshop Summary
Note: Workshop Summaries contain the opinion of the presenters, but do NOT reflect the conclusions of the IOM. Learn more about the differences between Workshop Summaries and Consensus Reports.

“For decades it seemed as if modern medicine had conquered many of the infectious diseases that once threatened human and animal health. But years of using, misusing, and overusing antibiotics and other antimicrobial drugs have led to the emergence of multidrug-resistant “superbugs.” Some strains of bacteria and viruses are now resistant to all but a single drug, while others have no effective treatments at all.

The IOM’s Forum on Microbial Threats held a public workshop April 6-7 to discuss the nature and sources of drug-resistant bacteria and viruses and their implications for global health. Speakers explored the evolutionary, genetic, and ecological origins of antimicrobial drug resistance and its effects on human and animal health worldwide. Participants discussed the causes of drug resistance; strategies for extending the life of antimicrobial drugs; alternative approaches for treating infections; incentives and disincentives for prudent antimicrobial drug use; and prospects for the next generation of antimicrobial treatments. This document summarizes the workshop.”

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