Stewardship continues to be an important strategy in trying to reduce antimicrobial resistance (AMR).
The Contagion team continued to cover how AMR is impacting health care and why stewardship is an important strategy to combat it. Throughout 2024, we spoke with experts from major institutions, pharmaceutical companies, and the federal agencies who are working together to reduce AMR. We spoke to a number of key stakeholders at this year’s World AMR Congress, and have included a few of those interviews.
Here is a list of stories that resonated with our audience this year regarding stewardship and ways to reduce AMR.
Click the headlines to read more from these stories.
The Slow-Moving Antimicrobial Resistance Train is Picking-up Morbidity and Mortality Steam
Antimicrobial resistance (AMR) is a slow-moving train that is picking up steam and in its path are all patients battling bacterial infections. AMR is a multifactorial problem that includes many aspects, and potentially chief among them is the missing communication and disconnect with the public, who do not understand the nature of how it happens nor the consequences of the misuse of antibiotics.
One of the disconnects is the public’s lack of responsibility in the usage of antibiotics and AMR. While the lay population understands the potential problem theoretically, in practice, nearly half of people polled don’t know their actions can lead to resistance. In a poll conducted by the Kaiser Family Foundation, it was found that 67% of respondents were aware of the negative implications when overusing antibiotics, which could lead to patients having to take stronger therapies, and about 6 in 10 saying it will lead to longer lasting and more dangerous bacterial infections (63%) and an increasing number of bacteria resistance to antibiotics (62%). However, a larger number of people believe the responsibility of protecting people from resistance belongs with drug companies and health care providers. In the same poll, 45% of respondents say they have not taken their antibiotics as prescribed by their clinician, which can, of course, lead to…
IDSA 2024 Guidance: Managing Antimicrobial-Resistant Gram-Negative Infections
The Infectious Diseases Society of America (IDSA) has released updated guidance for managing antimicrobial-resistant (AMR) infections, including those caused by extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E), AmpC β-lactamase-producing Enterobacterales (AmpC-E), carbapenem-resistant Enterobacterales (CRE), difficult-to-treat Pseudomonas aeruginosa (DTR P. aeruginosa), carbapenem-resistant Acinetobacter baumannii (CRAB), and Stenotrophomonas maltophilia. This update supersedes previous versions of the guidance.
The document outlines preferred and alternative treatment approaches based on the causative organism and antibiotic susceptibility results. It covers strategies for empiric treatment, transitioning to oral therapy, therapy duration, and other management considerations. The guidance is applicable to both adults and pediatric populations, but antibiotic dosages are provided only for…
Antimicrobial Resistance: A Catastrophic (and Neglected) Biological Threat
Prior to and post the COVID-19 pandemic, the notion of a catastrophe, specifically a biological one, was isolated to the kind of events we would see in films. The population-ending, mass casualty pandemic that rips across the globe is often what comes to mind. Although that is still possible, if history has shown us anything, it is that pandemics and the biggest biological threats are less likely to have the highest mortality rates and that, ultimately, catastrophe can mean many things. But catastrophe can also be slow-burning—the neglected issue we have had decades to combat yet still opt to drag our feet over as it kills…
750,000 Global Deaths Linked to AMR Could be Prevented Annually
In a new series launched by The Lancet, investigators conducted a novel modeling analysis that estimates existing infection prevention methods could prevent up to 750,000 deaths annually that are associated with antimicrobial resistant infections.
Specifically, the analysis says certain strategies such as the following can save thousands of lives…
Antibiotic De-Escalation: Is This the Right Outcome Measure?
The 21st century ushered in a new way of thinking about antimicrobial prescribing. Clinicians pivoted from a mentality of “start low and go slow” to “go big and go home.” This was due, in part, to the literature demonstrating worsened outcomes with delays in therapy for treating severe infections. Empiric use of broad-spectrum antimicrobials became commonplace, accompanied by a promise to tailor antimicrobials “later,” according to microbiology results. Antibiotic ‘de-escalation’ (to tailor, narrow, streamline, or optimize empiric therapy) was quickly adopted to mitigate broad-spectrum antimicrobial consumption.
Antibiotic de-escalation remains an essential antimicrobial stewardship (AMS) strategy, particularly in the critical care setting where extended-spectrum agents are utilized more frequently. It is recommended by international guidelines and is commonly used as a benchmark to measure the…
WHO Updates List of Drug-Resistant Pathogens
In early May, the World Health Organization (WHO) released its updated document, Bacterial Priority Pathogens List (BPPL) 2024, which details 24 pathogens across 15 families of antibiotic-resistant bacteria. The list is grouped into critical, high, and medium categories for prioritization for public health officials, clinicians, and other stakeholders to be aware of and treat accordingly. In addition, the list provides guidance on the development of new and necessary treatments to stop the spread of antimicrobial resistance (AMR).
“By mapping the global burden of drug-resistant bacteria and assessing their impact on public health, this list is key to guiding investment and grappling with the antibiotics pipeline and access crisis,” said Yukiko Nakatani, MD, PhD, WHO’s assistant director-general for Antimicrobial Resistance ad interim.
Here is a breakdown of the pathogens…
The Significance of Antimicrobial Stewardship in Dentistry
Traditionally, dental patients undergoing surgical procedures have often been prescribed antibiotics for prophylaxis purposes. For example, in patients with heart issues there were concerns over bacterial endocarditis that prompted this practice, but newer studies around this topic have shifted the need for antibiotics. “Guidance by the National Institute for Health and Care Excellence (NICE) in England and Wales states that antibiotic prophylaxis against infective endocarditis is not recommended routinely for people undergoing dental procedures.”
Debra Goff, PharmD, professor of Pharmacy Practice, The Ohio State University Wexner Medical Center, has been studying the subject of dentistry and antimicrobial stewardship for a number of years. She has become an advocate for the field and teaching dentists to understand fully…
An Update on the Pasteur Act
The Pasteur Act has been in Congress for a few years now, seemingly in a holding pattern. This bill authorizes the Department of Health and Human Services (HHS) to enter into subscription contracts for critical-need antimicrobial drugs, provides $6 billion in appropriations for activities under the bill, and contains other related provisions. Last year, Senators Michael Bennet (D-CO) and Todd Young (R-IN) and Representatives Drew Ferguson (R-GA) and Scott Peters (D-CA), reintroduced the Pasteur Act in Congress. The bill was initially introduced in Congress by Bennet and Young in September 2020; the pair, along with Representatives Mike Doyle (D-PA) and Ferguson, then reintroduced the bill in June 2021.
After the bill’s reintroduction last year, 5 national organizations…
Honoring Her Daughter’s Legacy After a Long-Standing Battle With Antimicrobial Resistance
Mallory Smith was diagnosed with cystic fibrosis (CF) when she was 3 years old, explained her mother, Diane Shader Smith, but it did not become problematic until the pathogen Burkholderia cepacia was found in her lungs when she was 12 years old.
When people with CF become colonized with a bacteria such as Burkholderia cepacia, they are often put in a situation where it becomes a revolving door of medical encounters including hospitalizations, lung treatments, and antibiotic therapy. Unfortunately, antibiotic treatment can see diminishing returns as previously effective therapies are no longer working against the bacteria and a greater antimicrobial resistance is seen against…
One Health, One Mission: Combatting AMR During US Antibiotic Awareness Week 2024
November 18-24 marks US Antibiotic Awareness Week (USAAW), a critical time dedicated to raising awareness about antimicrobial resistance (AMR) and promoting responsible antibiotic and antifungal use. Led by the CDC, this annual initiative highlights AMR as a global health crisis that threatens lives worldwide.
This year’s theme, “Fighting Antimicrobial Resistance Takes All of Us,” emphasizes the need for a collective, collaborative approach to AMR. It stresses the interconnectedness of human, animal, plant, and environmental health, a concept known as the One Health approach. This framework acknowledges that the health of people, animals, and ecosystems are inextricably linked, and coordinated action is essential to address…
