Antibiotic stewardship for staff nurses: Five Key Ways you Influence Antibiotic Use

Over the past decade, antibiotic resistance has increased and spread dramatically throughout the world. According to the Centers for Disease Control and Prevention (CDC), antibiotic use is the single most important factor leading to antibiotic resistance. The CDC estimates that every year, 2 million Americans develop serious infections involving bacteria that resist one or more antibiotics, and these infections kill at least 23,000 each year. Antibiotic prescribing in U.S. acute-care hospitals is common— and often unwarranted. A 2014 study found that up to half of hospitalized patients received at least one antibiotic and in 30% to 50% of these cases, antibiotics were unnecessary or inappropriate. Such antibiotic misuse contributes to the emergence and spread of antibioticresistant organisms, such as methicillin- resistant Staphylococcus aureus and vancomycin-resistant enterococci. (See Unheeded warnings.) If you’re a staff nurse, you’ve probably witnessed firsthand the consequences of inappropriate antibiotic use, ranging from development of Clostridium difficile (a well-recognized cause of healthcare- associated infectious diarrhea) to fatal infections with multidrugresistant pathogens against which no effective antibiotic therapy exists. What’s more, antibiotic-resistant infections add considerably to medical costs, with estimates as high as $35 billion a year

Almirall entra en el capital d'AB-Biotics

La farmacéutica, ubicada al Parc de Recerca UAB, invertirà prop d'un milió d'euros en l'spin-off AB-Biotics. Ambdues companyies col·laboraran en la promoció i comercialització de Neurofarmagen a Espanya, un test per optimitzar tractaments neuropsiquiàtrics

Accidental hepatic artery ligation in humans

Despite the vast amount of information from experimental animals, it has been difficult to obtain a clear-cut picture of the effects of ligation of the hepatic artery in humans with relatively normal livers. The last complete review of this subject in 1933 indicated that a mortality in excess of 50 per cent could be expected in non-cirrhotic patients with injury of the hepatic artery or its principal branches. Five cases of dearterialization of the normal human liver have been observed. These were due to accidental interruption of the right hepatic artery in four and the proper hepatic artery in one. The injured vessel was repaired in one case and ligated in the others. In four of the five patients the vascular disruption was the sole injury. In the other the common bile duct was also lacerated. There was no evidence of hepatic necrosis in any case although one patient died from complications of common duct repair. Transient changes in SGOT and temporary low grade bilirubinemia were commonly noted. In addition, all cases of ligation of the hepatic artery reported since 1933 have been compiled. On the basis of reviewed, as well as the presently reported cases, it is concluded that ligation of the hepatic artery or one of its branches in the patient with relatively normal hepatic function is not ordinarily fatal in the otherwise uncomplicated case. Adequate perfusion of the liver can usually be provided by the remaining portal venous flow and whatever arterial collaterals are present, unless additional factors further reduce the portal venous flow or increase hepatic oxygen need. These factors include fever, shock and anoxia. The key to therapy in unreconstructed injuries to the hepatic artery is avoidance of these secondary influences. © 1964

The impact of antibiotic use on transmission of resistant bacteria in hospitals: Insights from an agent-based model

Extensive antibiotic use over the years has led to the emergence and spread of antibiotic resistant bacteria (ARB). Antibiotic resistance poses a major threat to public health since for many infections antibiotic treatment is no longer effective. Hospitals are focal points for ARB spread. Antibiotic use in hospitals exerts selective pressure, accelerating the spread of ARB. We used an agent-based model to explore the impact of antibiotics on the transmission dynamics and to examine the potential of stewardship interventions in limiting ARB spread in a hospital. Agents in the model consist of patients and health care workers (HCW). The transmission of ARB occurs through contacts between patients and HCW and between adjacent patients. In the model, antibiotic use affects the risk of transmission by increasing the vulnerability of susceptible patients and the contagiousness of colonized patients who are treated with antibiotics. The model shows that increasing the proportion of patients receiving antibiotics increases the rate of acquisition non-linearly. The effect of antibiotics on the spread of resistance depends on characteristics of the antibiotic agent and the density of antibiotic use. Antibiotic's impact on the spread increases when the bacterial strain is more transmissible, and decreases as resistance prevalence rises. The individual risk for acquiring ARB increases in parallel with antibiotic density both for patients treated and not treated with antibiotics. Antibiotic treatment in the hospital setting plays an important role in determining the spread of resistance. Interventions to limit antibiotic use have the potential to reduce the spread of resistance, mainly by choosing an agent with a favorable profile in terms of its impact on patient's vulnerability and contagiousness. Methods to measure these impacts of antibiotics should be developed, standardized, and incorporated into drug development programs and approval packages

Prescribing antibiotics to preschool children in primary health care in Croatia

The use of antibiotics depends on cultural and socioeconomic factors, physician's characteristics as well as on microbiological considerations. Aim of our study was to asses antibiotic prescription among preschool children in primary health care in Croatia in relation to socioeconomic factors, symptoms and diagnoses, and type of health care provider. Retrospective longitudinal survey was conducted in 7 teaching primary health care offices in the Croatian capital of Zagreb during 2004, among 1700 preschool children. Antibiotics were prescribed to 611 (46%) children. Significantly more antibiotics were prescribed to boys (66.7%, P = 0.024) and to children whose parents had lower educational level. Most frequently antibiotics were prescribed for the symptoms such as fever (32%), cough (32.5%), nasal discharge (12%), and for the diagnoses such as respiratory diseases (J00-J99) (40%), infectious and parasitic diseases (A00-A99) (31%), and diseases of the middle ear and mastoid (H60-H95) (15%). Logistic regression analyses also predicted correlation of antibiotic prescriptions with socioeconomic factors, symptoms and diagnoses and health care of pediatrician. Prescription of antibiotics for preschool children in primary health care in Croatia related to socioeconomic factors, type of health care provider, certain symptoms and diagnosis groups which should be taken into account when assessing and planning primary health care for preschool children

AB-Biotics obté la patent europea per al probiòtic reductor del colesterol AB-Life

La patent protegeix la composició del producte i totes les seves aplicacions farmacèutiques i alimentàries. AB-Biotics, spin-off de la UAB, ja ha llicenciat el producte a farmacèutiques de Mèxic, Brasil, Veneçuela, Corea del Sud, sud-est d'Europa, Alemanya, Espanya i Portugal, i preveu llençar-lo a altres mercats europeus al 2014

AB-Biotics adquireix una patent per predir efectes secundaris dels antipsicòtics

El nou mètode permet predir, a partir de l'ADN, el risc d'un pacient tractat amb antipsicòtics de desenvolupar efectes secundaris relacionats amb el moviment, com rigidesa muscular, tremolors o parkinsonisme. AB-Biotics, spin-off de la UAB, incorporarà aquesta nova tecnologia patentada al seu servei de farmacogenètica Neurofarmagen, que ajuda al metge a identificar el tractament més adequat per a cada pacient a través de l'ADN