Nav: Home

'Antibiotic stewardship teams' must be planned and paid for to halt dangerous infections

August 01, 2017

There is an urgent need to plan and fund teams of specialist health workers to promote appropriate use of antibiotics, according to an expert commentary in Clinical Microbiology and Infection [1].

The authors say that these so-called antibiotic stewardship teams are needed in hospitals and in the community, and should ideally be made up of different specialists such as infectious diseases specialists, clinical microbiologists, nurses and pharmacists. Working together, they could improve diagnosis and treatment of infections for patients, and prevent the rise of drug-resistant bacteria.

The commentary says that these specialist teams will ensure we get the best use out of existing treatments for infectious diseases, such as pneumonia, sepsis and gonorrhoea, as well as ensuring that any new treatments remain effective.

The work of antibiotic stewardship teams would include giving expert guidance and education to health workers on prudent antibiotic use, issuing guidelines, monitoring antibiotic use and resistance, and feeding back these results to prescribers to help improve practices.

The lead author of the report is Professor Céline Pulcini, secretary of the European Society of Clinical Microbiology and Infectious Diseases' (ESCMID) Study Group for Antimicrobial stewardshiP (ESGAP) and an infectious diseases specialist based at Nancy University Hospital and University of Lorraine, France.

She explained: "Bacteria are becoming increasingly resistant to antibiotic treatment and there is a growing realisation that we must do all we can to keep antibiotics effective. An important way to do this is to ensure that the right treatments are given to the right patients at the right dose and for the shortest possible duration. By giving antibiotics to those who need them most and, importantly, not giving them to those who will not benefit, we can help more patients now and in the future.

"We know that individually, health workers prescribing antibiotics are trying to do this, but we also know that it takes specialist knowledge of antibiotics and infectious diseases and an overview of all the patients in a hospital or community to have the greatest impact.

"In this report, we highlight the scale of this problem and lay out some urgent first steps."

The report, which examines human resources for antibiotic stewardship teams around the world, found widespread agreement that these multidisciplinary teams are needed. However, in most countries they are non-existent and where they do exist, they are often understaffed. They also tend to be only in hospitals, even though the vast majority of antibiotics are prescribed in the community [2].

The report says that some countries, such as Belgium, France, Australia, Canada, and the USA, have brought in regulations to make hospital stewardship teams mandatory, but even these are not always enforced. The vast majority of countries do not have any national recommendations.

In the commentary, Prof. Pulcini and her co-authors say that an important first step is to identify an international minimum number of staff for antibiotic stewardship teams, set according to the size of the population. For example, there should be at least four team members from different specialties per 1,000 hospital beds. But, this should go beyond hospitals to include community settings and nursing homes.

Alongside this, they say there is a need for global estimates of funding needs for basic antibiotic stewardship activities across all healthcare settings. They recognise that securing funding will be challenging, even in wealthier nations. However, they say the cost of stewardship teams will be very small compared to the dramatic sums of public money that will be needed to bring new antibiotics to market.

Co-author of the report, Professor Evelina Tacconelli is an executive committee member of ESCMID and Chair of ESCMID's European Committee on Infection Control (EUCIC). She is based at the University Hospital Tübingen, Germany.

She said: "Global and coordinated efforts are essential to drive funding to organise and train antibiotic stewardship teams in every hospital. These teams play an essential role in increasing patients' safety and curb the burden of drug-resistant infections. This work is essential not only to preserving the drugs we have now but, even more, to preserve any new ones we develop in the future.

"This will not come cheap but the cost pales into insignificance compared to the costs associated with developing new antimicrobial drugs, not to mention the human cost if we do not take action on antibiotic resistance."

European Society of Clinical Microbiology and Infectious Diseases

Related Antibiotics Articles:

Antibiotics from the sea
The team led by Prof. Christian Jogler of Friedrich Schiller University, Jena, has succeeded in cultivating several dozen marine bacteria in the laboratory -- bacteria that had previously been paid little attention.
Antibiotics not necessary for most toothaches, according to new ADA guideline
The American Dental Association (ADA) announced today a new guideline indicating that in most cases, antibiotics are not recommended for toothaches.
Antibiotics with novel mechanism of action discovered
Many life-threatening bacteria are becoming increasingly resistant to existing antibiotics.
Resistance can spread even without the use of antibiotics
Antibiotic resistance does not spread only where and when antibiotics are used in large quantities, ETH researchers conclude from laboratory experiments.
Selective antibiotics following nature's example
Chemists from Konstanz develop selective agents to combat infectious diseases -- based on the structures of natural products
Antibiotics can inhibit skin lymphoma
New research from the LEO Foundation Skin Immunology Research Center at the University of Copenhagen shows, surprisingly, that antibiotics inhibit cancer in the skin in patients with rare type of lymphoma.
Antibiotics may treat endometriosis
Researchers at Washington University School of Medicine in St. Louis have found that treating mice with an antibiotic reduces the size of lesions caused by endometriosis.
How antibiotics help spread resistance
Bacteria can become insensitive to antibiotics by picking up resistance genes from the environment.
Overuse of antibiotics not what the doctor ordered
With increased use of antibiotics worldwide linked to growing antibiotic resistance, a world-first study co-authored by a QUT researcher has highlighted the growing impact of non-prescription supply of antibiotics in community pharmacies, and the urgent need for better enforcement of laws.
Bacterial armor could be a new target for antibiotics
Boosting efforts to fight antibiotic resistance, Stanford researchers have found that a thin membrane, thought to be just a shrink wrap around some bacterial cell walls, has structural properties critical for survival.
More Antibiotics News and Antibiotics Current Events

Top Science Podcasts

We have hand picked the top science podcasts of 2019.
Now Playing: TED Radio Hour

Accessing Better Health
Essential health care is a right, not a privilege ... or is it? This hour, TED speakers explore how we can give everyone access to a healthier way of life, despite who you are or where you live. Guests include physician Raj Panjabi, former NYC health commissioner Mary Bassett, researcher Michael Hendryx, and neuroscientist Rachel Wurzman.
Now Playing: Science for the People

#544 Prosperity Without Growth
The societies we live in are organised around growth, objects, and driving forward a constantly expanding economy as benchmarks of success and prosperity. But this growing consumption at all costs is at odds with our understanding of what our planet can support. How do we lower the environmental impact of economic activity? How do we redefine success and prosperity separate from GDP, which politicians and governments have focused on for decades? We speak with ecological economist Tim Jackson, Professor of Sustainable Development at the University of Surrey, Director of the Centre for the Understanding of Sustainable Propserity, and author of...
Now Playing: Radiolab

An Announcement from Radiolab