Expert Review of Anti-infective Therapy最新文献_第5页

Complicated urinary tract infections: evolving definitions, clinical burden, and treatment landscape amid antimicrobial resistance. 复杂尿路感染：不断发展的定义、临床负担和抗生素耐药性下的治疗前景。

IF 4.6 2区医学

Expert Review of Anti-infective Therapy Pub Date : 2026-09-01 Epub Date: 2026-07-10 DOI: 10.1080/14787210.2026.2700381

Kamal A Hamed, Abdullah H Salama, Greg Moeck, Florian M Wagenlehner

{"title":"Complicated urinary tract infections: evolving definitions, clinical burden, and treatment landscape amid antimicrobial resistance.","authors":"Kamal A Hamed, Abdullah H Salama, Greg Moeck, Florian M Wagenlehner","doi":"10.1080/14787210.2026.2700381","DOIUrl":"10.1080/14787210.2026.2700381","url":null,"abstract":"Introduction: Complicated urinary tract infection (cUTI) is a common and heterogeneous infection associated with substantial morbidity, high healthcare utilization, and increasing antimicrobial resistance. Evolving definitions, increasing device use, and changing patient populations have altered its epidemiology and management. Marked variability in diagnostic criteria, clinical trial endpoints within and outside registrational settings, and treatment strategies complicates clinical decision-making and interpretation of therapeutic advances.Areas covered: This review examines contemporary cUTI epidemiology, classification frameworks, and drivers of disease burden. It evaluates resistance trends and their therapeutic implications, alongside stewardship-based management strategies, including empiric antibiotic selection, intravenous-to-oral transition, treatment duration, and source control. Challenges in catheter-associated infection, recurrence, and regulatory endpoint design are discussed, together with the emerging role of novel agents targeting resistant Gram-negative pathogens.Expert opinion: Rising multidrug resistance and limited oral options are reshaping cUTI management, necessitating individualized, stewardship-aligned therapy guided by illness severity and local epidemiology. Current regulatory endpoints inadequately reflect patient-centered outcomes, particularly in the context of asymptomatic bacteriuria. Expanding availability of effective oral agents may enable earlier discharge and outpatient care. Integration of rapid diagnostics and risk stratification will be essential to optimize therapy, limit resistance, and improve outcomes.","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"827-844"},"PeriodicalIF":4.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148390196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effectiveness and safety of eravacycline-based regimens for resistant Acinetobacter baumannii infections: a systematic review and meta-analysis. 以厄伐环素为基础的方案治疗耐药鲍曼不动杆菌感染的有效性和安全性：一项系统综述和荟萃分析。

IF 4.6 2区医学

Expert Review of Anti-infective Therapy Pub Date : 2026-09-01 Epub Date: 2026-07-04 DOI: 10.1080/14787210.2026.2699179

Shahd Mohammad, Eman Awwad, Ayah Hajjar, Sulaiman Alzunaydi, Ahmed Ak Al-Hammadi, Thamer A Almangour, Matteo Bassetti

{"title":"Effectiveness and safety of eravacycline-based regimens for resistant Acinetobacter baumannii infections: a systematic review and meta-analysis.","authors":"Shahd Mohammad, Eman Awwad, Ayah Hajjar, Sulaiman Alzunaydi, Ahmed Ak Al-Hammadi, Thamer A Almangour, Matteo Bassetti","doi":"10.1080/14787210.2026.2699179","DOIUrl":"10.1080/14787210.2026.2699179","url":null,"abstract":"Introduction: Acinetobacter baumannii, particularly multidrug-resistant strains, is a high-burden nosocomial pathogen with limited therapeutic options. Eravacycline is increasingly used off-label despite limited supporting clinical evidence. This meta-analysis aimed to evaluate the effectiveness and safety of eravacycline versus non-eravacycline-based regimens in adults with resistant A. baumannii infections.Methods: MEDLINE, Embase, and Cochrane Central were searched for studies evaluating eravacycline regimens in hospitalized adults with A. baumannii infection. Risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using random-effects models. Data were analyzed using R statistical software.Results: Fifteen studies encompassing 462 patients were included. Populations consisted predominantly of older adults, with respiratory tract infections representing the most common source of infection (77.6%). Carbapenem-resistant A. baumannii accounted for 84.4% of evaluable cases. No statistically significant differences were observed between eravacycline and non-eravacycline-based regimens in all-cause mortality (RR 1.06; 95% CI 0.46-2.47), clinical cure (RR 0.90; 95% CI 0.77-1.07), or microbiological eradication (RR 0.88; 95% CI 0.56-1.37). Complementary single-arm pooled estimates among eravacycline-treated cohorts were favorable.Conclusion: This meta-analysis strengthens the evidence base for eravacycline effectiveness in resistant A. baumannii infections and supports its consideration when preferred regimens are not feasible; adequately powered randomized trials are needed to define optimal positioning.","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"855-865"},"PeriodicalIF":4.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148375019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of a clinical engagement targeted antimicrobial stewardship program on antimicrobial use in Pakistan: a multicenter longitudinal point prevalence survey. 临床参与目标抗菌药物管理计划对抗菌药物使用在巴基斯坦的影响：多中心纵向点流行病学调查。

IF 4.6 2区医学

Expert Review of Anti-infective Therapy Pub Date : 2026-09-01 Epub Date: 2026-07-12 DOI: 10.1080/14787210.2026.2703100

Tauqeer Mustafa, Hashaam Akhtar, Qadeer Ahsan, Babar Tasneem Shaikh, Saad Ahmed, Mariam Ashraf, Tayyab Mansoor Akhtar, Naveed Ahmed, Shahzad Ali Khan

{"title":"Impact of a clinical engagement targeted antimicrobial stewardship program on antimicrobial use in Pakistan: a multicenter longitudinal point prevalence survey.","authors":"Tauqeer Mustafa, Hashaam Akhtar, Qadeer Ahsan, Babar Tasneem Shaikh, Saad Ahmed, Mariam Ashraf, Tayyab Mansoor Akhtar, Naveed Ahmed, Shahzad Ali Khan","doi":"10.1080/14787210.2026.2703100","DOIUrl":"10.1080/14787210.2026.2703100","url":null,"abstract":"Background: Antimicrobial resistance is driven by excessive antibiotic use in hospitals, but evidence on the long-term effectiveness of antimicrobial stewardship interventions in public-sector hospitals in Pakistan is limited. We evaluated the impact of a structured clinical engagement AMS intervention affected antibiotic prescribing and stewardship in Pakistani public hospitals.Methods: A multicenter longitudinal study was conducted using serial WHO-standardized point prevalence surveys at baseline (February - March 2021), midline (July - August 2022), and endline (September - October 2023) across tertiary care public hospitals. Outcomes included antibiotic prescribing prevalence, guideline compliance, WHO AWaRe antibiotic distribution, microbiological practices, and institutional AMS capacity.Results: Across three survey rounds, 2,574 inpatients were assessed, and antibiotic use remained persistently high (78-80%). Guideline-concordant prescribing improved significantly (p < 0.0001), with modest increases in Access-category and reductions in Reserve-category antibiotics, while Watch-category antibiotics remained (~56%). Microbiological culture requests increased (p < 0.0001), but targeted therapy remained uncommon, with over 95% empirical prescribing. AMS infrastructure improved substantially, including the establishment of committees and the appointment of stewardship leadership.Conclusion: Clinical engagement-based AMS improved institutional capacity and some prescribing indicators but did not reduce overall antibiotic exposure. Ongoing empirical prescribing due to diagnostic limitations and entrenched practices underscores the need for better microbiology and diagnostic support.","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"877-889"},"PeriodicalIF":4.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Invasive candidiasis in the intensive care unit: diagnostic stewardship, source control, and precision antifungal therapy. 侵袭性念珠菌病在重症监护室：诊断管理，来源控制，和精确的抗真菌治疗。

IF 4.6 2区医学

Expert Review of Anti-infective Therapy Pub Date : 2026-08-31 DOI: 10.1080/14787210.2026.2726965

Ignacio Martin-Loeches, Yuetian Yu

{"title":"Invasive candidiasis in the intensive care unit: diagnostic stewardship, source control, and precision antifungal therapy.","authors":"Ignacio Martin-Loeches, Yuetian Yu","doi":"10.1080/14787210.2026.2726965","DOIUrl":"10.1080/14787210.2026.2726965","url":null,"abstract":"Introduction: Invasive candidiasis remains one of the most challenging infections in the intensive care unit (ICU) because diagnosis is complicated by nonspecific clinical manifestations, frequent colonization, altered host immunity, complex anatomical sources and unstable pharmacokinetics. Distinguishing true invasive disease from colonization is fundamental to optimizing patient outcomes while avoiding unnecessary antifungal exposure.Areas covered: This narrative review examines invasive candidiasis in critically ill adults from an ICU perspective, based on a structured PubMed/MEDLINE, Embase and Cochrane Library search of English-language literature (January 2005-May 2026). We discuss contemporary epidemiology, updated fungal nomenclature, risk factors and disease phenotypes, together with diagnostic stewardship using cultures, beta-D-glucan and molecular assays. Current evidence regarding source control, catheter management, empirical and targeted antifungal therapy, therapeutic drug monitoring, pharmacokinetic challenges during extracorporeal support, emerging agents and Candida auris is reviewed.Expert opinion: The principal challenge in ICU fungal infections is not delayed antifungal therapy alone but accurate attribution of invasive disease. Positive fungal cultures or biomarkers should be interpreted within their clinical and anatomical context rather than as independent indications for treatment. Future management should integrate rapid diagnostics, host immune profiling, optimized pharmacokinetics and effective source control into phenotype-driven strategies that improve outcomes while strengthening antifungal stewards.","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1-18"},"PeriodicalIF":4.6,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association of tocilizumab use with mortality and clinical outcomes in critically ill patients followed in the intensive care unit for COVID-19 pneumonia: a single-center retrospective cohort study. 托珠单抗使用与重症监护病房COVID-19肺炎危重患者死亡率和临床结局的关联：一项单中心回顾性队列研究

IF 4.6 2区医学

Expert Review of Anti-infective Therapy Pub Date : 2026-08-28 DOI: 10.1080/14787210.2026.2725738

Salih Gale, Nilgün Kavrut Öztürk

{"title":"Association of tocilizumab use with mortality and clinical outcomes in critically ill patients followed in the intensive care unit for COVID-19 pneumonia: a single-center retrospective cohort study.","authors":"Salih Gale, Nilgün Kavrut Öztürk","doi":"10.1080/14787210.2026.2725738","DOIUrl":"10.1080/14787210.2026.2725738","url":null,"abstract":"Objectives: Randomized trials show tocilizumab reduces mortality in selected COVID-19 patients treated early; its association with outcomes in real-world intensive care, where treatment is often delayed, remains uncertain. We evaluated this association in critically ill patients.Methods: Single-center retrospective cohort of adults admitted to the intensive care unit (ICU) with PCR-confirmed COVID-19 pneumonia and acute respiratory failure (March 2020-September 2021; n = 393), grouped by tocilizumab use: Group T (received tocilizumab, n = 117) and Group N (did not receive tocilizumab, n = 276). Outcomes were mortality (primary), ICU stay, and mechanical ventilation. Baseline imbalance was assessed with standardized mean differences (SMD); associations were adjusted by covariate adjustment, propensity score weighting, and 1:1 matching.Results: Overall mortality was 60.6%. Group T patients were younger with fewer comorbidities (age SMD -0.95). Unadjusted mortality was lower with tocilizumab (odds ratio [OR] 0.55; 95% CI 0.35-0.86), but this disappeared after adjustment (covariate-adjusted OR 1.28, 0.70-2.34; weighting OR 1.41, 0.89-2.24; matching OR 1.52). ICU stay did not differ. Independent mortality predictors were older age, cytokine apheresis, higher C-reactive protein, and lactate dehydrogenase. Median time to tocilizumab was 10 days.Conclusion: After adjustment, tocilizumab was not independently associated with mortality. Findings are observational and not causal; any benefit may depend on patient selection and timing.","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1-7"},"PeriodicalIF":4.6,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148826653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ensuring pragmatic and equitable paths forward for hepatitis B virus infection elimination in Latin America. 确保在拉丁美洲为根除乙型肝炎病毒感染开辟务实和公平的前进道路。

IF 4.6 2区医学

Expert Review of Anti-infective Therapy Pub Date : 2026-08-26 DOI: 10.1080/14787210.2026.2723574

Ezequiel Ridruejo, Javier Crespo, Hugo Cheinquer, Nelia Hernandez, Juan Turnes

{"title":"Ensuring pragmatic and equitable paths forward for hepatitis B virus infection elimination in Latin America.","authors":"Ezequiel Ridruejo, Javier Crespo, Hugo Cheinquer, Nelia Hernandez, Juan Turnes","doi":"10.1080/14787210.2026.2723574","DOIUrl":"10.1080/14787210.2026.2723574","url":null,"abstract":"Introduction: Latin America is a paradox in hepatitis B virus (HBV) elimination: aggregate prevalence is low, yet the region is far from WHO and PAHO 2030 targets because the burden is structurally concealed within underserved populations and fragmented health systems.Areas covered: This review examines regional epidemiology, structural and programmatic barriers to elimination, and a pragmatic framework for populations of concentrated unmet need (indigenous communities, incarcerated and displaced persons, and people living with HIV), alongside perinatal prevention; hepatitis D, a defective satellite virus that requires hepatitis B surface antigen to replicate, endemic in the Amazon basin and the most rapidly progressive chronic viral hepatitis; simplified versus precise diagnosis in low-prevalence settings; and locally validated, equity-aware computational tools for case-finding, risk stratification, and investment prioritization. Evidence came from PubMed/MEDLINE (January 2010 to 30 April 2026) plus WHO, PAHO, and ALEH sources.Expert opinion: Only 23% of people with chronic HBV in the WHO Region of the Americas are diagnosed and 4.5% treated. Closing that gap requires a shift from coverage-centered to precision-centered delivery: reaching the right individuals and coupling decentralization to active linkage to care. HBV elimination in Latin America is a systems delivery challenge under low apparent prevalence.","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1-16"},"PeriodicalIF":4.6,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sequential vancomycin trough and dosing interval prediction in ICU patients using general purpose large language models: a head-to-head comparison of ChatGPT and GROK AI. 使用通用大语言模型预测ICU患者万古霉素序贯期和给药间隔：ChatGPT和GROK AI的头对头比较

IF 4.6 2区医学

Expert Review of Anti-infective Therapy Pub Date : 2026-08-26 DOI: 10.1080/14787210.2026.2721559

Azfar Athar Ishaqui, Tauqeer Hussain Mallhi, Emad Ali Alsaleh, Rayah Asiri, Saira Faraz Shah, Amer Hayat Khan, Khalid Orayj, Salman Ashfaq Ahmad, Muhammad Imran, Narendar Kumar, Adnan Iqbal, Muhammad Bilal Maqsood

{"title":"Sequential vancomycin trough and dosing interval prediction in ICU patients using general purpose large language models: a head-to-head comparison of ChatGPT and GROK AI.","authors":"Azfar Athar Ishaqui, Tauqeer Hussain Mallhi, Emad Ali Alsaleh, Rayah Asiri, Saira Faraz Shah, Amer Hayat Khan, Khalid Orayj, Salman Ashfaq Ahmad, Muhammad Imran, Narendar Kumar, Adnan Iqbal, Muhammad Bilal Maqsood","doi":"10.1080/14787210.2026.2721559","DOIUrl":"10.1080/14787210.2026.2721559","url":null,"abstract":"Background and objectives: Vancomycin monitoring remains challenging due to fluctuating renal function and ICU physiology. This study compares ChatGPT and Grok for predicting sequential vancomycin trough levels and dosing intervals across varying renal function.Research design and methods: This retrospective study used deidentified MIMIC-IV ICU data. Admissions with three sequential vancomycin troughs and complete dosing history were included (239 admissions, 717 predictions: T1-T3). Structured clinical snapshots were submitted to both models to predict trough concentrations (mg/L) and dosing intervals (hours). Performance was assessed using MAE, RMSE, bias, ±2 mg/L and ±2-hour accuracy, sequence success, and generalized estimating equations.Results: ChatGPT outperformed Grok in trough prediction (MAE 4.07 vs 5.08 mg/L; RMSE 5.55 vs 7.53 mg/L; ±2 mg/L accuracy 37.0% vs 29.0%), with greater advantage at T1/T2 and in renal dysfunction. Grok was superior for interval prediction (MAE 1.36 vs 1.61 hours; RMSE 2.09 vs 2.98 hours). ChatGPT achieved more successful trough sequences (≥2/3 within ±2 mg/L: 35.1% vs 23.0%), while Grok had more accurate interval sequences (all 3 within ±2 hours: 67.8% vs 59.8%).Conclusions: These findings represent comparative model benchmarking and require validation against pharmacist-led therapeutic drug monitoring and Bayesian AUC-guided dosing platforms before clinical use.","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1-12"},"PeriodicalIF":4.6,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evolutionary convergence of enzymatic and target-mediated resistance in Escherichia coli: from CTX-Ms to PBP-3 insertions. 大肠杆菌酶和靶标介导抗性的进化趋同：从CTX-Ms到PBP-3插入。

IF 4.6 2区医学

Expert Review of Anti-infective Therapy Pub Date : 2026-08-25 DOI: 10.1080/14787210.2026.2723573

Johann Dd Pitout, Gisele Peirano, Marleen Kock

{"title":"Evolutionary convergence of enzymatic and target-mediated resistance in Escherichia coli: from CTX-Ms to PBP-3 insertions.","authors":"Johann Dd Pitout, Gisele Peirano, Marleen Kock","doi":"10.1080/14787210.2026.2723573","DOIUrl":"10.1080/14787210.2026.2723573","url":null,"abstract":"Introduction: Antimicrobial-resistant (AMR) Escherichia coli has undergone significant transformations over the past three decades. Largely susceptible to the fluoroquinolones (FQs) and cephalosporins (cephs) during the 1990s, E. coli has evolved into major multidrug-resistant (MDR) pathogens through the sequential acquisition of chromosomal target modifications and plasmid-mediated β‑lactamases.Areas covered: This evolution consisted of two major waves of convergence: an initial merger of quinolone resistance-determining regions (QRDR) mutations (FQ-R) with CTX-M β‑lactamases (ceph-R) during the 2000s, followed by combining penicillin-binding proteins (PBP)‑3 insertions (YRIN, YRIK) with NDMs (carbapenem-R) during the 2010s. These AMR mergers were largely driven by MDR high-risk clones, notably ST131 (QRDR mutations + CTX-M-15) and ST410/ST167 (PBP3 insertions + NDM-5). MDR strains harboring YRIN and YRIK exhibit reduced susceptibilities to last-line therapies, such as newer β-lactam/β-lactamase inhibitors (especially those containing aztreonam, cefepime, and ceftazidime).Expert opinion: These developments underscore the remarkable adaptability of E. coli under antimicrobial pressure and highlight the need for improved surveillance, diagnostics, and therapeutic strategies to combat the ongoing expansion of MDR strains.","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1-13"},"PeriodicalIF":4.6,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148790149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Different problems, different levers: a reply on prioritizing administrative reform of Pakistan's antibiotic market. 不同的问题，不同的手段：对巴基斯坦抗生素市场行政改革优先次序的答复。

IF 4.6 2区医学

Expert Review of Anti-infective Therapy Pub Date : 2026-08-20 DOI: 10.1080/14787210.2026.2719694

Saad Abdullah, Brian Godman, Zikria Saleem

引用次数: 0

Antimicrobial stewardship implementation in Western Uganda: a narrative policy and implementation review. 西乌干达抗菌剂管理实施：叙述政策和实施审查。

IF 4.6 2区医学

Expert Review of Anti-infective Therapy Pub Date : 2026-08-19 DOI: 10.1080/14787210.2026.2720593

Esther Ugo Alum, Bashar Haruna Gulumbe, Friday Ogbu Edeh, Christine Ainebyoona, Daniel Ejim Uti, Okechukwu Paul-Chima Ugwu, Benedict Nnachi Alum, Michael Ben Okon, Patrick Maduabuchi Aja, Vaithiyalingam Subramanian Manjula, Peter Chinedu Agu

{"title":"Antimicrobial stewardship implementation in Western Uganda: a narrative policy and implementation review.","authors":"Esther Ugo Alum, Bashar Haruna Gulumbe, Friday Ogbu Edeh, Christine Ainebyoona, Daniel Ejim Uti, Okechukwu Paul-Chima Ugwu, Benedict Nnachi Alum, Michael Ben Okon, Patrick Maduabuchi Aja, Vaithiyalingam Subramanian Manjula, Peter Chinedu Agu","doi":"10.1080/14787210.2026.2720593","DOIUrl":"10.1080/14787210.2026.2720593","url":null,"abstract":"Introduction: Antimicrobial resistance (AMR) is a major health-system challenge in Uganda. Western Uganda has documented inappropriate antibiotic prescribing and local resistance patterns, but evidence on routine antimicrobial stewardship (AMS) implementation remains fragmented.Areas covered: This structured narrative policy and implementation review synthesizes evidence on AMR and antimicrobial stewardship (AMS) implementation in Western Uganda, drawing on Western Uganda-specific studies, Uganda-wide evidence, national policy documents, and broader low- and middle-income country implementation literature. Evidence was identified through targeted PubMed searches, World Health Organization resources, and Ugandan Ministry of Health repositories focused on AMR, AMS, antibiotic use, diagnostics, surveillance, community pharmacies, drug shops, One Health, and low-resource settings.Expert opinion: The strongest immediate case for stewardship in Western Uganda is supported by local prescribing studies, national hospital point-prevalence data, and Uganda's current policy framework. A feasible minimum package should combine named facility responsibility, Uganda Clinical Guideline and AWaRe-informed prescribing support, small-sample prescription review, laboratory referral and feedback, private pharmacy engagement, and district supervision. The phased framework proposed in this review is an author-developed implementation synthesis; it has not yet been adopted or evaluated.","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1-12"},"PeriodicalIF":4.6,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0