JAC-Antimicrobial Resistance最新文献

{"title":"AMRrounds: susceptibility to the new tetracycline-derivative eravacycline of New Delhi metallo-β-lactamase-producing <i>Klebsiella pneumoniae</i> complex.","authors":"Valentina Galfo, Giusy Tiseo, Cesira Giordano, Alessandro Leonildi, Aurelio Lepore, Manuela Pogliaghi, Niccolò Riccardi, Simona Barnini, Marco Falcone","doi":"10.1093/jacamr/dlaf153","DOIUrl":"10.1093/jacamr/dlaf153","url":null,"abstract":"","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 4","pages":"dlaf153"},"PeriodicalIF":3.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12392884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PO-llution control: a cross-sectional study on the role of antimicrobial stewardship in reducing healthcare's carbon footprint.","authors":"Saied Ali, Sadhbh Gash, Niamh Weir, Karen Burns, Binu Dinesh, Helene Mcdermott, Fidelma Fitzpatrick, Sinead O'Donnell, Ciara O'Connor","doi":"10.1093/jacamr/dlaf146","DOIUrl":"10.1093/jacamr/dlaf146","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the environmental impact of prolonged IV antimicrobial courses and identify opportunities for improved antimicrobial stewardship (AMS) practices.</p><p><strong>Methods: </strong>A retrospective cross-sectional study was conducted using AMS ward-round data from January 2023 to December 2024 at a tertiary hospital in Dublin, Ireland. Data on IV antimicrobial prescriptions, AMS recommendations for discontinuation or IV to oral switch (IVOS) and prescriber acceptance were reviewed. A life cycle assessment, informed by published literature, was used to estimate the carbon footprint associated with IV use.</p><p><strong>Results: </strong>Of 1929 antimicrobial prescriptions reviewed, 58% (<i>n</i> = 1119) were being administered IV. Among 435 IV prescriptions with AMS, recommendations to stop (<i>n</i> = 357) or IVOS (<i>n</i> = 78), 229 (52.6%) were accepted, resulting in a reduction of 106.5 kg of clinical waste and 261.2 kg carbon dioxide equivalents (CO₂e) emissions. The remaining 206 IV prescriptions (47.4%) were categorized as prolonged IV prescriptions, generating 98.8 kg of clinical waste and 245.8 kg CO₂e; averaging 0.48 kg of waste and 1.19 kg CO₂e per prescription. To contextualize, the carbon footprint of each prolonged prescription equates to driving 6.2 km, performing 10 chest X-rays or operating a 10 W light-emitting diode bulb continuously for 1200 h. Piperacillin-tazobactam, amoxicillin-clavulanic acid, cefuroxime, metronidazole and meropenem together accounted for over 84% of total emissions, with piperacillin-tazobactam alone contributing 97.5 kg CO₂e and 41.6 kg of waste from 62 prolonged prescriptions.</p><p><strong>Conclusions: </strong>In addition to patient safety risks, prolonged IV antimicrobial courses generate considerable environmental waste. Aligning AMS with sustainability goals may contribute to addressing the dual crises of antimicrobial resistance and climate change.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 4","pages":"dlaf146"},"PeriodicalIF":3.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12391753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microbiome and resistome characterization of patients colonized with carbapenem-resistant Enterobacterales by long-read metagenomic next-generation sequencing of rectal swabs.","authors":"John A Fissel, Yehudit Bergman, Victoria L Campodónico, Dana M Walsh, Brian Fanelli, Keshav Arogyaswamy, Jennie H Kwon, Aaron M Milstone, Pranita D Tamma, Patricia J Simner","doi":"10.1093/jacamr/dlaf152","DOIUrl":"10.1093/jacamr/dlaf152","url":null,"abstract":"<p><strong>Objectives: </strong>Evaluation of differences in the intestinal microbiome and resistome among high-risk patients (i.e. intensive care, oncology, transplant recipients) who are and are not colonized with carbapenem-resistant Enterobacterales (CRE).</p><p><strong>Methods: </strong>One hundred and twelve rectal swabs were obtained from 85 patients with known CRE colonization status and cohorted. Long-read metagenomic next-generation sequencing (mNGS) was performed on rectal swabs. Microbiome and resistome analysis were performed by assessing α-diversity, β-diversity, relative abundance assessment and linear discriminant analysis effect size (LEfSe), comparing patients colonized (CRE positive) and not colonized (CRE negative) with CRE. Longitudinal analysis of sequential swabs collected over multiple hospital encounters on a subset of patients was performed at the patient level.</p><p><strong>Results: </strong>The microbiomes of cohorts were similar when comparing α- and β-diversity measures and relative abundance. LEfSe analysis identified Gram-negative pathobionts enriched among CRE-positive samples and Gram-positive taxa enriched among CRE-negative samples. α-Diversity of the resistome differed at class, gene and allele levels. Relative abundance and LEfSe analysis demonstrated enrichment of genes conferring β-lactam resistance among CRE-positive patients; LEfSe also demonstrated enrichment of antimicrobial resistance genes to multiple antimicrobial classes. At the patient level, fluctuations in the microbiome and resistome among longitudinally collected swabs were associated with antibiotic exposure.</p><p><strong>Conclusions: </strong>Differences between the microbiomes of CRE-positive- and CRE-negative-colonized patients at the cohort level were relatively muted, whereas statistically significant differences were observed among their resistomes. In patients followed longitudinally, shifts in microbiome and resistome composition were dramatic in between encounters and antibiotic exposures.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 4","pages":"dlaf152"},"PeriodicalIF":3.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12392892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of intraoperative excessive bleeding on the pharmacokinetics of ampicillin and sulbactam in recipients of living donor liver transplantation in Japan.","authors":"Yuji Wakimoto, Koh Okamoto, Takehito Yamamoto, Nobuhisa Akamatsu, Taro Kariya, Yoko Hoshino, Sohei Harada, Hideki Hashimoto, Daisuke Jubishi, Takehiro Tanaka, Ryo Yamaguchi, Junichi Kaneko, Shu Okugawa, Tappei Takada, Kiyoshi Hasegawa, Kanji Uchida, Takeya Tsutsumi","doi":"10.1093/jacamr/dlaf149","DOIUrl":"https://doi.org/10.1093/jacamr/dlaf149","url":null,"abstract":"<p><strong>Objective: </strong>Guidelines recommend redosing with intravenous prophylactic antibiotics when excessive bleeding exceeds 1500 mL during surgery based on the pharmacokinetics data of cefazolin. However, the necessity for redosing of other antibiotics and the threshold volume of blood loss necessitating such supplementation remain undefined. We investigated plasma antibiotic concentrations during liver transplant surgery in patients with frequent excessive bleeding.</p><p><strong>Methods: </strong>A single-centre, prospective, observational pharmacokinetic study was conducted. Adult liver transplant recipients who received 2 g of ampicillin and 1 g of sulbactam every 3 h during surgery were included. Blood samples were collected hourly during surgery, and intraoperative bleeding amounts were reviewed from anaesthesia records. Plasma concentrations of ampicillin and sulbactam were determined using validated liquid chromatography-tandem mass spectrometry. The probability of target attainment was set at 80% free time above the MIC (fT > MIC).</p><p><strong>Results: </strong>Twenty participants were included. Of these, 11 participants (55%) were female. The median age, body weight, and bleeding volume were 52 years, 62.1 kg, and 11 158 mL, respectively. The intraoperative clearance of ampicillin was 80.28 mL/min, and sulbactam was 77.23 mL/min. The fT > MIC for both ampicillin and sulbactam tended to be lower with bleeding > 20 000 mL than with less bleeding. Plasma concentrations of ampicillin and sulbactam were maintained during surgery without redosing, even after bleeding exceeded 1500 mL.</p><p><strong>Conclusions: </strong>Even with excessive bleeding, administering 3 g of ampicillin/sulbactam every 3 h maintained sufficient plasma concentration. Redosing may be unnecessary unless total bleeding exceeds 20 000 mL.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 4","pages":"dlaf149"},"PeriodicalIF":3.3,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacokinetic/pharmacodynamic parameters of teicoplanin for predicting clinical outcome of glycopeptide-susceptible <i>Enterococcus faecium</i> bacteraemia.","authors":"Ryo Yamaguchi, Takehito Yamamoto, Sohei Harada, Mayu Shibuya, Miyuki Mizoguchi, Yoshimi Higurashi, Miho Echizenya, Takeya Tsutsumi, Tappei Takada","doi":"10.1093/jacamr/dlaf151","DOIUrl":"10.1093/jacamr/dlaf151","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this study was to determine the pharmacokinetic/pharmacodynamic parameters of teicoplanin associated with optimal outcomes in glycopeptide-susceptible <i>Enterococcus faecium</i> (GSEF) bacteraemia.</p><p><strong>Patients and methods: </strong>We conducted a retrospective review of GSEF bacteraemia cases treated with teicoplanin between 1 April 2009 and 30 May 2023. Total area under the concentration-time curve over 24 h (AUC₂₄) was calculated using a Bayesian approach. The free AUC₂₄ (fAUC₂₄) was estimated based on patient serum albumin levels. MICs were determined using the gradient diffusion method (Etest), and the fAUC₂₄/MIC_Etest ratio was calculated. The primary outcome was treatment failure, defined as a composite of (i) 30-day all-cause mortality and (ii) microbiological failure, defined as persistent bacteraemia (a positive follow-up blood culture obtained >72 h after initiation of appropriate therapy). Classification and regression tree analysis (CART) was employed to identify the optimal teicoplanin fAUC₂₄/MIC_Etest value associated with treatment failure.</p><p><strong>Results: </strong>A total of 76 patients were included. Treatment failure occurred in 18 patients (23.7%). A CART-derived teicoplanin fAUC₂₄/MIC_Etest ≥ 462 was significantly associated with reduced treatment failure (<i>P</i> = 0.002). Multivariable regression analysis revealed that achievement of an fAUC₂₄/MIC_Etest ≥ 462 was an independent predictor significantly associated with reduced treatment failure (OR, 0.099; 95% CI, 0.005-0.562; <i>P</i> = 0.032).</p><p><strong>Conclusions: </strong>An fAUC₂₄/MIC_Etest ≥ 462 was associated with a reduction in treatment failure in GSEF bacteraemia. Further studies are necessary to establish optimal pharmacokinetic/pharmacodynamic targets for GSEF bacteraemia.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 4","pages":"dlaf151"},"PeriodicalIF":3.3,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12368495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Pitt candidaemia score as an assessment tool for mortality in patients with candidaemia caused by <i>Candida tropicalis</i> and other <i>Candida</i> species: a multicentre study conducted in Japan.","authors":"","doi":"10.1093/jacamr/dlaf138","DOIUrl":"10.1093/jacamr/dlaf138","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/jacamr/dlaf078.].</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 4","pages":"dlaf138"},"PeriodicalIF":3.3,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12364027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facing antimicrobial resistance in cancer care: what the AIOM survey tells us about oncologists' awareness.","authors":"A Lasagna, P Cambieri, S Figini, F Baldanti, M Andreoni, F Perrone, N Silvestris, P Pedrazzoli","doi":"10.1093/jacamr/dlaf150","DOIUrl":"10.1093/jacamr/dlaf150","url":null,"abstract":"<p><strong>Background: </strong>Infections with antimicrobial-resistant (AMR) organisms significantly worsen outcomes in cancer patients. Since the main cause of AMR is the inappropriate use of antibiotics for prophylactic or empirical treatment, antimicrobial stewardship programmes (ASPs) have been developed. Few papers on ASPs describe prospective audits in oncology settings. In light of this, the Italian Association of Medical Oncology (AIOM) has decided to evaluate the oncologists' perceptions of this issue with a brief survey.</p><p><strong>Methods: </strong>An anonymous 14-item questionnaire was shared online during the XXVI National Congress on the AIOM website. The survey was divided into two sections. The first set of questions collected the hospital organization and practices (Q1-Q6), while the second one was about the clinical practices and antibiotic therapy (Q7-Q14).</p><p><strong>Results: </strong>Sixty-four medical oncologists completed the anonymous questionnaire. Seventy-two percent of respondents believe that AMR is a significant issue in cancer patients, and an equal percentage considers it likely that a cancer patient will become infected with a MDR pathogen. Despite these concerns, only 48% (<i>n</i> = 31/64) report having an active ASP in their centre. Just 6% of respondents (<i>n</i> = 4/64) consider themselves very confident in prescribing antibiotic therapy, while most consider themselves fairly or not very confident (<i>n</i> = 34/64, 53%, and <i>n</i> = 26/64, 36%, respectively).</p><p><strong>Conclusions: </strong>This survey highlights the urgent need for educating and training oncologists on AMR, as well as the importance of the development of oncology-specific guidelines to mitigate the impact of AMR in this high-risk population.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 4","pages":"dlaf150"},"PeriodicalIF":3.3,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12359028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First-in-human study of the benzothiazinone and DprE1 inhibitor BTZ-043, a novel drug candidate for the treatment of Tuberculosis.","authors":"Wandini Lutchmun, Norbert Heinrich, Elin M Svensson, Florian Kloss, Sarah Konsten, Julia Dreisbach, Michael Hoelscher","doi":"10.1093/jacamr/dlaf127","DOIUrl":"10.1093/jacamr/dlaf127","url":null,"abstract":"<p><strong>Objectives: </strong>This first-in-human, single ascending dose study evaluated the safety, tolerability and pharmacokinetics (PK) of the decaprenylphosphoryl-β-D-ribose-2'-epimerase (DprE1) inhibitor BTZ-043.</p><p><strong>Methods: </strong>BTZ-043 was administered as an oral suspension at doses of 125, 250 and 500 mg along with placebo to healthy participants. Safety assessments included evaluation of laboratory parameters, vital signs, physical and neurological examination, and 12-lead ECG. Blood samples for PK assessment in plasma were collected over a 36 h post-dose period. PK parameters were calculated using non-compartmental analysis for parent BTZ-043, metabolites M1 and M2, and BTZ-043_total (sum of BTZ-043 and M2) in plasma.</p><p><strong>Results: </strong>Thirty participants completed the study. All administered BTZ-043 doses were safe and well tolerated. Nervous system disorders (dizziness and headache) and vascular disorders (hypertension and hot flush) were the most frequently reported adverse events (AEs). All AEs were mild or moderate. The parent compound BTZ-043 was rapidly metabolized to metabolite M2 (unknown activity), with median time to maximum concentration in plasma (<i>t</i> _max) of 1.5 h (1-2 h). BTZ-043 and M2 had a short half-life. The second main inactive metabolite M1 showed a median <i>t</i> _max of 7-8.5 h and a geometric mean half-life of 8.4-9.0 h. The increases in AUC and maximum concentration of drug in plasma (<i>C</i> _max) of BTZ-043 were more than dose-proportional, and those of BTZ-043_total were almost dose-proportional. No relevant differences in systemic exposures between males and females were observed.</p><p><strong>Conclusions: </strong>BTZ-043 was safe, well tolerated and underwent rapid absorption, metabolism and elimination, supporting further clinical development.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 4","pages":"dlaf127"},"PeriodicalIF":3.3,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12359132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antimicrobial resistance burden landscape in Germany in 2019: a comparative country-level estimation.","authors":"Tomislav Meštrović, Sebastian Haller, Gisela Robles Aguilar, Annika Meinen, Anna Gershberg Hayoon, Christine Geffers, Achim Dörre, Muna Abu Sin, Authia P Gray, Lucien R Swetschinski, Kevin S Ikuta, Erin Chung, Eve E Wool, Chieh Han, Daniel T Araki, Rebecca Hsu, Christiane Dolecek, Tim Eckmanns, Mohsen Naghavi","doi":"10.1093/jacamr/dlaf142","DOIUrl":"10.1093/jacamr/dlaf142","url":null,"abstract":"<p><strong>Objectives: </strong>Our aim was to present the most comprehensive set of pre-COVID-19 antimicrobial resistance (AMR) burden estimates for Germany to date, with a focus on regional variations and hotspots.</p><p><strong>Methods: </strong>The study estimated deaths and disability-adjusted life-years (DALYs) due to AMR for 23 bacterial pathogens and 88 pathogen-drug combinations in Germany in 2019, with the use of two counterfactual scenarios: deaths attributable to AMR (those that would not have occurred if infections were susceptible) and deaths associated with AMR (cases where AMR was present but not necessarily the cause of death). Models were cross-validated for out-of-sample predictive validity, and uncertainty intervals (UIs) calculated. In stratified analyses we compared death estimates and DALYs with previously published estimates.</p><p><strong>Results: </strong>The total burden of mortality and DALYs associated with AMR in Germany were 45 692 (95% UI, 31 281-64 591) deaths and 752 697 (500 313-1 076 187) DALYs, respectively, with the total burden attributable to AMR 9648 (6520-13 918) deaths and 159 032 (105 021-232 459) DALYs, respectively. Bloodstream, respiratory and intra-abdominal infections were the major contributors to the fatal AMR burden. The leading pathogens responsible for AMR-associated deaths were <i>Escherichia coli</i>, <i>Staphylococcus aureus</i>, <i>Enterococcus faecium</i>, <i>Klebsiella pneumoniae</i> and <i>Pseudomonas aeruginosa</i>. <i>E. coli</i> resistant to β-lactam/β-lactamase inhibitors and aminopenicillin were top pathogen-drug combinations causing deaths attributable to and associated with AMR, respectively. The presented estimates align with previous research.</p><p><strong>Conclusions: </strong>The high resistance levels and significant health burden highlight AMR as a serious public health challenge in Germany, emphasizing the need to further strengthen targeted prevention and control measures against key pathogen-drug combinations.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 4","pages":"dlaf142"},"PeriodicalIF":3.3,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12351539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of oral fluoroquinolones in France between 2014 and 2023: a nationwide drug utilization study.","authors":"Daniele Saade, Marie-Joelle Jabagi, Marion Bertrand, Karima Hider-Mlynarz, Lamiae Grimaldi, Mahmoud Zureik","doi":"10.1093/jacamr/dlaf145","DOIUrl":"10.1093/jacamr/dlaf145","url":null,"abstract":"<p><strong>Objectives: </strong>This study describes fluoroquinolone (FQ) use and trends in France from 2014 to 2023, amid efforts to curb resistance and adverse effects.</p><p><strong>Methods: </strong>A nationwide observational study was conducted using data from the French National Health Insurance Database. All individuals with at least one reimbursed outpatient prescription for oral FQs between 2014 and 2023 were included. Annual cross-sectional data described prescriptions, user demographics and prescriber specialties. Trends and variations in FQ use were assessed by percent changes and compound annual growth rates. Age- and sex-standardized incidence rates (IRs) of FQ use were calculated.</p><p><strong>Results: </strong>FQ use declined by 50% from 2014 to 2023, with users dropping from 3.5 to 1.7 million and prescriptions from 4.8 to 2.2 million. Users mean age increased from 54.8 to 58.2 years, and the female proportion fell from 68% to 51%. FQ use dropped by 40% in those aged 60+  and 60% in younger individuals. Standardized IRs dropped from 54.9 to 25.6 per 1000 person-years. From 2014 to 2023, ofloxacin, ciprofloxacin, levofloxacin and moxifloxacin use decreased by 40%, 22%, 5% and 72%, respectively. Norfloxacin and lomefloxacin use dropped by 86% and 79% from 2014 to 2019, the year their reimbursement ended. General practitioners were the primary prescribers, accounting for 82.9% of prescriptions in 2023, followed by urologists-nephrologists (6.1%), ophthalmologists (1.6%), otolaryngologists (1.2%) and gynaecologists (1.1%).</p><p><strong>Conclusions: </strong>FQ use in France has declined significantly over the past decade, driven by awareness efforts and guideline changes, but remains high compared with other European countries, highlighting the need for ongoing stewardship.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 4","pages":"dlaf145"},"PeriodicalIF":3.3,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12351542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}