JAC-Antimicrobial Resistance最新文献

{"title":"Nursing home nurses' opinion profiles on the potential evolution of their role in antimicrobial stewardship and associated factors: a national cross-sectional study in France.","authors":"Elie Ishara-Nshombo, Céline Bridey, Céline Pulcini, Nathalie Thilly, Aurélie Bocquier","doi":"10.1093/jacamr/dlae189","DOIUrl":"10.1093/jacamr/dlae189","url":null,"abstract":"<p><strong>Background: </strong>Antibiotic resistance is a major public health threat, especially in nursing homes (NHs). Nursing home nurses (NHNs) can play a crucial role in antimicrobial stewardship (AMS), but research on their opinions regarding potential expanded AMS roles is limited.</p><p><strong>Objectives: </strong>To identify different profiles of NHNs according to their opinions on the potential evolution of their AMS roles and to study facilitators/barriers to implementing new AMS roles and the demographic and professional characteristics associated with these profiles.</p><p><strong>Methods: </strong>Data were collected from a national cross-sectional online survey conducted from May to July 2022 among French NHNs. Profiles were identified via hierarchical clustering. Factors associated with the identified profiles were studied via Fisher's exact tests.</p><p><strong>Results: </strong>Among the 922 participants included in the analysis, three distinct profiles were identified. NHNs 'more favourable to the evolution of the AMS role' (40% of the sample) expressed strong support for the potential evolution of their AMS role. NHNs 'moderately favourable to the evolution of the AMS role' (46%) were less prone to reinforce discussion with general practitioners about antibiotic prescription. NHNs 'less favourable to the evolution of the AMS role' (14%) showed little or no agreement regarding several potential new AMS roles. Being a head nurse was associated with more favourable opinions on the evolution of the AMS role as opposed to practicing in NHs connected to a hospital.</p><p><strong>Conclusions: </strong>These findings could help healthcare managers and policy-makers tailor the implementation of these new roles among NHNs, if they prove effective and safe.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"6 6","pages":"dlae189"},"PeriodicalIF":3.7,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11577609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681922","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":"Capturing the complexity of veterinarians' antibiotic prescribing practices in the livestock sector: a meta-ethnography across contexts: Veterinarians' antibiotic prescribing in different contexts.","authors":"Sebastián Moya, Rebecca Hibbard, Gabriela Asenjo, Nanna K Skjølstrup, Kin Wing Chan, Josephine Eberhart, Nicolas Fortané, Mathilde C Paul","doi":"10.1093/jacamr/dlae177","DOIUrl":"10.1093/jacamr/dlae177","url":null,"abstract":"<p><p>Strategies and policies to tackle the global public health threat of antimicrobial resistance are increasingly addressing antimicrobial use prescribing practices in both the human and animal health sectors. Veterinarians' antibiotic prescribing practices are influenced by different factors and conditioned by the context within which antibiotic prescribing decisions are made, complexifying the implementation of behaviour change interventions. A better understanding of these factors could therefore help in the design and application of such interventions. Meta-ethnography was used to explore the antibiotic prescribing behaviour of veterinarians in different contexts and to construct a new conceptual framework. A search was conducted in PubMed, Web of Science Core Collection and SciELO Citation Index between 2016 and 2024. The final sample consisted of 29 articles, 27 of which were selected from the 561 articles identified in the search and 2 of which were added by the authors. The results were synthesized and presented through four contextual situations influencing antibiotic prescribing by livestock veterinarians: priorities and pressures, uncertain field conditions, systemic challenges and an enabling environment. The results are presented as a conceptual framework that views veterinarians' antibiotic prescribing behaviour as dynamic, adapting in response to the different contextual situations they encounter. The findings provide an integrated and contextualized understanding of veterinarians' antibiotic prescribing behaviours, which could be implemented to facilitate the development and application of future antimicrobial stewardship interventions.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"6 6","pages":"dlae177"},"PeriodicalIF":3.7,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11550921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620712","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":"Impact of a multifaceted antibiotic stewardship programme in a paediatric acute care unit over 8 years.","authors":"Giulia Brigadoi, Emelyne Gres, Elisa Barbieri, Cecilia Liberati, Sara Rossin, Lorenzo Chiusaroli, Giulia Camilla Demarin, Francesca Tesser, Linda Maestri, Francesca Tirelli, Elena Carrara, Evelina Tacconelli, Silvia Bressan, Carlo Giaquinto, Liviana Da Dalt, Daniele Donà","doi":"10.1093/jacamr/dlae181","DOIUrl":"10.1093/jacamr/dlae181","url":null,"abstract":"<p><strong>Background: </strong>Antibiotics are the most prescribed drugs for children worldwide, but overuse and misuse have led to an increase in antibiotic resistance. Antimicrobial stewardship programmes (ASPs) have proven feasible in reducing inappropriate antimicrobial use. The study aimed at evaluating the impact and sustainability of an ASP with multiple interventions over 8 years.</p><p><strong>Methods: </strong>This quasi-experimental study was conducted between 2014 and 2022 in the paediatric acute care unit of Padua University Hospital. Demographic and clinical data were retrieved from the electronic clinical records. Daily prescriptions were collected and analysed based on the AWaRe classification and using days of therapy (DOT) out of 1000 patient days (DOT/1000PDs). The primary outcome was to assess the change in overall antibiotic consumption and of access and watch antibiotics, stratifying patients with and without comorbidities. Trends in antibiotic consumption (DOTs/1000PD) were assessed using joinpoint regression analysis.</p><p><strong>Findings: </strong>A total of 3118 children were included. Total antibiotic consumption remained stable and low in patients without comorbidities, ∼300 DOT/1000PDs, whereas a statistically significant constant reduction was observed in children with comorbidities, from almost 500 DOT/1000PPDs to <400 DOT/1000PDs. Access consumption increased in both groups of patients, whereas watch consumption constantly decreased, although statistically significant only in children with comorbidities.</p><p><strong>Interpretation: </strong>Implementing a multistep ASP has proven feasible and sustainable in improving antibiotic prescriptions for previously healthy and fragile children. All the implemented interventions were low cost, and with efficient use of resources, ensuring an ASP that was effective, practical, and easily replicable and implementable in various healthcare settings.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"6 6","pages":"dlae181"},"PeriodicalIF":3.7,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589227","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":"Characterization of <i>bla</i> _NDM in two <i>Escherichia coli</i> ST1193 clinical isolates in the Gulf region.","authors":"Clement Kin-Ming Tsui, Fatma Ben Abid, Christi Lee McElheny, Manal M Hamed, Andres Perez-Lopez, Ali S Omrani, Yohei Doi","doi":"10.1093/jacamr/dlae166","DOIUrl":"10.1093/jacamr/dlae166","url":null,"abstract":"<p><strong>Introduction: </strong><i>Escherichia coli</i> ST1193 is an emerging high-risk clone associated with the production of plasmid-mediated CTX-type extended-spectrum β-lactamases. However, this clone has seldom been found to contain plasmids carrying carbapenemase genes. We report two epidemiologically unlinked multidrug-resistant (MDR) clinical isolates of <i>E. coli</i> ST1193 with plasmids harbouring NDM-type carbapenemase genes from the Gulf region.</p><p><strong>Methods: </strong>The isolates were identified by MALDI-TOF MS and antibiotic susceptibility testing was performed using the VITEK 2/Phoenix system. A conjugation experiment was performed to assess the transferability of the resistance plasmids. Genomic DNA of both isolates was subject to Illumina sequencing; one isolate was also sequenced using Oxford Nanopore technology. Bioinformatics analyses were performed to detect antimicrobial resistance genes, and to annotate the genetic context of the NDM genes.</p><p><strong>Results and conclusions: </strong>Both isolates were resistant to carbapenems using phenotypic tests. Conjugation experiment confirmed that NDM-5-encoding plasmids of both strains could be transferred to the recipient cells. The completed NDM-5-encoding plasmid of <i>E. coli</i> isolate FQ71 was highly similar to several plasmids from ST410 isolates in the NCBI database. Genomic analysis revealed the presence of transposase genes and transposons in the flanking regions of the NDM genes in the plasmids. Since carbapenems constitute first-line agents for the treatment of serious infections caused by ESBL producers, <i>E. coli</i> ST1193 isolates co-producing ESBL and NDM-type carbapenemases represent a serious challenge for antimicrobial stewardship and infection control programmes.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"6 6","pages":"dlae166"},"PeriodicalIF":3.7,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591089","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":"Associations between neighbourhood-level median household income and outpatients' risk of antibiotic non-susceptible uropathogens in a major urban centre, USA.","authors":"Chanda M L Mwansa, Ahmed Babiker, Sarah Satola, Latania K Logan, Maya L Nadimpalli","doi":"10.1093/jacamr/dlae179","DOIUrl":"10.1093/jacamr/dlae179","url":null,"abstract":"<p><strong>Introduction: </strong>Resistance to first-line antibiotics among urinary tract infections continues to rise, but how neighbourhood-level socioeconomic status impacts this risk remains unclear. We examined the effect of neighbourhood-level income on a patient's risk of having a uropathogen non-susceptible to trimethoprim/sulfamethoxazole (TMP/SMX) or nitrofurantoin.</p><p><strong>Methods: </strong>We used electronic health record data and antibiotic susceptibility test results for urinary <i>Escherichia coli</i> and <i>Klebsiella pneumoniae</i> collected at Emory Healthcare outpatient facilities in greater Atlanta between October 2022 and September 2023. We determined patients' block group median household income (MHI) using their residential addresses and 2017-21 US census data. We performed a logistic regression with <i>a priori</i> risk factors using a generalized estimating equation, with subgroup analysis by organism and for patients with diabetes mellitus.</p><p><strong>Results: </strong>We included 9325 urine <i>E. coli</i> and <i>K. pneumoniae</i> isolates from 3867 outpatients. Compared to uropathogenic <i>E. coli</i>, <i>K. pneumoniae</i> were more likely to be non-susceptible to nitrofurantoin (<i>P</i> < 0.001) and less likely to be non-susceptible to TMP/SMX (<i>P</i> < 0.001). Compared to the lowest MHI quintile, patients in the highest MHI quintile neighbourhoods had 0.78 odds of harbouring a non-susceptible uropathogen (95% CI: 0.64, 0.95) after controlling for patient age, sex and race/ethnicity, along with neighbourhood-level characteristics. This association was stronger for <i>K. pneumoniae</i> infections and non-significant among people with diabetes.</p><p><strong>Conclusions: </strong>Higher neighbourhood-level MHI was associated with lower individual risk of harbouring a first-line antibiotic-non-susceptible uropathogen.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"6 6","pages":"dlae179"},"PeriodicalIF":3.7,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11535660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582796","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":"Impact of a hub-and-spoke approach to hospital antimicrobial stewardship programmes on antibiotic use in Zambia.","authors":"Aubrey Chichonyi Kalungia, Martin Kampamba, David Banda, Andrew Munkuli Bambala, Sarah Marshall, Melanie Newport, Anja St Clair-Jones, Luke Alutuli, Elias Chambula, Lucky Munsaka, Audrey Hamachila, Chiluba Mwila, Duncan Chanda, Joseph Chizimu, Roma Chilengi, Michael Okorie","doi":"10.1093/jacamr/dlae178","DOIUrl":"10.1093/jacamr/dlae178","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial stewardship programmes (ASPs) aim to optimize antibiotic use and prevent antimicrobial resistance.</p><p><strong>Objective: </strong>This study assessed the impact of ASPs, initiated using a hub-and-spoke approach, on antibiotic use in Zambian public hospitals.</p><p><strong>Methods: </strong>A pre-post study was conducted in 10 ASP-naive hospitals across Zambia using the Centers for Disease Control and Prevention (CDC)'s hospital-based ASP core elements (i.e. leadership, accountability, pharmacy expertise, stewardship actions, tracking progress, reporting and education) checklist and the global point prevalence survey methodology. The intervention involved technical staff from a national 'hub' hospital with an established ASP providing on-site orientation and mentorship to multidisciplinary teams of healthcare workers at 10 'spoke' hospitals to build capacity in antimicrobial stewardship. ASP core elements and inpatient antibiotic use prevalence (AUP) were assessed before and 12 months after ASP implementation. Data were statistically analysed.</p><p><strong>Results: </strong>The adoption of ASP core elements improved significantly (<i>P</i> = 0.001, 95% CI: -17.8 to -5.42). AUP decreased from 50.1% (±5.8, <i>n</i> = 1477) to 44.3% (±4.6, <i>n</i> = 1400) after 12 months, though the reduction was not statistically significant (<i>P</i> = 0.442; 95% CI: -9.8 to 21.6), with 'Watch' list antibiotics remaining the most commonly prescribed across the hospitals.</p><p><strong>Conclusions: </strong>The hub-and-spoke approach successfully catalysed ASPs in public hospitals in Zambia, demonstrating the potential for improving antibiotic use practices over time, provided structural challenges are addressed. This approach and insights can guide stakeholders in Zambia and similar settings in enhancing hospital ASPs.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"6 6","pages":"dlae178"},"PeriodicalIF":3.7,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11535659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582800","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":"Outcomes of <i>Enterococcus faecalis</i> infective endocarditis according to MIC of amoxicillin: a multicentric study.","authors":"Hermann Do Rego, Yousra Kherabi, Stephane Corvec, Chloé Plouzeau-Jayle, Coralie Bouchiat, Gabriel Macheda, Sylvain Meyer, Vincent Cattoir, Caroline Piau, Thomas Guillard, Jean-Ralph Zahar, Eric Farfour, Raphaël Lecomte, Marlène Amara, Christophe Isnard, Alban Le Monnier, Benoit Pilmis","doi":"10.1093/jacamr/dlae167","DOIUrl":"10.1093/jacamr/dlae167","url":null,"abstract":"<p><strong>Background: </strong>The incidence of <i>Enterococcus faecalis</i> infective endocarditis is increasing over time. Data on the impact of minimum inhibitory concentration (MIC) of amoxicillin on treatment outcomes are scarce. The objective of this study was to describe the epidemiology of <i>E. faecalis</i> infective endocarditis and to evaluate whether the MIC of amoxicillin might influence mortality.</p><p><strong>Materials: </strong>We retrospectively included all consecutive patients diagnosed with definite <i>E. faecalis</i> infective endocarditis between 2013 and 2020 in 11 French hospitals. We extracted data from the local diagnosis-related group (DRG) database and matched these data with microbiological results. Amoxicillin MIC was determined by Etest strip. The primary endpoints were endocarditis-related mortality and risk factors for endocarditis-related mortality including amoxicillin MIC.</p><p><strong>Results: </strong>A total of 403 patients with definite <i>E. faecalis</i> infective endocarditis were included. Patients were predominantly male (76.4%) with a median age of 74 years (67-82). Embolic complications occurred in 170 (42.1%) patients. Cardiac surgery was performed in 158 (61.5%) patients. The endocarditis-related mortality rate was 28.3% and the median delay between mortality and onset of hospitalization was 24 (9; 41) days. <i>E. faecalis</i> MIC of amoxicillin was available for 246 (61%) patients. The median MIC was 0.5 mg/L (0.4-0.7). Amoxicillin MIC was not found to be associated with in-hospital mortality. None of the variables included in the multivariate model were identified as a risk factor for mortality and there was no correlation between mortality and the duration of treatment for 4 weeks versus 6 weeks.</p><p><strong>Conclusions: </strong>Higher amoxicillin MIC was not a risk factor leading to endocarditis-related mortality in definite <i>E. faecalis</i> infective endocarditis. However, further studies are needed to assess the effect of amoxicillin MIC on relapse.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"6 6","pages":"dlae167"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568561","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":"Experience with expanded use of oritavancin in a tertiary hospital: indications, tolerability and outcomes.","authors":"Thilinie Dulanjalee Bandaranayake, Christopher Radcliffe, Melanie Cvercko, Marjorie Golden, Ritche Manos Hao","doi":"10.1093/jacamr/dlae174","DOIUrl":"10.1093/jacamr/dlae174","url":null,"abstract":"<p><strong>Background: </strong>Oritavancin is a lipoglycopeptide antibacterial agent used to treat infections caused by Gram-positive organisms. It is FDA-approved for the treatment of acute bacterial skin and soft tissue infections (ABSSIs) but is increasingly being used off-label to treat invasive bacterial infections such as osteomyelitis, prosthetic joint infection and infective endocarditis.</p><p><strong>Objectives: </strong>This study describes the clinical outcomes and adverse reactions related to oritavancin.</p><p><strong>Patients and methods: </strong>This was a retrospective study conducted over a 5 year period at a tertiary care medical centre. Ninety-five adult patients were included in this study and were followed for 1 year after the last dose of oritavancin.</p><p><strong>Results: </strong>The most common indication for oritavancin at our institution was osteomyelitis, followed by ABSSI. Other indications were vertebral infection, hardware-associated infection, bacteraemia and infective endocarditis. Fourteen percent (13/95) of patients developed an adverse reaction to oritavancin during the study period. Cure with no recurrence up to 1 year after the last dose of oritavancin was achieved in 74% (53/71) of patients, and the treatment failure rate was 19% (14/71 patients).</p><p><strong>Conclusions: </strong>Oritavancin is an effective agent that can be used to treat invasive Gram-positive bacterial infections other than ABSSI. Adverse events requiring drug discontinuation were common.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"6 6","pages":"dlae174"},"PeriodicalIF":3.7,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568560","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 use in hospitalized patients: a point prevalence survey across four tertiary hospitals in Niger.","authors":"Ounoussa Tapha, Cyriaque Comlan Degbey, Abdourahamane Yacouba, Espère Mahouna Tchioundjro, N'Kpingou Théodore Nadakou, Ibrahim Alkassoum Salifou, Sahada Moussa Saley, Mamane Daou, Souleymane Brah, Eric Omar Adehossi, Antoine Vikkey Hinson, Saidou Mamadou","doi":"10.1093/jacamr/dlae175","DOIUrl":"10.1093/jacamr/dlae175","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial resistance (AMR) is a global threat to public health. Misuse or overuse of antimicrobials contributes to the emergence of AMR. Data on antimicrobial prescribing represent the cornerstone for guiding antimicrobial stewardship strategies. This study aimed to assess the use, indications, classification, and quality indicators of antimicrobials prescribed to patients in four tertiary hospitals in Niger.</p><p><strong>Methods: </strong>This cross-sectional study used the methodology for Global Point Prevalence Surveys in tertiary hospitals between January and April 2024. Hospital records of all inpatients on admission at 08:00 hours on a specific day were reviewed for antimicrobial use during the survey.</p><p><strong>Results: </strong>The overall prevalence of antibiotic use across hospitals was 54.5% (<i>n</i> = 470/862), ranging between 66.2% (<i>n</i> = 149/234) and 44.3% (<i>n</i> = 183/258). Most antibiotics used were antibacterials (89.0%, <i>n</i> = 637). Third-generation cephalosporins (48.2%, 307/637), imidazole derivatives (14.7%, 105/716), penicillins with extended spectrum (9.6%, 69/716), and fluoroquinolones (6.1%, 44/716) were the most commonly prescribed classes of antibiotics. Most antibiotics (84.9%, <i>n</i> = 608) were prescribed to treat community-acquired infections, while surgical prophylaxis accounted for 6.4% (<i>n</i> = 47/716). Most antibiotics (96.1%; <i>n</i> = 688/716) were used empirically, and less than a quarter (20.7%) of antibiotics prescribed had a documented stop/review date recorded. Only, 4.2% (<i>n</i> = 31/716) of prescribed antibiotics had cultures and susceptibility testing requested.</p><p><strong>Conclusion: </strong>This study shows that antibiotic prescription rates are high in tertiary hospitals, with relatively high use of third-generation cephalosporins. Most antibiotics were empirically used and not guided by culture and susceptibility testing. These results could be the subject of key interventions for hospital antibiotic stewardship strategies in Niger.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"6 5","pages":"dlae175"},"PeriodicalIF":3.7,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545479","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":"Community pharmacists' knowledge and practices towards antimicrobial stewardship: findings and implications.","authors":"Webrod Mufwambi, Kunda Musuku, Jimmy Hangoma, Ngoni Veddie Muzondo, Larry Mweetwa, Steward Mudenda","doi":"10.1093/jacamr/dlae176","DOIUrl":"https://doi.org/10.1093/jacamr/dlae176","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial stewardship (AMS) programmes have been implemented around the world to optimally manage antimicrobial use to attenuate antimicrobial resistance (AMR). This study assessed the knowledge and practices of community pharmacists towards AMS strategies in the Lusaka District, Zambia.</p><p><strong>Methods: </strong>This cross-sectional study was conducted among 194 community pharmacists in the Lusaka district using a structured questionnaire from August 2022 to September 2022. Data analysis was done using Statistical Package for Social Science (SPSS) version 22.0.</p><p><strong>Results: </strong>Of the 194 participants, 86% of the community pharmacists had good knowledge of AMS. The present study found that 83.5% were aware of AMS strategies used in community pharmacy practice. Further, 83.5% of the CPs were familiar with the goals of AMS and 89.2% believed that AMS was necessary for their pharmacy practice. Furthermore, 66.7% of the participants exhibited good practice towards the AMS strategies. Finally, 61.3% frequently avoided the use of broad-spectrum antimicrobials that were not necessary.</p><p><strong>Conclusions: </strong>According to the findings of this study, the majority of community pharmacists had good knowledge of the AMS strategies that were employed to combat AMR; nonetheless, some of them had poor practices. Therefore, there is a need for community pharmacists to have access to sufficient ongoing professional development programmes and educational activities through AMS programmes to address AMR.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"6 5","pages":"dlae176"},"PeriodicalIF":3.7,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545480","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}