JAC-Antimicrobial Resistance最新文献

{"title":"Reducing antibiotic prescribing rates in young children in an outpatient primary care setting-a systemwide quality improvement initiative.","authors":"Liz Corteville, Christopher Penfold, Donna M Lecky, Sanjay Patel","doi":"10.1093/jacamr/dlaf041","DOIUrl":"https://doi.org/10.1093/jacamr/dlaf041","url":null,"abstract":"<p><strong>Objectives: </strong>To improve antimicrobial stewardship (AMS) and reduce unnecessary antibiotic prescriptions in young children in a British primary care setting.</p><p><strong>Methods: </strong>Forty-nine general practices in the South of England each hosted a 1 h in-house workshop, facilitated by trained local pharmacy professionals. This type of educational outreach approach using TARGET (Target Antibiotics Responsibly, Guidance, Education and Tools) antibiotic materials has previously been shown to reduce antibiotic dispensing in a UK primary care setting. The workshop included a review of antibiotic prescribing data, a presentation on paediatric AMS showcasing locally agreed paediatric prescribing guidelines and safety-netting resources from the Healthier Together website, and formulation of a local action plan. The primary outcome measure was total oral antibiotic prescriptions ('items') dispensed per 1000 patients aged under 5 years for the year after the workshop, compared with the previous year's dispensing.</p><p><strong>Results: </strong>The median prescribing rate for children under 5 years of age changed from a baseline of 48.9 per 1000 patients prior to the intervention to a new median monthly prescribing rate of 39.0 per 1000 patients following the intervention. There was no increase in paediatric presentations to primary care following the intervention.</p><p><strong>Conclusions: </strong>This low-cost intervention has the potential to reduce primary care antibiotic prescribing in children and we did not detect an increase in GP attendance rates after this intervention in our study. It could easily be rolled out nationwide.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 2","pages":"dlaf041"},"PeriodicalIF":3.3,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954511","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":"Aerosolized delivery resulting in high polymyxin B concentration levels in epithelial lining fluid ensures efficacy in ventilator-associated pneumonia.","authors":"Xiaofen Liu, Lei Yang, Meihua Wang, Yu Wang, Beining Guo, Chuhan Zhang, Xingyi Qu, Chenxue Guo, Yaxin Fan, Hailan Wu, Xin Li, Jin Hu, Jing Zhang","doi":"10.1093/jacamr/dlaf023","DOIUrl":"10.1093/jacamr/dlaf023","url":null,"abstract":"<p><strong>Background: </strong>Aerosolized polymyxin B delivery was a promising approach for the treatment of ventilator-associated pneumonia (VAP). However, there were little data on the concentrations of polymyxin B in epithelial lining fluid (ELF), which impedes the optimal use of aerosolized polymyxin B in clinics.</p><p><strong>Methods: </strong>We present four cases of patients diagnosed with VAP caused by Gram-negative bacteria, who enrolled in a prospective, therapeutic drug monitoring (TDM) study of polymyxin B. The patients were treated with aerosolized and intravenous administration of polymyxin B. Polymyxin B concentrations in both ELF and plasma were determined using validated LC-MS/MS methods.</p><p><strong>Results: </strong>All four patients achieved bacterial eradication, with three of them reaching clinical improvement or cure. Following aerosol administration (25 or 50 mg, q12h) and intravenous infusion (50-100 mg, q12h) of polymyxin B, it was observed that the concentrations of polymyxin B in ELF were significantly higher in ELF (20.6-97.6 mg/L) compared to those in plasma (1.19-5.16 mg/L) during the steady sate. The area under the concentration-time curve for 24 h (AUC_24h,ELF) ranged from 283.6 to 1872.9 mg•h/L.</p><p><strong>Conclusions: </strong>This study presented polymyxin B concentrations in ELF following aerosolized delivery, supporting its clinical use from a PK/PD perspective. Following combined aerosol and intravenous administration, polymyxin B achieved notably higher concentrations in ELF than those observed in plasma.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 2","pages":"dlaf023"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763949","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 impact of the COVID-19 pandemic on antimicrobial usage: an international patient-level cohort study.","authors":"Refath Farzana, Stephan Jürgen Harbarth, Ly-Mee Yu, Edoardo Carretto, Catrin E Moore, Nicholas Alexander Feasey, Ana C Gales, Ushma Galal, Onder Ergonul, Dongeun Yong, Md Abdullah Yusuf, Balaji Veeraraghavan, Kenneth Chukwuemeka Iregbu, James Anton van Santen, Aghata Cardoso da Silva Ribeiro, Carolina Maria Fankhauser, Chisomo Judith Chilupsya, Christiane Dolecek, Diogo Boldim Ferreira, Fatihan Pinarlik, Jaehyeok Jang, Lal Sude Gücer, Laura Cavazzuti, Marufa Sultana, M D Nazmul Haque, Murielle Galas Haddad, Nubwa Medugu, Philip Ifeanyi Nwajiobi-Princewill, Roberta Marrollo, Rui Zhao, Vivekanandan B Baskaran, J V Peter, Sujith J Chandy, Yamuna Devi Bakthavatchalam, Timothy R Walsh","doi":"10.1093/jacamr/dlaf037","DOIUrl":"10.1093/jacamr/dlaf037","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the trends in antimicrobial prescription during the first 1.5 years of COVID-19 pandemic.</p><p><strong>Methods: </strong>This was an observational, retrospective cohort study using patient-level data from Bangladesh, Brazil, India, Italy, Malawi, Nigeria, South Korea, Switzerland and Turkey from patients with pneumonia and/or acute respiratory distress syndrome and/or sepsis, regardless of COVID-19 positivity, who were admitted to critical care units or COVID-19 specialized wards. The changes of antimicrobial prescription between pre-pandemic and pandemic were estimated using logistic or linear regression. Pandemic effects on month-wise antimicrobial usage were evaluated using interrupted time series analyses (ITSAs).</p><p><strong>Results: </strong>Antimicrobials for which prescriptions significantly increased during the pandemic were as follows: meropenem in Bangladesh (95% CI: 1.94-4.07) with increased prescribed daily dose (PDD) (95% CI: 1.17-1.58) and Turkey (95% CI: 1.09-1.58), moxifloxacin in Bangladesh (95% CI: 4.11-11.87) with increased days of therapy (DOT) (95% CI: 1.14-2.56), piperacillin/tazobactam in Italy (95% CI: 1.07-1.48) with increased DOT (95% CI: 1.01-1.25) and PDD (95% CI: 1.05-1.21) and azithromycin in Bangladesh (95% CI: 3.36-21.77) and Brazil (95% CI: 2.33-8.42). ITSA showed a significant drop in azithromycin usage in India (95% CI: -8.38 to -3.49 g/100 patients) and South Korea (95% CI: -2.83 to -1.89 g/100 patients) after WHO guidelines v1 release and increased meropenem usage (95% CI: 93.40-126.48 g/100 patients) and moxifloxacin (95% CI: 5.40-13.98 g/100 patients) in Bangladesh and sulfamethoxazole/trimethoprim in India (95% CI: 0.92-9.32 g/100 patients) following the Delta variant emergence.</p><p><strong>Conclusions: </strong>This study reinforces the importance of developing antimicrobial stewardship in the clinical settings during inter-pandemic periods.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 2","pages":"dlaf037"},"PeriodicalIF":3.7,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11945301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730012","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":"Factors associated with blood culture sampling for adult acute care hospital patients with suspected severe infection: a scoping review using a socioecological framework.","authors":"Deborah Bamber, Nicholas Fahy, Tim Coats, Clare Gillies, David R Jenkins, Eva M Krockow, Anthony Locke, Alison Prendiville, Laura Shallcross, Carolyn Tarrant","doi":"10.1093/jacamr/dlaf043","DOIUrl":"10.1093/jacamr/dlaf043","url":null,"abstract":"<p><strong>Background: </strong>Reliable blood culture sampling for patients with suspected severe infection is critical, but evidence suggests that blood culture samples are not always reliably collected for acute hospital patients with severe infection. There is a pressing need to understand the barriers and facilitators of optimal sampling practices for patient safety and antimicrobial stewardship.</p><p><strong>Methods: </strong>We conducted a scoping review to identify evidence of factors associated with reliable blood culture sampling, for adult patients with suspected severe infection in acute care in high-income countries. We searched bibliographic databases (MEDLINE, Scopus, Web of Science, CINAHL), reference lists and citations between 2013 and February 2024. Findings were mapped to a socioecological framework.</p><p><strong>Results: </strong>We retrieved 1823 records from the database searches; 7 studies were eligible for inclusion, with 8 additional studies identified from reference lists and citation searches. All 15 included papers identified factors at the individual level of influence, including patient factors (demographics, clinical signs and symptoms) and staff factors (knowledge of guidelines, attitudes and beliefs, emotion, clinical experience and training, and perception of economic cost). Evidence gaps existed in relation to factors at interpersonal, situational, organizational, community and policy levels.</p><p><strong>Conclusions: </strong>Our review provides insights into blood culture sampling practices in hospitals, and highlights possible evidence gaps as potential areas to guide future research and inform the development of interventions to improve blood culture sampling in hospitals. Existing research has been dominated by a focus on individual levels of influence, with a paucity of evidence on influences at the interpersonal, situational, organization, community and policy levels.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 2","pages":"dlaf043"},"PeriodicalIF":3.7,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669847","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":"Do policies that allow access to unregistered antimicrobials address the unmet need? Australia as a case study of a high-income country with universal healthcare.","authors":"Nadine T Hillock, Allen Cheng, Andrew Bowskill","doi":"10.1093/jacamr/dlae216","DOIUrl":"10.1093/jacamr/dlae216","url":null,"abstract":"<p><strong>Background: </strong>Ensuring timely and equitable access to effective and optimal antimicrobials is crucial for optimal patient care, to minimize the use of less appropriate treatment options and reduce the risk of antimicrobial resistance (AMR).</p><p><strong>Objectives: </strong>To determine the average time for new antibacterials to gain registration for use in Australia after obtaining marketing approval internationally, and to quantify the use of 'new' and older unregistered antimicrobials in Australian clinical practice between 2018 and 2023.</p><p><strong>Methods: </strong>Two data sources were utilized to estimate the usage of antimicrobials not registered for use in Australia. Annual hospital inpatient usage data were sourced from the National Antimicrobial Utilisation Surveillance Program (NAUSP) and data on Special Access Scheme (SAS) applications for unregistered antimicrobial was sourced from the Australian Government Department of Health and Aged Care.</p><p><strong>Results: </strong>Between 2018 and 2023 there were 36 131 applications to access unapproved antimicrobials in Australia. In 26.6% of cases, access to an unapproved antimicrobial was for the treatment of a critically ill patient. Levofloxacin, pyrazinamide, tetracycline and pristinamycin were the most frequently accessed unregistered antimicrobials. Applications for 'new' antibacterials increased from 55 in 2018 to 249 in 2023. Inpatient use of nine new antibacterials was reported in Australian hospitals in 2023, two registered and seven unregistered.</p><p><strong>Conclusions: </strong>Unapproved antimicrobials are frequently accessed by clinicians for patients unable to be treated with registered antimicrobials in Australia. Policy reform and economic incentives are required to support the registration of antimicrobials needed for otherwise untreatable infections and to ensure the sustainability of supply.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 1","pages":"dlae216"},"PeriodicalIF":3.7,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557083","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":"Duration of antibiotic treatment for respiratory tract infections in primary care.","authors":"Carl Llor, Malene Plejdrup Hansen, Jesper Lykkegaard, Jonas Olsen, Bent Håkan Lindberg, Ingrid Keilegavlen Rebnord, Pia Touboul Lundgren, Pascale Bruno, Anna Kowalczyk, Christos Lionis, Ruta Radzeviciene, Lina Jaruseviciene, Lars Bjerrum, Ana García-Sangenís","doi":"10.1093/jacamr/dlaf028","DOIUrl":"10.1093/jacamr/dlaf028","url":null,"abstract":"<p><strong>Objectives: </strong>The primary driver of antimicrobial resistance is excessive antibiotic use, posing a global threat to public health. Reducing individual exposure to antibiotics is a key to addressing the problem. This study aimed to assess the duration of antibiotic courses administered to patients with acute respiratory tract infections (RTIs) in primary care.</p><p><strong>Methods: </strong>Consecutive patients presenting with RTI symptoms were prospectively included from general practices and out-of-hours services in France, Greece, Lithuania, Poland and Spain for two winter periods (February to April 2022 and 2023). Data were collected using a paper-based Audit Project Odense template, with clinicians recording patient age, gender, RTI diagnosis, type of antibiotic prescribed and treatment duration.</p><p><strong>Results: </strong>A total of 196 doctors (133 in general practice and 63 in out-of-hours services) registered 11 270 cases, with 34.0% (3835) receiving antibiotics. The mean antibiotic course duration was 7.52 days (SD 2.11), which was significantly longer for pneumonia, COVID-19 infection and pharyngotonsillitis (8.01, 8.00 and 7.74 days, respectively), and lowest for predominantly viral infections, such as the common cold and flu infection, laryngitis and acute bronchitis (6.32, 6.48 and 6.98 days, respectively; <i>P</i> < 0.001). A total of 26.7% of the courses were prescribed for 10 days or longer.</p><p><strong>Conclusions: </strong>Antibiotic courses for common RTIs are often prolonged, which does not align with current recommendations for course duration. Antibiotics should be avoided in cases of predominantly viral infections and most mixed infections; however, if deemed necessary, the courses should be substantially reduced to minimize unnecessary exposure.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 1","pages":"dlaf028"},"PeriodicalIF":3.7,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11851008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143501381","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":"Emerging β-lactam non-susceptibility in <i>Group A Streptococcus</i>: implications for Ethiopia's healthcare system.","authors":"Alene Geteneh, Sirak Biset, Melese Abate Reta","doi":"10.1093/jacamr/dlaf020","DOIUrl":"10.1093/jacamr/dlaf020","url":null,"abstract":"<p><p>The emergence of β-lactam non-susceptibility in <i>Group A Streptococcus</i> (GAS) or <i>Streptococcus pyogenes</i> represents a major challenge for the global public health, particularly in resource-limited settings like Ethiopia. GAS, a primary cause of pharyngitis and invasive infections, is conventionally treated with β-lactam antibiotics such as penicillin. However, the recent evidence raises concerns about the treatment efficacy with reduced susceptibility, the diagnostic limitations, and the potential for complications such as acute rheumatic fever. This commentary calls for attention to the antimicrobial resistance trends in Ethiopian GAS isolates, underscoring the need for routine susceptibility testing, advanced molecular diagnostics, and strengthened laboratory capacities to guide effective treatment strategies and mitigate the antibiotic resistance-associated risks.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 1","pages":"dlaf020"},"PeriodicalIF":3.7,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483095","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":"Heteroresistance associated with the production of fosfomycin-resistant inner colonies during disk diffusion testing among a geographically diverse collection of <i>Klebsiella pneumoniae</i> clinical isolates.","authors":"Morgan L Bixby, Lindsey B Collins, Ellora C Daley, Jenna M Salay, Sofia Oliver, Alexandra L Bryson, Elizabeth B Hirsch","doi":"10.1093/jacamr/dlaf013","DOIUrl":"10.1093/jacamr/dlaf013","url":null,"abstract":"<p><strong>Background: </strong>Fosfomycin susceptibility breakpoints apply only to <i>Escherichia coli</i> despite clinical use against <i>Klebsiella pneumoniae.</i> EUCAST and CLSI have different breakpoints and guidelines for disk diffusion (DD) interpretation that are frequently extrapolated to <i>K. pneumoniae.</i> Guidelines differ in interpreting inner colonies (IC) that grow within the zone of inhibition, but specificity to <i>E. coli</i> leaves knowledge gaps when extrapolating to other uropathogens.</p><p><strong>Objectives: </strong>To examine the frequency and MIC of <i>K. pneumoniae</i> IC during fosfomycin DD testing and to determine potential relationships between IC production, heteroresistance and <i>fosA</i> presence.</p><p><strong>Methods: </strong>A collection of <i>K. pneumoniae</i> clinical isolates (<i>n</i> = 262) and their IC (<i>n</i> = 116) underwent broth microdilution testing. Heteroresistance screening and PCR for <i>fosA</i> was performed on susceptible isolates that either never produced (NP) IC (<i>n</i> = 14) or produced ≥5 resistant IC (<i>n</i> = 43).</p><p><strong>Results: </strong>The MIC range (≤2 to >256 mg/L) of clinical isolates increased to 32 to >1024 mg/L for the IC collection with a median MIC increase of three, 2-fold dilutions. IC producers had 1.71 greater odds (<i>P</i> < 0.01) of a positive heteroresistance screen compared to NP isolates. No relationship was found between <i>fosA</i> presence and either IC production or heteroresistance.</p><p><strong>Conclusions: </strong>Production of ≥5 IC among clinical <i>K. pneumoniae</i> isolates was frequent and often resulted in an increased IC isolate MIC. Significantly greater odds of heteroresistance among IC producers were found when compared to NP isolates. Thus, presence of IC during fosfomycin DD testing should prompt avoidance of fosfomycin treatment.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 1","pages":"dlaf013"},"PeriodicalIF":3.7,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11840249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467867","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":"AMRrounds: presumed mechanisms of resistance in a case of XDR <i>Klebsiella pneumoniae</i> empyema.","authors":"Michael Casias, Madison Salam","doi":"10.1093/jacamr/dlaf019","DOIUrl":"10.1093/jacamr/dlaf019","url":null,"abstract":"","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 1","pages":"dlaf019"},"PeriodicalIF":3.7,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11839836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467866","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":"Host-response testing with MeMed BV in community-acquired pneumonia: an economic evaluation from the UK NHS perspective.","authors":"Emily Gregg, Sara Graziadio, William Green, Daniela Afonso, Monica Garrett, Karina Watts, Deborah Watkins, Enitan D Carrol, Jonathan Cooke, Tim Felton","doi":"10.1093/jacamr/dlaf016","DOIUrl":"10.1093/jacamr/dlaf016","url":null,"abstract":"<p><strong>Background: </strong>Community-acquired pneumonia (CAP) remains a leading cause of hospital admissions and mortality. A novel host-response test, MeMed BV (MMBV), has been developed for discriminating between bacterial and viral infection that could improve the clinical management of CAP.</p><p><strong>Objectives: </strong>To evaluate the cost-effectiveness of using MMBV to guide antibiotic decisions in the clinical management of CAP in the UK.</p><p><strong>Methods: </strong>An economic model was developed to understand the incremental cost per person associated with the implementation of MMBV from the UK NHS perspective. A qualitative care pathway analysis was performed to inform the standard of care (SOC) and SOC plus MMBV (SOC + MMBV) clinical pathways captured in the model.</p><p><strong>Results: </strong>In the base case analysis, the SOC + MMBV strategy for a hypothetical cohort of 1000 patients (adults and children modelled independently) presenting to the emergency department with suspected CAP was estimated to provide total cost savings of £134 018 and £105 750 for adults and children, respectively. Cost savings were associated with reductions in total antibiotic treatment, the number of patients receiving additional diagnostic tests, and hospital admissions. Deterministic sensitivity analysis revealed that the specificity of SOC + MMBV and sensitivity of the SOC were primary drivers of the cost model for adults, whereas the specificity of SOC and SOC + MMBV were primary drivers for paediatrics.</p><p><strong>Conclusions: </strong>Overall, the model predicts that the introduction of SOC + MMBV has the potential to be cost-saving and promote antimicrobial stewardship for both adult and paediatric CAP patients.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 1","pages":"dlaf016"},"PeriodicalIF":3.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458011","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}