Antimicrobial stewardship & healthcare epidemiology : ASHE最新文献

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Culture-based viability PCR: strategies to harness sensitivity and minimize false positives. 基于培养的生存力PCR:利用敏感性和最小化假阳性的策略。
Antimicrobial stewardship & healthcare epidemiology : ASHE Pub Date : 2025-07-18 eCollection Date: 2025-01-01 DOI: 10.1017/ash.2025.10071
Bobby G Warren, Aaron Barrett, Guerbine Fils-Aime, Amanda M Graves, Deverick J Anderson
{"title":"Culture-based viability PCR: strategies to harness sensitivity and minimize false positives.","authors":"Bobby G Warren, Aaron Barrett, Guerbine Fils-Aime, Amanda M Graves, Deverick J Anderson","doi":"10.1017/ash.2025.10071","DOIUrl":"10.1017/ash.2025.10071","url":null,"abstract":"","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e158"},"PeriodicalIF":0.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692555","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}
引用次数: 0
Implementation and performance of a nurse administered modified PEN-FAST clinical decision rule in the electronic health record. 在电子健康记录中护士管理的修改后的PEN-FAST临床决策规则的实现和性能。
Antimicrobial stewardship & healthcare epidemiology : ASHE Pub Date : 2025-07-18 eCollection Date: 2025-01-01 DOI: 10.1017/ash.2025.10066
Wesley J Hoffmann, Shivani Patel, Elizabeth J Lee, Natalie A Finch, Christy P Su, Nicole A Teran, Yao-Hsuan Huang, Fadi Shehadeh, Muhammad Yasser Alsafadi
{"title":"Implementation and performance of a nurse administered modified PEN-FAST clinical decision rule in the electronic health record.","authors":"Wesley J Hoffmann, Shivani Patel, Elizabeth J Lee, Natalie A Finch, Christy P Su, Nicole A Teran, Yao-Hsuan Huang, Fadi Shehadeh, Muhammad Yasser Alsafadi","doi":"10.1017/ash.2025.10066","DOIUrl":"10.1017/ash.2025.10066","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate performance of registered nurse assessments of the PEN-FAST penicillin allergy clinical decision rule compared to antimicrobial stewardship pharmacists.</p><p><strong>Design: </strong>Prospective, blinded, non-interventional, quality assurance study.</p><p><strong>Setting: </strong>This study took place across 4 inpatient hospitals within a large health system in Houston, Texas.</p><p><strong>Methods: </strong>We implemented PEN-FAST rule questions into the electronic health record (EHR) for registered nurses to perform. Patients were randomly selected in a prospective fashion, with nurse documented scores hidden, for re-assessment by antimicrobial stewardship pharmacists to compare risk stratification and scores.</p><p><strong>Results: </strong>Overall agreement of high risk and low risk results was 84.3%. Registered nurse evaluations with the PEN-FAST clinical decision rule for detecting a high-risk patient demonstrated a sensitivity of 67%, specificity of 89.8%, positive predictive value of 67.9%, and negative predictive value of 89.5%. Additionally, 34.4% of patients with a documented penicillin allergy admitted to tolerating amoxicillin or amoxicillin/clavulanate since their last recalled reaction to penicillin.</p><p><strong>Conclusions: </strong>Registered nurse assessment of the PEN-FAST clinical decision rule demonstrated good performance and can effectively be used to screen for low-risk penicillin allergy patients. Incorporation of the PEN-FAST rule into EHR can be scaled into large health systems to help appropriately stratify patients with low- and high-risk penicillin allergies and improve documentation.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e159"},"PeriodicalIF":0.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692556","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}
引用次数: 0
Utility of microbial cell-free DNA sequencing in the diagnosis of mycobacterial infections in a quaternary care center. 微生物无细胞DNA测序在四级护理中心分枝杆菌感染诊断中的应用。
Antimicrobial stewardship & healthcare epidemiology : ASHE Pub Date : 2025-07-17 eCollection Date: 2025-01-01 DOI: 10.1017/ash.2025.10057
Fernando H Centeno, Todd Lasco, Ahmed M Hamdi, Mayar Al Mohajer
{"title":"Utility of microbial cell-free DNA sequencing in the diagnosis of mycobacterial infections in a quaternary care center.","authors":"Fernando H Centeno, Todd Lasco, Ahmed M Hamdi, Mayar Al Mohajer","doi":"10.1017/ash.2025.10057","DOIUrl":"10.1017/ash.2025.10057","url":null,"abstract":"<p><p>We examine the performance of microbial cell-free DNA (mcfDNA) next-generation sequencing (NGS) testing on patients admitted to a quaternary care hospital in Houston, Texas. The test was 75.0% sensitive and 97.8% specific for all mycobacterial infections. mcfDNA NGS results led to adjustments in antimicrobial therapy for seven of nine patients with positive results.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e160"},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692559","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}
引用次数: 0
The impact of an intervention to increase follow-up blood cultures for patients with Staphylococcus aureus bacteriuria. 增加金黄色葡萄球菌患者随访血培养干预的影响。
Antimicrobial stewardship & healthcare epidemiology : ASHE Pub Date : 2025-07-17 eCollection Date: 2025-01-01 DOI: 10.1017/ash.2025.10067
Jared Olson, Vincent Anella, Brandon J Webb, Andrew T Pavia, Emily A Thorell, Adam L Hersh, Dustin Waters
{"title":"The impact of an intervention to increase follow-up blood cultures for patients with <i>Staphylococcus aureus</i> bacteriuria.","authors":"Jared Olson, Vincent Anella, Brandon J Webb, Andrew T Pavia, Emily A Thorell, Adam L Hersh, Dustin Waters","doi":"10.1017/ash.2025.10067","DOIUrl":"10.1017/ash.2025.10067","url":null,"abstract":"<p><strong>Background: </strong><i>Staphylococcus aureus</i> bacteriuria (SABU) may represent bacteremia in a subset of patients. We describe the impact of a microbiology alert recommending follow-up blood cultures (FUBC) for patients with SABU in a large integrated health system.</p><p><strong>Methods: </strong>We conducted a quasi-experimental implementation study in adult ambulatory patients with documented SABU. We excluded patients with confirmed SAB up to 14 days prior to index SABU culture and with blood cultures obtained on the day of SABU. The primary outcome was rate of FUBC (collected between 1 and 5 days of SABU) among all cases of SABU. Secondary outcomes included percentage of patients with early SAB (collected between 1 and 5 days of SABU). We used interrupted time series analysis to compare rates of FUBC pre vs postintervention.</p><p><strong>Results: </strong>A total of 2 540 patients were identified; 1 213 (48%) were male. By the end of the postintervention period, the rate of FUBC (20.6%) had increased by 6.3 percentage points (<i>P</i> = .005) compared to the counterfactual (14.2%) had no intervention taken place (44.5% relative increase). Early SAB detection due to FUBC increased from .6% preintervention to 2.0% postintervention (<i>P</i> = .004).</p><p><strong>Conclusion: </strong>The microbiology alert initiative increased FUBC in patients with SABU by 44%, but the overall rate of FUBC remained low. The intervention increased early SAB detection. Risk-targeted strategies are needed to optimize FUBC collection in patients with SABU.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e157"},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692557","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}
引用次数: 0
Factors associated with using penicillins as the first-choice antimicrobial among dentists in Japan: a national cross-sectional study. 日本牙医使用青霉素作为首选抗菌药物的相关因素:一项全国性的横断面研究。
Antimicrobial stewardship & healthcare epidemiology : ASHE Pub Date : 2025-07-14 eCollection Date: 2025-01-01 DOI: 10.1017/ash.2025.10065
Ryuji Koizumi, Masahiro Ishikane, Yoshiki Kusama, Shinya Tsuzuki, Yusuke Asai, Yasuyuki Shimada, Chika Tanaka, Akihiro Kaneko, Norio Ohmagari
{"title":"Factors associated with using penicillins as the first-choice antimicrobial among dentists in Japan: a national cross-sectional study.","authors":"Ryuji Koizumi, Masahiro Ishikane, Yoshiki Kusama, Shinya Tsuzuki, Yusuke Asai, Yasuyuki Shimada, Chika Tanaka, Akihiro Kaneko, Norio Ohmagari","doi":"10.1017/ash.2025.10065","DOIUrl":"10.1017/ash.2025.10065","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to identify the factors associated with the use of penicillins as the first-choice antimicrobial in Japan's dental clinics.</p><p><strong>Design: </strong>Cross-sectional questionnaire-based survey.</p><p><strong>Setting: </strong>Dental clinics throughout Japan.</p><p><strong>Participants: </strong>Dentists at the participating clinics.</p><p><strong>Methods: </strong>Questionnaires were sent to 1,700 dental care facilities in July 2020, and responses were collected until September 2020. The survey gathered data on clinic characteristics, provision of on-site antimicrobial dispensing, choice of antimicrobials, and knowledge regarding antimicrobial resistance (AMR) and infective endocarditis (IE). Descriptive epidemiology and logistic regression analyses were performed to identify the factors associated with on-site dispensing of penicillins and their use as the first-choice antimicrobial.</p><p><strong>Results: </strong>Responses were obtained from 342 (response rate: 20.1 %) dentists from dental clinics. While 93.9% of respondents were aware of the term \"AMR,\" only 20.8% were familiar with Japan's National Action Plan on AMR. AMR countermeasures were implemented in 79.4% of clinics, but 58.4% of respondents lacked awareness of IE guidelines. In the multivariable logistic regression analyses, \"adherence to IE guidelines\" (odds ratio: 2.56, <i>P</i> = .001) and \"clinic stocks ≥2 antimicrobials\" (5.02, <i>P</i> = .002) were positively associated with on-site dispensing of penicillins. In contrast, \"clinic with ≥2 full-time dentists\" (odds ratio: .45, <i>P</i> = .033) was negatively associated with the use of penicillins as the first-choice antimicrobial.</p><p><strong>Conclusions: </strong>There was a low awareness of the National Action Plan and IE guidelines among dentists. Enhancing educational activities and fostering environments that facilitate collaborative decision-making regarding antimicrobial use may help to improve antimicrobial stewardship in Japan's dental clinics.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e156"},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12260247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644206","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}
引用次数: 0
Evaluating chain-of-thought prompting in a GPT chatbot for BCID2 interpretation and stewardship: how does AI compare to human experts? 评估用于bccid2解释和管理的GPT聊天机器人中的思维链提示:人工智能与人类专家相比如何?
Antimicrobial stewardship & healthcare epidemiology : ASHE Pub Date : 2025-07-11 eCollection Date: 2025-01-01 DOI: 10.1017/ash.2025.10059
Daniel M Tassone, Matthew M Hitchcock, Connor J Rossier, Douglas Fletcher, Julia Ye, Ian Langford, Julie Boatman, J Daniel Markley
{"title":"Evaluating chain-of-thought prompting in a GPT chatbot for BCID2 interpretation and stewardship: how does AI compare to human experts?","authors":"Daniel M Tassone, Matthew M Hitchcock, Connor J Rossier, Douglas Fletcher, Julia Ye, Ian Langford, Julie Boatman, J Daniel Markley","doi":"10.1017/ash.2025.10059","DOIUrl":"10.1017/ash.2025.10059","url":null,"abstract":"<p><strong>Background: </strong>Rapid molecular diagnostics, such as the BIOFIRE® Blood Culture Identification 2 (BCID2) panel, have improved the time to pathogen identification in bloodstream infections. However, accurate interpretation and antimicrobial optimization require Infectious Disease (ID) expertise, which may not always be readily available. GPT-powered chatbots could support antimicrobial stewardship programs (ASPs) by assisting non-specialist providers in BCID2 result interpretation and treatment recommendations. This study evaluates the performance of a GPT-4 chatbot compared to ASP prospective audit and feedback interventions.</p><p><strong>Methods: </strong>This prospective observational study assessed 43 consecutive real-world cases of bacteremia at a 399-bed VA Medical Center from January to May 2024. The GPT-chatbot utilized \"chain-of-thought\" prompting and external knowledge integration to generate recommendations. Two independent ID physicians evaluated chatbot and ASP recommendations across four domains: BCID2 interpretation, source control, antibiotic therapy, and additional diagnostic workup. The primary endpoint was the combined rate of harmful or inadequate recommendations. Secondary endpoints assessed the rate of harmful or inadequate responses for each domain.</p><p><strong>Results: </strong>The chatbot had a significantly higher rate of harmful or inadequate recommendations (13%) compared to ASP (4%, <i>p</i> = 0.047). The most significant discrepancy was observed in the domain of antibiotic therapy, where harmful recommendations occurred in up to 10% (<i>p</i> <0.05) of chatbot evaluations. The chatbot performed well in BCID2 interpretation (100% accuracy) but provided more inadequate responses in source control consideration (10% vs. 2% for ASP, <i>p</i> = 0.022).</p><p><strong>Conclusions: </strong>GPT-powered chatbots show potential for supporting antimicrobial stewardship but should only complement, not replace, human expertise in infectious disease management.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e154"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12247004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627811","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}
引用次数: 0
Letter to the Editor regarding "blood culture bottle shortage mitigation efforts: analysis of impact on ordering and patient impact" by Doern et al. Doern等人关于“血液培养瓶短缺缓解努力:对订购和患者影响的影响分析”的致编辑信。
Antimicrobial stewardship & healthcare epidemiology : ASHE Pub Date : 2025-07-11 eCollection Date: 2025-01-01 DOI: 10.1017/ash.2025.10053
Anuschka Y van der Zaag, Amber G den Hollander, Sheena C Bhagirath, Prabath W B Nanayakkara
{"title":"Letter to the Editor regarding \"blood culture bottle shortage mitigation efforts: analysis of impact on ordering and patient impact\" by Doern et al.","authors":"Anuschka Y van der Zaag, Amber G den Hollander, Sheena C Bhagirath, Prabath W B Nanayakkara","doi":"10.1017/ash.2025.10053","DOIUrl":"10.1017/ash.2025.10053","url":null,"abstract":"","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e153"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12246999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627812","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}
引用次数: 0
Management of a respiratory syncytial virus outbreak in a memory care unit at a long-term care facility. 在一家长期护理机构的记忆护理病房发生呼吸道合胞体病毒爆发的处理。
Antimicrobial stewardship & healthcare epidemiology : ASHE Pub Date : 2025-07-11 eCollection Date: 2025-01-01 DOI: 10.1017/ash.2025.10048
Alaina S Ritter, Debbie Manderville, Laura Netardus, Amy Y Vittor
{"title":"Management of a respiratory syncytial virus outbreak in a memory care unit at a long-term care facility.","authors":"Alaina S Ritter, Debbie Manderville, Laura Netardus, Amy Y Vittor","doi":"10.1017/ash.2025.10048","DOIUrl":"10.1017/ash.2025.10048","url":null,"abstract":"<p><strong>Background: </strong>Respiratory syncytial virus (RSV), although frequently reported in pediatric populations, is also associated with significant morbidity and mortality in vulnerable adults. From an Infection Control perspective, it is therefore of particular concern in hospital and long-term care settings.</p><p><strong>Objective: </strong>We report an RSV outbreak that occurred in the memory care unit of a Veterans Affairs-affiliated long-term care facility where the characteristics of the resident population posed unique challenges to halting transmission.</p><p><strong>Setting: </strong>The outbreak occurred in a 30-bed unit within a 230-bed Veterans Affairs-affiliated long-term care facility in Florida.</p><p><strong>Methods: </strong>An investigation was performed in coordination with the local Department of Health. All residents on the affected unit had dementia with resulting difficulty participating in infection prevention measures, including isolation, masking, and hand hygiene. Interventions implemented included twice weekly RSV testing, enhanced cleaning protocols, staggered mealtimes/outdoor dining, and cancellation of group activities, visitations, and new admissions. A retrospective case-control study was performed to assess for potential risk factors for acquiring RSV.</p><p><strong>Results: </strong>Over a 21-day period in 2022, 20 out of 29 residents tested positive for RSV within the affected unit. No other units were involved. Univariate analysis did not find any statistically significant risk factors for acquiring RSV infection, although small sample size may have impacted the results.</p><p><strong>Conclusions: </strong>A multifaceted approach was ultimately successful in preventing ongoing transmission of RSV within and beyond the unit. The infection control techniques utilized in this unique patient population could potentially be applicable to challenging outbreak situations at other facilities.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e150"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12260249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644207","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}
引用次数: 0
Uniting disciplines against antimicrobial resistance (AMR): highlights from a multidisciplinary inaugural AMR summit. 联合学科对抗抗菌素耐药性:多学科首届抗菌素耐药性峰会的亮点。
Antimicrobial stewardship & healthcare epidemiology : ASHE Pub Date : 2025-07-11 eCollection Date: 2025-01-01 DOI: 10.1017/ash.2025.10039
Brittany Rodriguez, Andrea M Prinzi, Brandon K Hill, Robert Tibbetts, Heinz Salazar, David McAdams, Awilda M Rivera-Acosta, Minkey Wungwattana, Denver T Niles, Suzane Silbert
{"title":"Uniting disciplines against antimicrobial resistance (AMR): highlights from a multidisciplinary inaugural AMR summit.","authors":"Brittany Rodriguez, Andrea M Prinzi, Brandon K Hill, Robert Tibbetts, Heinz Salazar, David McAdams, Awilda M Rivera-Acosta, Minkey Wungwattana, Denver T Niles, Suzane Silbert","doi":"10.1017/ash.2025.10039","DOIUrl":"10.1017/ash.2025.10039","url":null,"abstract":"<p><p>Antimicrobial resistance (AMR) poses a significant global health threat, projected to cause 10 million deaths annually by 2050. Addressing AMR requires a coordinated, multidisciplinary approach encompassing infectious disease (ID) clinicians, pharmacists, microbiologists, infection preventionists, and policymakers. The inaugural AMR Summit, hosted by bioMérieux in collaboration with Tampa General Hospital and the University of South Florida Morsani College of Medicine in November 2024, convened experts from various fields to explore innovative strategies for combating AMR. Key topics discussed included the role of multidisciplinary teams in antimicrobial stewardship programs, advancements in rapid diagnostic tests and antimicrobial susceptibility testing, the application of implementation science in AMR, and the integration of next-generation sequencing in ID diagnostics. The summit underscored the importance of diagnostic innovation, interdisciplinary collaboration, policy, advocacy, and public engagement in advancing efforts against AMR.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e149"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12260250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644208","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}
引用次数: 0
Temporal trends in vaccination and antibiotic use among young children in the United States, 2000-2019. 2000-2019年美国幼儿接种疫苗和抗生素使用的时间趋势
Antimicrobial stewardship & healthcare epidemiology : ASHE Pub Date : 2025-07-11 eCollection Date: 2025-01-01 DOI: 10.1017/ash.2025.10044
Amanda L Eiden, Qing Liu, Yoonyoung Choi, Yan Song, Gary S Marshall, Nicolae Done, Travis Wang, Goran Bencina, James Signorovitch
{"title":"Temporal trends in vaccination and antibiotic use among young children in the United States, 2000-2019.","authors":"Amanda L Eiden, Qing Liu, Yoonyoung Choi, Yan Song, Gary S Marshall, Nicolae Done, Travis Wang, Goran Bencina, James Signorovitch","doi":"10.1017/ash.2025.10044","DOIUrl":"10.1017/ash.2025.10044","url":null,"abstract":"<p><strong>Objective: </strong>Routine immunization programs may reduce antibiotic use, but few studies have comprehensively examined their impact on antibiotic utilization. We aimed to explore temporal trends in vaccination and antibiotic use among young children in the United States.</p><p><strong>Design: </strong>Ecological study using the Merative® MarketScan Commercial Claims and Encounters database.</p><p><strong>Methods: </strong>We analyzed claims data on pediatric vaccine uptake (pneumococcal conjugate, <i>Haemophilus influenzae</i> type b, diphtheria-tetanus-pertussis, and influenza) and antibiotic prescriptions and antibiotic-treated respiratory tract infections among US children <5 years during 2000-2019. Vaccination status was assessed annually, and children were categorized based on receipt of all four vaccines, 1-3 vaccines, or no vaccines. Antibiotic prescriptions were classified by spectrum and drug class. Respiratory infections included otitis media, pharyngitis, pneumonia, sinusitis, and viral infections.</p><p><strong>Results: </strong>Among 6.7 million children, vaccine uptake increased from 32.5% receiving all four vaccines in 2004 to 66.8% in 2019. During this period, overall antibiotic prescriptions decreased from 1.89 to 1.01 per person-year, with the greatest reductions in macrolides (73.3%) and broad-spectrum antibiotics (57.0%). Antibiotic-treated respiratory tract infections declined from 2.43 to 1.61 episodes per person-year, with the largest decreases in sinusitis (64.7%) and pharyngitis (39.8%).</p><p><strong>Conclusions: </strong>The findings suggest a temporal association between routine childhood immunization uptake and reduced antibiotic utilization. Although immunization programs are primarily aimed at protecting children from vaccine-preventable diseases, their potential role in complementing antimicrobial stewardship efforts and other factors influencing antibiotic reduction warrants further investigation through more rigorous study designs.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"5 1","pages":"e151"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12247003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627813","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}
引用次数: 0
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