Antibiotic stewardship in the era of precision medicine

Watkins, Richard R.

doi:10.1093/jacamr/dlac066

Cited by 16 publications

(8 citation statements)

References 54 publications

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“…In the UK, ASPs include the measurement of PCT in patients admitted to the hospital with SARS-CoV-2, with antibiotic discontinuation considered in those with a PCT level < 0.25 ng/L [27]. PCT contributed to antibiotics discontinuation in 32% of patients and reduced the antibiotic prescription rate from 70% to 36.5%.…”

Section: Covid-19: Pct and Crpmentioning

confidence: 99%

Role of biomarkers in antimicrobial stewardship: physicians’ perspectives

Seok,

Park

2024

Korean J Intern Med

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Biomarkers are playing an increasingly important role in antimicrobial stewardship. Their applications have included use in algorithms that evaluate suspected bacterial infections or provide guidance on when to start or stop antibiotic therapy, or when therapy should be repeated over a short period (6–12 h). Diseases in which biomarkers are used as complementary tools to determine the initiation of antibiotics include sepsis, lower respiratory tract infection (LRTI), COVID-19, acute heart failure, infectious endocarditis, acute coronary syndrome, and acute pancreatitis. In addition, cut-off values of biomarkers have been used to inform the decision to discontinue antibiotics for diseases such as sepsis, LRTI, and febrile neutropenia. The biomarkers used in antimicrobial stewardship include procalcitonin (PCT), C-reactive protein (CRP), presepsin, and interleukin (IL)-1β/IL-8. The cut-off values vary depending on the disease and study, with a range of 0.25–1.0 ng/mL for PCT and 8–50 mg/L for CRP. Biomarkers can complement clinical diagnosis, but further studies of microbiological biomarkers are needed to ensure appropriate antibiotic selection.

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Section: Covid-19: Pct and Crpmentioning

confidence: 99%

Role of biomarkers in antimicrobial stewardship: physicians’ perspectives

Seok,

Park

2024

Korean J Intern Med

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“…Thus, precision medicine has the potential to combat AMR by providing targeted and effective solutions and addressing the drawbacks of traditional antibiotic therapy. 77,78…”

Section: Limitationsmentioning

confidence: 99%

Combating Antimicrobial Resistance: A paradigm shift from general to precision medicine

Ahmed,

Shamim,

Das

et al. 2024

CBL

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Antimicrobial resistance (AMR) poses a significant threat to global health. It makes treating bacterial infections increasingly difficult. AMR arises from various mechanisms of antibiotic resistance including enzymatic inactivation, target alteration, efflux pumps, and decreased permeability. The limited and often ineffective treatments relying on antibiotics and their combinations result in increased morbidity and mortality. Therefore, it is essential to explore alternative methods for combating the challenge of AMR. In recent years, there has been a notable shift towards precision medicine in the battle against AMR. Precision medicine, characterized by its focus on individualized treatment tailored to patients' specific genetic makeup, offers a paradigm shift in addressing AMR challenges. By pinpointing molecular targets responsible for infection, precision medicine enables more targeted and effective therapies, minimizing the risk of antimicrobial resistance development. Precision medicine can provide an alternative option to combat AMR by focusing on targets responsible for the infection. Bacteriophages and antimicrobial peptides (AMPs) are groups of antimicrobials that can serve as novel alternatives to antibiotics for combating the global antibiotic resistance challenge. They have the potential to be used as targeted therapy. Despite challenges such as limited host range, which refers to the specific bacteria they can infect, and regulatory concerns related to their approval and usage, bacteriophages have proven effective against bacteria causing infections. Meanwhile, AMPs provide a potential treatment approach against antibiotic-resistant bacteria due to their low molecular weight and broad-spectrum antimicrobial activity. AMPs can serve as a first line of defense against microorganisms. When used alone or combined with other biomaterials to increase therapeutic action, they can serve as a first line of defense against microorganisms. This review article aims to provide a comprehensive overview of the current understanding and clinical potential of bacteriophages and AMPs as alternatives to conventional antibiotics in addressing the pressing challenge of AMR.

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“…Naturally, bacteria may have inherent resistance to certain antibiotics, but these resistances can be amplified by the acquisition of additional resistance genes often driven by human activities such as the inappropriate use of antibiotics [7]. WHO advocates that only 50% of antibiotics are used correctly [8]. It has been approved that the use, misuse, and overuse of antibiotics have led to direct and indirect correlations with the emergence of bacterial resistance through the phenomenon of selection pressure from resistant mutants [9,10].…”

Section: Introductionmentioning

confidence: 99%

Pharmaco-Epidemiological Study and Correlation between Antibiotic Resistance and Antibiotic Consumption in a Tunisian Teaching Hospital from 2010 to 2022

Kasbi,

Sellami,

Ferjani

et al. 2024

Preprint

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The exponential rise of bacterial resistance poses a threat to antibiotic efficacy, with a great impact on public health. This study aims to analyze the correlation between antibiotic consumption and the emergence of bacterial resistance. Conducted retrospectively at Charles Nicolle Hospital in Tunis, Tunisia from 2010 to 2022, this study was based on STKMED® software for antibiotic consumption data, hospital administrative records for the number of hospitalization days, and SIRSCAN® software for bacteriological data. Data processing was performed using Excel® software, and analysis was conducted using SPSS23®. In 2022, Consumption was almost evenly split between the two major “AWaRe” groups, with 49.33% for "Access" and 46.89% for "Watch", and the consumption of the "Reserve" group also increased, accounting for 3.77% of the total. Bacterial resistances, notably carbapenem-resistant Klebsiella pneumoniae, increased. Seventy-four significant correlations were identified, including those be-tween carbapenem consumption and resistance in Escherichia coli and Klebsiella pneumoniae strains. However, no significant corre-lation was observed with imipenem-resistant Pseudomonas aeruginosa strains. The significant correlations between the emergence of bacterial resistance and antibiotic use, particularly with antibiotics in the "Watch" and "Reserve" groups, underscore the urgent need to continue efforts to combat this threat through rational antibiotic use.

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Antibiotic stewardship in the era of precision medicine

Cited by 16 publications

References 54 publications

Role of biomarkers in antimicrobial stewardship: physicians’ perspectives

Role of biomarkers in antimicrobial stewardship: physicians’ perspectives

Combating Antimicrobial Resistance: A paradigm shift from general to precision medicine

Pharmaco-Epidemiological Study and Correlation between Antibiotic Resistance and Antibiotic Consumption in a Tunisian Teaching Hospital from 2010 to 2022

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