The Attributable Direct Medical Cost of Healthcare Associated Infection Caused by Multidrug Resistance Organisms in 68 Hospitals of China

Huixue, Jia; Li, Weiguang; Hou, Tieying; Ma, Hongxia; Yang, Yun; Wu, Anhua; Liu, Yunxi; Wen, Jie; Yang, Huai; Luo, Xiaorong; Xing, Yanwei; Zhang, Weihong; Wu, Yinghong; Ding, Lili; Liu, Weiping; Lin, Ling; Liu, Ying; Chen, Mei-Lian; Li, Liuyi

doi:10.1155/2019/7634528

Cited by 24 publications

(29 citation statements)

References 31 publications

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“…However, there is no doubt that the indiscriminate use of wide-spectrum antibiotics has been accepted as a definitive risk factor for the emergence of MDR pathogens [21], which have been reported to potentially worsen the severity of UTIs compared with pathogens without the resistance [24]. In other words, MDR would contribute to the high economic burden to the healthcare system due to frequent laboratory examinations, longer length of hospital stay, and administration of broad-spectrum antibiotics for worse infections [25]. A multinational observational study including 20 hospitals in eight countries showed that the presence of MDR was related to a higher cost [26].…”

Section: Discussionmentioning

confidence: 99%

Cefaclor as a first-line treatment for acute uncomplicated cystitis: a retrospective single-center study

et al. 2020

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Background: Wide-spectrum antibiotics have been favored to treat acute uncomplicated cystitis (AUC) for a long time, leading to the emergence of multi-drug resistant bacteria. We hypothesize that narrow-spectrum antibiotics might mitigate the issue and aim to investigate the clinical efficacy of cefaclor in patients with AUC. Methods: We retrospectively reviewed the clinical data of female outpatients with AUC treated with cefaclor and evaluated the safety and clinical efficacy. Clinical cure was defined as the elimination of clinical symptom under 4 white blood cells (WBCs) per high power field on microscopy.Results: Overall, 223 women with AUC were enrolled. Escherichia coli was the dominant pathogen (n = 160; 68.6%), followed by Klebsiella species and E. coli-extended spectrum β-lactamase (ESBL) (n = 19; 8.1% and n = 18; 7.7%). Overall success rate was 94.0% (n = 219) and susceptibility rate of cefazolin was 84.1%, which was close to that of levofloxacin (82.9%). Ampicillin showed the lowest rate of 63.7% with a significantly greater resistance rate of 35.3% among all antibiotics (P < 0.001). In the subgroup analysis, the success rate in patients with resistance to levofloxacin or cefazolin was 100% (n = 24) or 93.3% (n = 14). The rate in patients with resistance to both antibiotics was 60.0% (n = 9), and the pathogens in the other 40.0% (n = 6) of patients with treatment failure were E. coli-ESBL.Conclusion: Cefaclor showed excellent efficacy in AUC patients, even in those with in vitro resistance to cefazolin or levofloxacin. Cefaclor may be considered as a first-line option in patients with AUC and a second-line option for those with levofloxacin treatment failure.

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Section: Discussionmentioning

confidence: 99%

Cefaclor as a first-line treatment for acute uncomplicated cystitis: a retrospective single-center study

et al. 2020

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“…Indeed, the threat of antibiotic resistance is increasing globally, and this has caused many infectious diseases to become untreatable, with considerable increases in treatment complexity, side effects, disability, and mortality [1,2]. Moreover, it is well established that antibiotic-resistant infectious diseases lead to an increase of healthcare costs for hospitalizations, additional diagnostic investigations, and treatments [3][4][5][6]. The prevention of antibiotic-resistant bacteria's development and diffusion is a worldwide public health priority and requires a complex approach that includes the participation of healthcare professionals, patients, the agricultural sector, and policy makers.…”

Section: Introductionmentioning

confidence: 99%

The Knowledge, Attitudes, and Practices of Community Pharmacists in their Approach to Antibiotic Use: A Nationwide Survey in Italy

et al. 2019

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Background: This investigation has been carried out to evaluate the knowledge, attitudes, and practices toward antibiotic resistance and antibiotic use among community pharmacists in Italy and to investigate their influencing factors. Methods: A cross-sectional telephone survey using a semi-structured interview was performed between September 2018 and April 2019 among a random sample of community pharmacists. Results: Almost two thirds (61.5%) correctly answered that the overuse of antibiotics in primary care, hospital settings, and veterinary medicine is a significant cause of antibiotic resistance. Males, those who worked a lower number of hours per week, and those who acquired information through scientific journals and educational activity were more likely to know that the overuse of antibiotics causes antibiotic resistance. More than two thirds of those pharmacists (70.8%) often or always inform the public about the risks of antibiotic resistance. Those who have been practicing for a higher number of years were more likely to act in that way, whereas pharmacy directors and those who did not need additional information on antibiotic resistance were less likely to inform the public. Conclusions: Pharmacists need to be aware of the issue of antibiotic resistance and policy makers should promote the implementation of antibiotic use public educational interventions in this setting.

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“…However, there is no doubt that the indiscriminate use of widespectrum antibiotics has been accepted as a definitive risk factor for emergence of MDR pathogens, 21 which have been reported to potentially worsen the severity of UTIs compared with pathogens without the resistance [24]. In other words, MDR would contribute to the high economic burden to the healthcare system due to frequent laboratory examinations, longer length of hospital stay, and administration of broad-spectrum antibiotics for worse infections [25]. A multinational observational study including 20 hospitals in eight countries showed that the presence of MDR was related to a higher cost [26].…”

Section: Resultsmentioning

confidence: 99%

Cefaclor as a first-line treatment for acute uncomplicated cystitis

Koguchi¹,

Murakami²,

Ikeda³

et al. 2020

Preprint

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Background: Wide-spectrum antibiotics have been favored to treat acute uncomplicated cystitis (AUC) for a long time, leading to the emergence of multi-drug resistant bacteria. We hypothesize that narrow-spectrum antibiotics might mitigate the issue and aim to investigate the clinical efficacy of cefaclor in patients with AUC.Methods: We retrospectively reviewed the clinical data of female outpatients with AUC treated with cefaclor and evaluated the safety and clinical efficacy. Clinical cure was defined as the elimination of clinical symptom under 4 white blood cells (WBCs) per high power field on microscopy.Results: Overall, 223 women with AUC were enrolled. Escherichia coli was the dominant pathogen (n=160; 68.6%), followed by Klebsiella species and E. coli-extended spectrum β-lactamase (ESBL) (n=19; 8.1% and n=18; 7.7%). Overall success rate was 94.0% (n=219) and susceptibility rate of cefazolin was 84.1%, which was close to that of levofloxacin (82.9%). Ampicillin showed the lowest rate of 63.7% with a significantly greater resistance rate of 35.3% among all antibiotics (P<0.001). In the subgroup analysis, the success rate in patients with resistance to levofloxacin or cefazolin was 100% (n=24) or 93.3% (n=14). The rate in patients with resistance to both antibiotics was 60.0% (n=9), and the pathogens in the other 40.0% (n=6) of patients with treatment failure were E. coli-ESBL.Conclusion: Cefaclor showed an excellent efficacy in AUC patients, even in those with resistance to cefazolin or levofloxacin. Cefaclor has the potential to be the first-line and second-line therapies for patients with levofloxacin treatment failure.

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The Attributable Direct Medical Cost of Healthcare Associated Infection Caused by Multidrug Resistance Organisms in 68 Hospitals of China

Cited by 24 publications

References 31 publications

Cefaclor as a first-line treatment for acute uncomplicated cystitis: a retrospective single-center study

Cefaclor as a first-line treatment for acute uncomplicated cystitis: a retrospective single-center study

The Knowledge, Attitudes, and Practices of Community Pharmacists in their Approach to Antibiotic Use: A Nationwide Survey in Italy

Cefaclor as a first-line treatment for acute uncomplicated cystitis

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