An Update on Antibiotic Stewardship: From the 22nd European Congress of Clinical Microbiology and Infectious Diseases

Here is a nice article by Canton and Bryan that provides an update on Antibiotic Stewardship as reported at the 22nd European Congress of Clinical Microbiology and Infectious Diseases. The article references several poster presentations from this meeting as well as multiple studies that are already in print.

Infection with antibiotic-resistant organisms
has been associated with an increased
risk of death (cdc.gov)

Antibiotic Stewardship is a field of study and practice focused on decreasing the emergence of antibiotic resistance and optimizing antibiotic use.

A survey project that polled 324 facilities from six continents revealed that over half of these have Antibiotic Stewardship Programs (ASPs), although only 1/3rd had formally assessed these programs' impact. Those programs that had done formal assessments found that stewardship efforts were associated with decreased use of broad-spectrum antibiotics and decreased costs. 

cdc.gov

Targeted interventions in long-term care facilities (a known reservoir of antibiotic resistant organisms) led to decreased antibiotic use in these settings. 

Some countries are better stewards of antibiotics (in the outpatient
setting) than others. Antibiotics are often prescribed for viral
upper respiratory illnesses, a practice that drives antibiotic
resistance and has no affect on these infections (antibiotics are active
against bacteria, not viruses) (cdc.gov)

A study by Denes and colleagues found that there was poor adherence by primary care doctors to guidelines for UTIs in France. 

There are a paucity of new antibiotics in the "pipeline." This is especially true for multi-drug resistant (MRD) gram-negative infections. 

The article (part of a two-part series) by Canton and Bryan is a nice overview of the research presented at the European Congress of Clinical Microbiology and Infectious Diseases. These studies add to the growing Antibiotic Stewardship literature. However, critical questions still remain.  What interventions are best for decreasing the emergence of antibiotic resistance? What interventions are best in certain settings (hospitals/ long-term care facilities/ the general practitioner's office)? We know ASPs can lead to decreased use of broad-spectrum antibiotics and reduce costs, but what really works in terms of decreasing resistance? Robust, high-quality research is needed to answer these critical questions. 

The antibiotic pipeline is "drying up." This is especially
true for drugs to combat resistant gram-negative
infections (cdc.gov)

Beyond this, the future is still bleak in terms of new antibiotics to combat multi-drug resistant gram-negative infections. It is critical we preserve the antibiotics we have and reduce the spread of resistant organisms.