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Stewardship / Resistance Scan for Apr 28, 2021

Stewardship / Resistance Scan for Apr 28, 2021

ASP network boosts stewardship activity at community hospitals

Community hospitals participating in a collaborative network focused on antibiotic stewardship program (ASP) implementation saw an increase in ASP activities and a decline in antibiotic use over 42 months, researchers reported yesterday in Clinical Infectious Diseases.

In the study, researchers with the Duke Center for Antimicrobial Stewardship and Infection Prevention analyzed ASP practices and antibiotic use at 17 community hospitals belonging to the Duke Antimicrobial Stewardship Outreach Network (DASON). Among the services that hospitals in the network receive are onsite consultation from infectious disease physicians and pharmacists, a shared database for routine feedback and benchmarking of antibiotic prescribing, and educational programs.

ASP practice was assessed using structured interviews, and monthly hospital-level antibiotic use rates were measured in days of therapy (DOT) per 1,000 patient days (PD).

Analyzed data included more than 2.5 million DOT and almost 3 million PD from January 2013 to December 2018. The participating hospitals increased their ASP activities over the study period, with significant increases in the number of hospitals implementing formulary restriction processes (initial 65% vs 94%) and prospective audit and feedback (56% vs 94%).

During the first month after entry in the network, the median rate of all antibiotic use among DASON hospitals was 925 DOT/1,000 PD, with a flat trend over the first 12 months. But after a year, the monthly antibiotic use rate trended down slowly. The relative rate (RR) comparing month 42 to month 13 showed a decline of 5% (RR, 0.95; 95% confidence interval [CI], 0.91 to 0.99). The observed median antibiotic use rate at month 42 was 867 DOT/1,000 PD.

Fluoroquinolone use dropped significantly, while other antibiotic classes demonstrated a non-significant downward trajectory after year one. Large variation was seen in hospital-specific antibiotic use.

“In summary, the DASON model provides distinct advantages for individual hospital ASPs compared to ‘going it alone,’ including access to stewardship expertise, educational resources, and shared data infrastructure to further optimize program activities,” the study authors wrote. “Ultimately, this network served an individual hospital’s priorities for program implementation but also produced larger, network-level effects.”
Apr 27 Clin Infect Dis abstract

X-Biotix announces suspension of antibacterial research program

Biotechnology company X-Biotix Therapeutics of Waltham, Massachusetts, announced this week that it is suspending its current antibacterial research efforts, citing a lack of funding for early-stage antibiotic research and development (R&D).

X-Biotix was founded in 2016 and has focused on delivering small-molecule, first-in-class antibiotics that target multidrug-resistant gram-negative pathogens and defeat known antibiotic-resistance mechanisms. Among its projects, the company has been working on developing antibiotics that target the LpxA and LpxC enzymes, which play a role in constructing the tough outer membrane of gram-negative bacteria.

The company said it’s now changing its strategy and will instead focus on submitting manuscripts that describe its process in identifying and developing novel small-molecule antibiotic scaffolds and on strengthening its intellectual property position. The company also said it will explore out-licensing or new funding opportunities for some of its research programs.

“This issue is driven by a critical lack of sustained sources of funding to support early-stage research in this field, combined with lack of an appropriate market infrastructure to support the successful commercialization of novel antibiotics,” Stephen Isaacs, PhD, chairman of X-Biotix, said in a company press release. “Policy makers must enact market-based reforms, including reimbursement reform and commercial ‘pull’ incentives, in order to revitalize the antibiotics market and drive sustainable investments in antibiotics R&D.”

X-Biotix is the latest in a line of companies abandoning antibiotic development because of lack of funding and the broken market for new antibiotics, which do not provide companies with a strong return on investment. According to research from the Pew Charitable Trusts’ antibiotic resistance project, private investors poured $9.7 billion into R&D efforts for oncology drugs in 2019, while research into antibiotics received only $132 million.
Apr 26 X-Biotix press release

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