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Stewardship / Resistance Scan for Aug 09, 2021

Survey examines caregiver attitudes on antibiotic use

A survey of US caregivers found that more than 1 in 10 either planned or had already administered a nonprescription antibiotic (NPA) to their child, researchers reported last week in the Journal of the Pediatric Infectious Diseases Society.

Among the 396 caregivers of children younger than 18 who answered all the questions in the survey, which was conducted from January 2019 through July 2019, 119 (30%) caregivers requested antibiotics from a clinician, 65 (16%) reported storing antibiotics currently in the home, and 47 (12%) reported intent to use an antibiotic without a clinician’s directive or had already done so. Amoxicillin was the most common antibiotic stored in the home, followed by amoxicillin/clavulanate, cephalexin, and ciprofloxacin.

Further analysis of the respondents in the NPA group found that 40% reported requesting antibiotics from a clinician, and those with an annual income of over $75,000 were more than twice as likely as other caregivers (odds ratio, 2.04; 95% confidence interval [CI], 1.01 to 4.14) to store and use antibiotics without a clinician’s directive. Nineteen percent of the NPA group agreed with the statement “It’s okay to use antibiotics that were given to a friend or family member as long as it was used to treat a similar illness,” compared with 3% of other caregivers.

“Our data highlight that the issue of antibiotic misuse by caregivers of children is complex and must be tackled systematically,” the study authors wrote. “Future antibiotic stewardship efforts should include education for clinicians, pharmacists, and the public about leftover medication and nonprescription antibiotic use.” 
Aug 7 J Pediatric Infect Dis Soc abstract


Study finds COVID surges linked to increase in hospital infections

An analysis of US hospital data found that surges in COVID-19 hospitalizations were associated with elevated rates of healthcare-associated infections (HAIs) and drug-resistant pathogens, researchers reported today in Clinical Infectious Diseases.

Using data collected from 148 hospitals in 17 states from March through September 2020, the researchers found that increased relative rates of central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), and methicillin-resistant Staphylococcus aureus (MRSA) bacteremia increased as the COVID-19 burden increased.

Over 7 months, there were 60% more CLABSIs, 43% more CAUTIs, and 44% more cases of MRSA bacteremia than expected based on predicted HAIs had there been no COVID-cases.

Microbiology data from a subset of 81 hospitals with microbiology and cluster data through December 2020 confirmed those findings. Over 10 months, COVID-19 surges were temporally associated with a 24% increase in hospital-onset bloodstream infections and multidrug-resistant organisms, including a 30% increase in hospital-onset MRSA infections, a 44% increase in hospital-onset vancomycin-resistant Enterococci infections, and 27% increase in infections caused by multidrug-resistant gram-negative organisms. In addition, clusters of hospital-onset pathogens increased as the COVID-19 burden increased.

The findings support the researchers’ hypothesis that routine HAI prevention practices, such as central line and urinary catheter care, may have been negatively impacted by disruptions to infection prevention and control measures during the pandemic.

“Although the per-patient risk of a hospital-onset infection remained very low, HAI rates increased during COVID-19 surges,” the study authors write. “Further research is necessary to elucidate the specific ways in which the COVID-19 burden is affecting HAI rates, but our results identify a need to build capacity in infection prevention and control.”
Aug 9 Clin Infect Dis abstract

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