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Antimicrobials: New Approaches to Managing Infections in a Post-COVID Era

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A special issue of Antibiotics (ISSN 2079-6382).

Deadline for manuscript submissions: closed (31 July 2023) | Viewed by 11507

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Special Issue Editors

Prof. Dr. Tracey Thornley

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Guest Editor

School of Pharmacy, University of Nottingham, Nottingham, UK
Interests: health economics; community pharmacy; antimicrobial resistance; pharmacogenomics; medicines value
Special Issues, Collections and Topics in MDPI journals

Prof. Philip Howard

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Guest Editor

University of Leeds, Leeds, UK
Interests: antimicrobial resistance; antimicrobial stewardship; antimicrobial shortages

Special Issue Information

Dear Colleagues,

The recent COVID pandemic has had a detrimental effect on health and social care systems globally but has driven many improvements. Scientists, healthcare professionals, academics and policymakers have had to work differently, and at an unpreceded pace to develop new medicines and technologies to respond to the virus. Better access and use of data, innovative applications (including environmental), genomic sequencing capacity and global research collaboration have resulted in early surveillance systems that have delivered evidenced-based care. We would like to invite papers that help us to understand how we utilize these advances and insights collected over the course of the pandemic to support approaches to managing infections in the post-COVID era. In particular, we would encourage submissions that consider implications for policy, research and practice. Examples would include novel approaches to developing, funding or testing new or existing therapies or diagnostics, and maintaining living prevention and management guidelines in a rapidly changing evidence-base. We would welcome interventions that directly impact patients (such as communication, behavior change, infection prevention strategies, diagnostics and self-testing, monitoring and reporting safety concerns and narrowing the health inequalities gap). Whilst the pandemic demonstrated a striking impact on global pollution through minimizing travel, it caused a hiatus in improving sustainability in healthcare equipment and medication so any lessons for improvement to protect the environment and minimize climate change would be well received.

Prof. Dr. Philip Howard
Prof. Dr. Tracey Thornley
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

surveillance
prevention
risk-stratification
environmental
health inequalities
patient safety
diagnostics
stewardship
sustainability
behavioral

Published Papers (4 papers)

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Research

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16 pages, 384 KiB

Open AccessArticle

Addressing Consumer Misconceptions on Antibiotic Use and Resistance in the Context of Sore Throat: Learnings from Social Media Listening

by Sabiha Essack, John Bell, Douglas Burgoyne, Khalid Eljaaly, Wirat Tongrod, Thomas Markham, Adrian Shephard and Elsa López-Pintor

Antibiotics 2023, 12(6), 957; https://doi.org/10.3390/antibiotics12060957 - 24 May 2023

Viewed by 3886

Abstract

A misunderstanding of the mechanism of action and bacterial targets of antibiotics by consumers may drive inappropriate antibiotic use and antimicrobial resistance (AMR). Tackling AMR requires an in-depth understanding of consumer beliefs and misconceptions. We explored consumer conversations on a number of social media platforms on antibiotic use and AMR in the context of sore throat and how coronavirus disease 2019 (COVID-19) affected online conversations between 1 January 2018 and 25 November 2021 across eight countries. Five distinct consumer groups were identified (antibiotic-preserving peer educators, antibiotic-cautious consumers, medication-resistant antibiotic opponents, believers in the strength of antibiotics, determined pro-antibiotic consumers) with a wide spectrum of beliefs around antibiotics in sore throat. Many opinions were based upon misconceptions, the most prominent of which was that antibiotics are strong medications that can treat all types of sore throat. COVID-19 had a multifaceted effect on the sore throat and AMR conversation. Sore throat triggered anxiety as consumers feared it may be a COVID-19 symptom while engagement in conversations around antibiotics for COVID-19 increased. Finally, consumers sought multiple routes to access antibiotics, such as directly from the pharmacy or by attempting to persuade physicians to prescribe. Knowledge obtained from this study could be used to develop focused approaches to dispel consumer misconceptions and mitigate AMR. Full article

(This article belongs to the Special Issue Antimicrobials: New Approaches to Managing Infections in a Post-COVID Era)

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9 pages, 509 KiB

Open AccessArticle

Acute Respiratory Infection Hubs: A Service Model with Potential to Optimise Infection Management

by Sarah Jawad, Anna Buckingham, Charlotte Richardson, Aoife Molloy, Bola Owolabi and Matt Inada-Kim

Antibiotics 2023, 12(5), 819; https://doi.org/10.3390/antibiotics12050819 - 27 Apr 2023

Cited by 1 | Viewed by 1874

Abstract

Patients with acute respiratory infections (ARI)—including those with upper and lower respiratory infections from both bacterial and viral pathogens—are one of the most common reasons for acute deterioration, with large numbers of potentially avoidable hospital admissions. The acute respiratory infection hubs model was developed to improve healthcare access and quality of care for these patients. This article outlines the implementation of this model and its potential impacts in a number of areas. Firstly, by improving healthcare access for patients with respiratory infections by increasing the capacity for assessment in community and non-emergency department settings and also by providing flexible response to surges in demand and reducing primary and secondary care demand. Secondly, by optimising infection management (including the use of point-of-care diagnostics and standardised best practise guidance to improve appropriate antimicrobial usage) and reducing nosocomial transmission by cohorting those with suspected ARI away from those with non-infective presentations. Thirdly, by addressing healthcare inequalities; in areas of greatest deprivation, acute respiratory infection is strongly linked with increased emergency department attendance. Fourthly, by reducing the National Health Service’s (NHS) carbon footprint. Finally, by providing a wonderful opportunity to gather community infection management data to enable large-scale evaluation and research. Full article

(This article belongs to the Special Issue Antimicrobials: New Approaches to Managing Infections in a Post-COVID Era)

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Other

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10 pages, 278 KiB

Open AccessPerspective

Improving Antimicrobial Use to Protect the Environment: What Is the Role of Infection Specialists?

by Sarah Catherine Walpole, Min Na Eii, Tracy Lyons and Catherine Aldridge

Antibiotics 2023, 12(4), 640; https://doi.org/10.3390/antibiotics12040640 - 24 Mar 2023

Cited by 3 | Viewed by 2723

Abstract

Anthropogenic environmental changes are causing severe damage to the natural and social systems on which human health depends. The environmental impacts of the manufacture, use, and disposal of antimicrobials cannot be underestimated. This article explores the meaning of environmental sustainability and four sustainability principles (prevention, patient engagement, lean service delivery, and low carbon alternatives) that infection specialists can apply to support environmental sustainability in health systems. To prevent inappropriate use of antimicrobials and consequent antimicrobial resistance (AMR) requires international, national, and local surveillance plans and action supporting antimicrobial stewardship (AMS). Engaging patients in addressing environmental sustainability, for example through public awareness campaigns about the appropriate disposal of unused and expired antimicrobials, could drive environmentally sustainable changes. Streamlining service delivery may include using innovative methods such as C-reactive protein (CRP), procalcitonin (PCT), or genotype-guided point of care testing (POCT) to reduce unnecessary antimicrobial prescribing and risk of adverse effects. Infection specialists can assess and advise on lower carbon alternatives such as choosing oral (PO) over intravenous (IV) antimicrobials where clinically appropriate. By applying sustainability principles, infection specialists can promote the effective use of healthcare resources, improve care quality, protect the environment, and prevent harm to current and future generations. Full article

(This article belongs to the Special Issue Antimicrobials: New Approaches to Managing Infections in a Post-COVID Era)

8 pages, 536 KiB

Open AccessPerspective

Relevance of Pharmacogenomics to the Safe Use of Antimicrobials

by Ann K. Daly

Antibiotics 2023, 12(3), 425; https://doi.org/10.3390/antibiotics12030425 - 21 Feb 2023

Cited by 3 | Viewed by 2327

Abstract

There has been widespread implementation of pharmacogenomic testing to inform drug prescribing in medical specialties such as oncology and cardiology. Progress in using pharmacogenomic tests when prescribing antimicrobials has been more limited, though a relatively large number of pharmacogenomic studies on aspects such as idiosyncratic adverse drug reactions have now been performed for this drug class. Currently, there are recommendations in place from either National Regulatory Agencies and/or specialist Pharmacogenomics Advisory Groups concerning genotyping for specific variants in MT-RNR1 and CYP2C19 before prescribing aminoglycosides and voriconazole, respectively. Numerous additional pharmacogenomic associations have been reported concerning antimicrobial-related idiosyncratic adverse drug reactions, particularly involving specific HLA alleles, but, to date, the cost-effectiveness of genotyping prior to prescription has not been confirmed. Polygenic risk score determination has been investigated to a more limited extent but currently suffers from important limitations. Despite limited progress to date, the future widespread adoption of preemptive genotyping and genome sequencing may provide pharmacogenomic data to prescribers that can be used to inform prescribing and increase the safe use of antimicrobials. Full article

(This article belongs to the Special Issue Antimicrobials: New Approaches to Managing Infections in a Post-COVID Era)

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