Surveillance and Optimization of Antibiotics Usage

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotics Use and Antimicrobial Stewardship".

Deadline for manuscript submissions: closed (15 May 2024) | Viewed by 7604

Special Issue Editors


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Guest Editor
Department of Pharmacy Administration and Clinical Pharmacy, Peking University, Beijing, China
Interests: evidence-based pharmacy; therapeutic drug monitoring; clinical pharmacy
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Guest Editor
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
Interests: pharmacoepidemiology; clinical epidemiology and evidence-based medicine
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

From ancient quinine to the newly synthesized oxazolidinones, antibiotics have drastically changed human civilization and modern medicine in just over 100 years, widely prescribed in medical institutions across all departments, patients, and places of treatment. In community pharmacies, antibiotics are one of the most commonly prescribed drugs. The appropriateness of antibiotics is a global issue, mainly associated with factors such as antibacterial resistance evaluation, the rational choice of drugs, the optimization of drug usage and dosages, and the management of drug adverse reactions and costs.

Antibiotic use is strictly managed in hospitals, considering how widely they are used, the expenditure, and the serious consequences of antimicrobial abuse. Additionally, bacterial resistance surveillance systems are relatively well established, providing data for guidance on the appropriateness of antibiotics. Nevertheless, with the increasing complexity of clinical infections, the rational use of antibiotics still needs further research and improvement.

This Special Issue focuses on the appropriateness of antibiotic use, for which we invite scholars to report on the latest research and review results. This Special Issue also seeks manuscript submissions capable of further improving our understanding and experience surrounding rational antibiotic use.

Prof. Dr. Suodi Zhai
Prof. Dr. Siyan Zhan
Guest Editors

Manuscript Submission Information

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Keywords

  • appropriateness of antibiotics
  • bacterial resistance
  • optimization of antibiotic usage and dosages
  • prescription
  • medical institutions
  • community pharmacies

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Published Papers (3 papers)

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Research

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12 pages, 661 KiB  
Article
Exploring Prescription Practices: Insights from an Antimicrobial Stewardship Program at a Tertiary Healthcare Facility, Rwanda
by Misbah Gashegu, Noel Gahamanyi, François Xavier Ndayambaje, Jean Bosco Munyemana, Vedaste Ndahindwa, Fredrick Lukwago, Lambert Ingabire, Fiona Gambanga, Pierre Gashema, Albert Tuyishime, Tafadzwa Dzinamarira, Damas Dukundane, Thierry Zawadi Muvunyi and Claude Mambo Muvunyi
Antibiotics 2024, 13(6), 548; https://doi.org/10.3390/antibiotics13060548 - 12 Jun 2024
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Abstract
Antimicrobial resistance (AMR) is a major public health threat linked to increased morbidity and mortality. It has the potential to return us to the pre-antibiotic era. Antimicrobial stewardship (AMS) programs are recognized as a key intervention to improve antimicrobial use and combat AMR. [...] Read more.
Antimicrobial resistance (AMR) is a major public health threat linked to increased morbidity and mortality. It has the potential to return us to the pre-antibiotic era. Antimicrobial stewardship (AMS) programs are recognized as a key intervention to improve antimicrobial use and combat AMR. However, implementation of AMS remains limited in Africa, particularly in Rwanda. This study aimed to assess prescription practices, identify areas for improvement, and promote adherence to AMS principles. Conducted at King Faisal Hospital in Rwanda, this qualitative study used semi-structured interviews with eight participants until saturation was reached. The interviews were recorded, transcribed, and thematically analyzed, revealing four emerging themes. The first theme was on AMS activities that were working well based on availability of microbiology laboratory results and prescription guidelines as factors influencing antibiotic prescription adjustments. The second theme was related to challenges during the implementation of the AMS program, including the prescription of broad-spectrum antibiotics, limited local data on AMR patterns, and stock-outs of essential antibiotics. The third theme was on the importance of adhering to AMR management guidelines at KFH. The last emerged on recommendations from participants centered on regular training for healthcare workers, widespread dissemination of AMR findings across departments, and the enforcement of antibiotic restriction policies. These actions can improve prescription behaviors, upholding the highest standards of patient care, and strengthening the nascent AMS program. Full article
(This article belongs to the Special Issue Surveillance and Optimization of Antibiotics Usage)
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13 pages, 1273 KiB  
Systematic Review
Antimicrobial Resistance in the WHO African Region: A Systematic Literature Review 2016–2020
by Laetitia Gahimbare, Claude Mambo Muvunyi, Nathalie Aya Kouadio Guessennd, Jean Pierre Rutanga, Pierre Gashema, Walter Fuller, Ambele Judith Mwamelo, Sheick Oumar Coulibaly, Fausta Shakiwa Mosha, Olga Perovic, Hassiba Tali-Maamar and Ali Ahmed Yahaya
Antibiotics 2024, 13(7), 659; https://doi.org/10.3390/antibiotics13070659 - 17 Jul 2024
Cited by 1 | Viewed by 2120
Abstract
Antimicrobial resistance (AMR) is a significant global public health threat. This review presents the most recent in-depth review of the situation of the main AMR types in relation to the most commonly prescribed antibiotics in the World Health Organization (WHO) African Region. Underlying [...] Read more.
Antimicrobial resistance (AMR) is a significant global public health threat. This review presents the most recent in-depth review of the situation of the main AMR types in relation to the most commonly prescribed antibiotics in the World Health Organization (WHO) African Region. Underlying genes of resistance have been analyzed where possible. A search to capture published research data on AMR from articles published between 2016 and 2020 was done using PubMed and Google Scholar, with rigorous inclusion/exclusion criteria. Out of 48003 articles, only 167 were included. Among the tested gram-negative bacteria species, Klebsiella spp. remain the most tested, and generally the most resistant. The highest overall phenotypic resistance for imipenem was reported in E. coli, whereas for meropenem, E. coli and Haemophilus spp. showed an equal resistance proportion at 2.5%. For gram-positive bacteria, Streptococcus pneumoniae displayed high resistance percentages to trimethoprim/sulfamethoxazole (64.3%), oxacillin (32.2%), penicillin (23.2%), and tetracycline (28.3%), whereas Staphylococcus aureus contributed to 22.8% and 10% resistance to penicillin and oxacillin, respectively. This review shows that AMR remains a major public health threat. The present findings will help public health decision-makers in developing efficient preventive strategies and adequate policies for antibiotic stewardship and surveillance in line with the global action plan for AMR. Full article
(This article belongs to the Special Issue Surveillance and Optimization of Antibiotics Usage)
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13 pages, 614 KiB  
Perspective
Empowering Low- and Middle-Income Countries to Combat AMR by Minimal Use of Antibiotics: A Way Forward
by Mohammed Kanan, Maali Ramadan, Hanan Haif, Bashayr Abdullah, Jawaher Mubarak, Waad Ahmad, Shahad Mari, Samaher Hassan, Rawan Eid, Mohammed Hasan, Mohammed Qahl, Atheer Assiri, Munirah Sultan, Faisal Alrumaih and Areej Alenzi
Antibiotics 2023, 12(10), 1504; https://doi.org/10.3390/antibiotics12101504 - 2 Oct 2023
Cited by 10 | Viewed by 3475
Abstract
Antibiotic overuse poses a critical global health concern, especially in low- and middle-income countries (LMICs) where access to quality healthcare and effective regulatory frameworks often fall short. This issue necessitates a thorough examination of the factors contributing to antibiotic overuse in LMICs, including [...] Read more.
Antibiotic overuse poses a critical global health concern, especially in low- and middle-income countries (LMICs) where access to quality healthcare and effective regulatory frameworks often fall short. This issue necessitates a thorough examination of the factors contributing to antibiotic overuse in LMICs, including weak healthcare infrastructure, limited access to quality services, and deficiencies in diagnostic capabilities. To address these challenges, regulatory frameworks should be implemented to restrict non-prescription sales, and accessible point-of-care diagnostic tools must be emphasized. Furthermore, the establishment of effective stewardship programs, the expanded use of vaccines, and the promotion of health systems, hygiene, and sanitation are all crucial components in combating antibiotic overuse. A comprehensive approach that involves collaboration among healthcare professionals, policymakers, researchers, and educators is essential for success. Improving healthcare infrastructure, enhancing access to quality services, and strengthening diagnostic capabilities are paramount. Equally important are education and awareness initiatives to promote responsible antibiotic use, the implementation of regulatory measures, the wider utilization of vaccines, and international cooperation to tackle the challenges of antibiotic overuse in LMICs. Full article
(This article belongs to the Special Issue Surveillance and Optimization of Antibiotics Usage)
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