Alliance against MDRO: Safeguarding antibiotics.

August 2012

[Article in French]

Carlet J, Rambaud C, Pulcini C; au nom de l’Alliance contre le développement des bactéries multirésistantes (ACdeBMR).

Source

9, rue de la Terrasse, 94000 Créteil, France.

Abstract

Keywords

• Alliance; 
• Antibiotics; 
• Resistance to antibiotics; 
• Hygiene; 
• Antibiotic stewardship

Resistance to antibiotics has increased recently to a dramatic extend, and the pipeline of new antibiotics is almost dry for the 5 next years. Failures happen already for trivial community acquired infections, like pyelonephritis, or peritonitis, and this is likely to increase. Difficult surgical procedures, transplants, and other immunosuppressive therapies will become far more risky. Resistance is mainly due to an excessive usage of antibiotics, in all sectors, including the animal one. Action is urgently needed. Therefore, an alliance against MDRO has been recently created, which includes health care professionals, consumers, health managers, and politicians. The document highlights the different proposed measures, and represents a strong consensus between the different professionals, including general practitioners, and veterinarians.

Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS

SciVerse

Antibiotic choices by paediatric residents and recently graduated paediatricians for typical infectious disease problems in children.

Antibiotic choices by paediatric residents and recently graduated paediatricians for typical infectious disease problems in children.

Paediatr Child Health. 2006 Dec

Smart K, Lemay JF, Kellner JD.
Pediatric Emergency Medicine.

OBJECTIVE: To evaluate antibiotic choices and recommendations for duration of therapy made by paediatric residents (PRs) and recently graduated paediatricians (RGPs) in several typical infectious disease conditions.

METHODS: In autumn 2002, a two-page questionnaire was sent to 276 core PRs in Canadian residency programs and to a random selection of 276 RGPs from across Canada. The questionnaire described 10 scenarios: otitis media, pharyngitis, sinusitis, bronchopneumonia, lobar pneumonia, meningitis, pyelonephritis, osteomyelitis, cellulitis, and fever and neutropenia. The participants were asked primarily about initial antibiotic selection and duration of treatment for each scenario.

RESULTS: There were 251 participants (overall response rate of 45%). The two most common antibiotic recommendations constituted 85% or more of the total for all scenarios except acute otitis media, sinusitis, cellulitis, and fever and neutropenia. There was a twofold or more difference in the range of recommended duration of treatment for all scenarios and a threefold or more difference for sinusitis, meningitis and osteomyelitis. PRs were more likely than RGPs to use broader spectrum cephalosporins for pneumococcal pneumonia (33% versus 15%, respectively; P=0.001) and to treat sinusitis for just five to 10 days (39% versus 22%, respectively; P=0.01). Also, 33% of all participants recommended amoxicillin/clavulanate or a cephalosporin rather than amoxicillin for sinusitis.

CONCLUSION: PRs and RGPs made similar and reasonable recommendations, largely in line with published guidelines, for most of the infectious disease scenarios presented. For some conditions, a significant minority of respondents unnecessarily recommended broad-spectrum antibiotics. The most variable responses were for duration of treatment, reflecting the lack of certainty in the published evidence base for many conditions.

PMID: 19030247 [PubMed - in process]