Effect of antibiotic stewardship programs on reduction of antimicrobial resistance in China

Abstract

Antimicrobial resistance is one of the most significant challenges to modern health care, causing morbidity and mortality. 1 Cassini A Hogberg LD Plachouras D Quattrocchi A Hoxha A Simonsen GS et al. Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis. Lancet Infect Dis. 2019; 19: 56-66 Abstract Full Text Full Text PDF PubMed Scopus (1406) Google Scholar Strategies for optimal antibiotic use plays an important role to limit the spread of antimicrobial resistance at both hospital and community levels. 2 Baur D Gladstone BP Burkert F Carrara E Foschi F Dobele S et al. Effect of antibiotic stewardship on the incidence of infection and colonisation with antibiotic-resistant bacteria and Clostridium difficile infection: a systematic review and meta-analysis. Lancet Infect Dis. 2017; 17: 990-1001 Abstract Full Text Full Text PDF PubMed Scopus (392) Google Scholar International researchers have identified the various effective elements of antibiotic stewardship programs (ASPs) against antimicrobial resistance in hospitals, that is, optimizing the duration of empirical therapy; restriction antibiotic prescribing system; antibiotic cycling; audit and feedback. 3 World Health Organization. Step-by-step approach for development and implementation of hospital and antibiotic policy and standard treatment guidelines. Available from: https://apps.who.int/iris/handle/10665/205912. Accessed November 11, 2019. Google Scholar Baur et al 2 Baur D Gladstone BP Burkert F Carrara E Foschi F Dobele S et al. Effect of antibiotic stewardship on the incidence of infection and colonisation with antibiotic-resistant bacteria and Clostridium difficile infection: a systematic review and meta-analysis. Lancet Infect Dis. 2017; 17: 990-1001 Abstract Full Text Full Text PDF PubMed Scopus (392) Google Scholar showed in a meta-analysis that effective ASPs significantly reduced 51% of infections due to multidrug-resistant gram-negative pathogens, as well as 37% of infections due to methicillin-resistant Staphylococcus aureus. In addition, Global Infection Prevention and Control Priorities 2018 to 2022 released by the World Health Organization, 4 Allegranzi B Kilpatrick C Storr J Kelley E Park BJ Donaldson L Global infection prevention and control priorities 2018-22: a call for action. Lancet Glob Health. 2017; 5: e1178-e1180 Abstract Full Text Full Text PDF PubMed Scopus (59) Google Scholar focuses on the burden of antimicrobial resistance, in particular in Southern Asia, and recommend the implementation of ASPs in terms of local conditions (ie, health care system, socioeconomic status). Unfortunately, due to limited medical resources and inadequate surveillance data, measuring the impacts of ASPs on antimicrobial resistance has become challenging. 5 Hasan MJ Rabbani R The need for adequate research data on carbapenem use and resistance in Bangladesh. Lancet Infect Dis. 2019; 19: 811 Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar