Issue link: https://beckershealthcare.uberflip.com/i/1149353
27 ANTIBIOTIC RESISTANCE & STEWARDSHIP Antibiotic guidelines ignored for most kids with community-acquired pneumonia, study finds By Anuja Vaidya E ven though the routine use of diagnostic testing and antibiotics is not recommended for chil- dren with community-acquired pneumonia, a study found that these patients do commonly undergo several tests, and most are given antibiotics. For the study, published in the Journal of the Pediat- ric Infectious Diseases Society, researchers examined a national sample of more than 6 million outpatient pediatric patients with community-acquired pneumonia between 2008 and 2015. The patients ranged in age from 1 to 6 years old. Researchers found that clinicians obtained a complete blood count for 8.6 percent of the patients, and 43 percent underwent radiography tests. A majority of patients (73.9 percent) were given antibiotics. This could contribute to the rise in antibiotic resistance among young children, making it harder for them to fight off diseases. There were no changes in diagnostic testing or antibi- otic use over time. n Sepsis patients with higher ED triage scores get antibiotics faster, study finds By Anuja Vaidya E mergency department sepsis patients with higher acuity scale scores get their antibiotics sooner than their counterparts with lower scores, giving them a greater chance at survival, researchers found. Researchers from Salt Lake City-based Intermountain Healthcare presented their findings at the annual inter- national conference of the American Thoracic Society in Dallas May 22. Study participants included sepsis patients who were treated in four Intermountain Healthcare EDs between July 2013 and January 2017. The EDs assign patients a score on a subjective 1-to-5 acuity scale, which helps providers tri- age patients and allocate resources appropriately. A score of 1 indicates the patient is most in need of immediate care and a score of 5 indicates the least need. Researchers focused on patients with mid-range scores, either a 2 (emergent) or 3 (urgent), who also had abnormal- ly low blood pressures. Of 799 eligible patients, 591 had a score of 2, and 208 had a score of 3. The study shows patients given a triage score of 3 had door-to-antibiotic times that were 32 minutes longer than patients assigned a triage score of 2. n 5 tips for sustainable antibiotic use By Mackenzie Bean T he creation of new antibiotics could help solve the global antimicrobial resistance crisis, but must be paired with more disciplined, strategic use of the medications, according to a paper pub- lished in Evolutionary Applications. Dr. Ben Raymond, a researcher at the University of Exeter in the U.K., au- thored the paper. He outlined five rules the healthcare industry should abide by to avoid resistance to new antibiotics: 1. Focus on prevention. Clinicians must stay away from heavy use of individual antibiotics for extended lengths, "as using drugs in this manner creates more 'selection pressure' — the conditions microbes need to evolve resistance," Dr. Raymond wrote. 2. Don't count on "fitness costs." Some strategies to fight antibiotic resistance call for stopping use of an antibiotic in the hope that drug-resistant bacteria die off because they are no longer useful, which is known as a "fitness cost." However, Dr. Raymond notes this can be an unreliable strategy that doesn't always lower resis- tance rates. 3. Limit the supply of bacteria mutations. Bacteria don't typically develop resistance to multiple antibiotics at once, so clinicians should use antibiotic combinations to treat patients, according to Dr. Raymond. 4. Pick short courses over low doses. Short, intensive courses of antibiotics may give microbes less opportunity to mutate than longer courses of low-dose antibiotics. 5. Information is power. Clinicians must know what types of resistance is occurring in their patients or health- care facility, according to Dr. Raymond. "The more data you have, the better you can design your resistance management programs," he said. n