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28 ANTIBIOTIC RESISTANCE & STEWARDSHIP Sepsis patients should get blood culture before antibiotics, study suggests By Mackenzie Bean P hysicians should take at least one blood culture from sepsis patients be- fore administering antibiotics, as the therapy can create less reliable test results, according to a study published in Annals of Internal Medicine. Sepsis treatment guidelines call for the early administration of antibiotics, with blood cultures drawn before and aer such therapy. For the study, researchers sought to determine whether immediate antibiotic use affects the diagnostic sensitivity of blood cultures. Researchers analyzed data on 325 adult sepsis patients from seven emergency de- partments in North America. Blood cultures were drawn before and within 120 minutes of patients receiving antibiotics. Researchers found blood cultures taken shortly aer antibiotic initiation were significantly less sensitive, which can hinder physicians' ability to diagnose the infection and tailor treatment appropriately, according to the study authors. "Now we know that even if blood cultures are performed very rapidly aer antibiot- ics, they lose a significant amount of their diagnostic ability," study co-author Murtaza Akhter, MD, an assistant professor of emer- gency medicine at the University of Arizona College of Medicine in Phoenix, said in a news release. "Although administering antibiotics to septic patients is important, it is imperative to get at least one blood culture before providing the treatment." n US-led push against antibiotic resistance adds hundreds of global supporters By Anuja Vaidya S ince it was launched in 2018, the United States' AMR Challenge has gathered nearly 350 commit- ments from 33 countries to implement specific actions to combat antibiotic resistance. The CDC and HHS led the global initiative, which includes commitments to antibiotic resistance efforts from pharmaceutical and health insurance companies, food animal producers and purchasers, and medical professionals and healthcare systems. More than 55 pharmaceutical and biotech groups committed to developing or increasing access to products that will mitigate drug-resistant infections and nearly half of the commitments focus on im- proving antibiotic use. Also, nearly 50 percent of the commitments focus on improving infection prevention and control. "The success of the challenge over the past year demonstrates what is possible, in the relatively short term, when we have real commitment to the fight against this pressing public health threat," said HHS Secretary Alex Azar. n Widespread use of 4 antibiotics tied to higher C. diff risk By Mackenzie Bean F acilitywide use of four antibiotic classes is linked to a higher risk of Clostridium difficile infections, according to a study published in Infection Control & Hospital Epidemiology. For the study, researchers analyzed 2016-17 data on high- risk antibiotic use and C. difficile incidence at 171 hospitals using the BD Insights Research Database. They looked at four classes of antibiotics that are believed to increase the risk of C. difficile: • Cephalosporins • Fluoroquinolones • Carbapenems • Lincosamides The median days of therapy for these antibiotics was 241.2 per 1,000 days. The overall hospital-associated C. difficile rate was 33 per 10,000 admissions. Researchers found that every 100 days of hospitalwide high-risk antibiotic use was linked to a 12 percent increase in hospital-associated C. difficile infections. When research- ers looked at each antibiotic separately, only cephalospo- rins showed a significant link to C. difficile infections. n