Becker's Clinical Quality & Infection Control

24 ANTIBIOTIC RESISTANCE & STEWARDSHIP Scientists Reengineer Vancomycin to Fight Superbugs By Brian Zimmerman A team of scientific researchers modified the last-resort anti- biotic vancomycin to improve its ability to fight Enterococ- ci bacteria, according to a study published in PNAS Plus. The modification to the drug results in a 1,000-fold increase to its antibiotic activity and works against the bacteria in three ways to make the development of drug-resistance more difficult. "This increases the durability of this antibiotic," said Dale Boger, co-chair of the La Jolla, Calif.-based Scripps Research Institute's chemistry department and one of the study's researchers, according to CNN. "Organisms just can't si- multaneously work to find a way around three independent mechanisms of action. Even if they found a solution to one of those, the organisms would still be killed by the other two." Enterococci bacteria can cause dangerous urinary and sur- gical wound infections. It could potentially take years before the revamped antibiotic clears the necessary clinic trials to become mass-produced antibiotic therapy. n Antibiotics Ineffective for Nearly 25% of Pneumonia Patients By Brian Zimmerman N early 25 percent of adult patients treated for pneumonia with antibiotics in an outpatient set- ting do not respond to the treatment, suggest the findings from a study presented during the 2017 American Thoracic Society International Conference held in Washington, D.C., from May 19 to May 24. For the study, researchers examined medical records for 251,947 adult patients treated with a single class of antibiotics between 2011 and 2015. Analysis revealed antibiotic prescriptions failed 22.1 percent of the time. Antibiotic failure was defined as the need to refill anti- biotic prescriptions, switching to a different antibiotic, a visit to the emergency room or hospitalization within 30 days of filling the initial antibiotic prescription. "Our data provide numerous insights into characteris- tics of patients who are at higher risk of complications and clinical failure," said James McKinnell, MD, a re- searcher and infectious disease specialist at Los Ange- les BioMed. "Perhaps the most striking example is the association between age and hospitalization: Patients over the age of 65 were nearly twice as likely to be hospitalized compared to younger patients when our analysis was risk adjusted and nearly three times more likely in unadjusted analysis. Elderly patients are more vulnerable and should be treated more carefully, po- tentially with more aggressive antibiotic therapy." n Unnecessary Antibiotic Use in Pediatric Care Can Be Cut Down With Enhanced Communication By Anuja Vaidya I mproving communication between parents and healthcare providers can help reduce the use of unnecessary antibiotics in pediatric care, according to a study published in the Journal of Applied Communication Research. Researchers examined 134 U.S. parents who were given antibiotics to administer to their children. ey were told not to use the antibiotics unless the child's condition worsened within a particular time period. e children were all under 5 years of age. e researchers asked the parents to recount their interactions with their child's healthcare providers, specifically focusing on what they were told to do. ey were also asked if they used the antibiotics. e study shows that only 4 percent of parents — who were told to use antibiotics only if their child's condition did not improve — could remem- ber receiving comprehensive advice for healthcare providers, including information about the infection and the risks of antibiotic overuse. e study also revealed when parents received comprehensive and detailed advice from providers, they were more likely to use antibiotics only if absolutely necessary. Additionally, researchers found parents may not fully understand the consequences of antibiotic resistance even when the providers mention it. us, providers need to more clearly discuss the challenges posed by antibiotic overuse. n Antibiotics Often Avoidable for UTI Treatment, Says Johns Hopkins Physician By Brian Zimmerman P rescribing antibiotics to older adults with urinary tract infections may oen be avoidable, according to a re- search paper penned by omas Finucane, MD, of the Johns Hopkins Geriatrics Center in Baltimore and published in the Journal of the American Geriatrics Society. In the paper, Dr. Finucane argues UTI diagnosis is vague and oen overused to explain changes in the bacterial composition of urine among geriatric patients. e physician cites advances in the scientific understanding of the human microbiome as evidence of the overuse of UTI diagnosis. "Sensitive diagnostic tests now demonstrate that healthy urinary tracts host a ubiquitous, complex microbial community," wrote Dr. Finu- cane. "From this perspective, most people who are treated for a 'UTI' would probably be better off without treatment. Elderly adults, little studied in this regard, face particular risk. Invasive bacterial diseases such as pyelonephritis and bacteremic bacteriuria are also 'UTIs.'" n

• Cover