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Anti-Infective Agents

Editor-in-Chief

ISSN (Print): 2211-3525
ISSN (Online): 2211-3533

Review Article

Antimicrobial Stewardship: Smart Approach to Combat Antibiotic Resistance

Author(s): Manoj S. Dikkatwar, Sharad Chand*, Treesa P. Varghese, Shrishti Shandily, Jeetu Biswas, Supriya Roy, Jitendra Vaghasiya and Rakesh K. Singh

Volume 22, Issue 4, 2024

Published on: 18 January, 2024

Article ID: e180124225736 Pages: 9

DOI: 10.2174/0122113525274628231220062819

Price: $65

Abstract

Antimicrobial resistance (AMR) is a major public health concern worldwide. It raises morbidity and mortality and is connected with substantial/significant economic costs. Effective prevention and treatment of an increasing number of diseases caused by pathogens that can no longer be treated with conventional drugs are threatened by antimicrobial resistance. AMS programme helps to encourage the appropriate use of antimicrobials. The rise and spread of antibiotic resistance and strategies to combat it are the main topics of this review. Antimicrobial stewardship programme is a healthcare strategy that optimizes the use of antibiotics and promotes the appropriate use of antimicrobials through the adoption of evidencebased interventions. AMS programme helps to encourage the right use of antimicrobials. This coordinated approach enhances patient outcomes, reduces microbial resistance, and slows the spread of diseases brought on by multidrug-resistant organisms. The growth of antibiotic resistance and the strategies for battling it have been the main topics of this review.

Graphical Abstract

[1]
Ventola, C.L. The antibiotic resistance crisis: Part 1: Causes and threats. P&T, 2015, 40(4), 277-283.
[PMID: 25859123]
[2]
Hindler, J.F.; Stelling, J. Analysis and presentation of cumulative antibiograms: A new consensus guideline from the Clinical and Laboratory Standards Institute. Clin. Infect. Dis., 2007, 44(6), 867-873.
[http://dx.doi.org/10.1086/511864] [PMID: 17304462]
[3]
Zaman, S.B.; Hussain, M.A.; Nye, R.; Mehta, V.; Mamun, K.T.; Hossain, N. A review on antibiotic resistance: Alarm bells are ringing. Cureus, 2017, 9(6), e1403.
[http://dx.doi.org/10.7759/cureus.1403] [PMID: 28852600]
[4]
Hutchings, M.I.; Truman, A.W.; Wilkinson, B. Antibiotics: Past, present and future. Curr. Opin. Microbiol., 2019, 51, 72-80.
[http://dx.doi.org/10.1016/j.mib.2019.10.008] [PMID: 31733401]
[5]
Dikkatwar, M.; Vaghasiya, J. Antibiogram and antimicrobial stewardship program: Fighting global antimicrobial resistance and rationalizing the antibiotic treatment. J. Young Pharm., 2022, 15(1), 1-8.
[6]
Purohit, M.R.; Lindahl, L.F.; Diwan, V.; Marrone, G.; Lundborg, C.S. High levels of drug resistance in commensal E. coli in a cohort of children from rural central India. Sci. Rep., 2019, 9(1), 6682.
[http://dx.doi.org/10.1038/s41598-019-43227-1] [PMID: 31040380]
[7]
Jeon, J.H.; Jang, K.M.; Lee, J.H.; Kang, L.W.; Lee, S.H. Transmission of antibiotic resistance genes through mobile genetic elements in Acinetobacter baumannii and gene-transfer prevention. Sci. Total Environ., 2023, 857(Pt 2), 159497.
[http://dx.doi.org/10.1016/j.scitotenv.2022.159497] [PMID: 36257427]
[8]
Velhner, M.; Todorović, D.; Novović, K.; Jovčić, B.; Lazić, G.; Kojić, M.; Kehrenberg, C. Characterization of antibiotic resistance in Escherichia coli isolates from Black-headed gulls (Larus ridibundus) present in the city of Novi Sad, Serbia. Vet. Res. Commun., 2021, 45(4), 199-209.
[http://dx.doi.org/10.1007/s11259-021-09801-7 ] [PMID: 34142260]
[9]
Vaghasiya, J.; Vaghasiya, J.; Mansuri, F.; Nath, M.; Chaudhari, M. Susceptibility and resistance pattern of bacterial isolates and development of antibiogram in a tertiary care hospital of western India. JMPAS, 2023, 12(1), 5504-5509.
[http://dx.doi.org/10.55522/jmpas.V12I1.3987]
[10]
Karkman, A.; Do, T.T.; Walsh, F.; Virta, M.P.J. Antibiotic-resistance genes in waste water. Trends Microbiol., 2018, 26(3), 220-228.
[http://dx.doi.org/10.1016/j.tim.2017.09.005] [PMID: 29033338]
[11]
Ibrahim, S.; Al-Saryi, N.; Al-Kadmy, I.M.S.; Aziz, S.N. Multidrug-resistant Acinetobacter baumannii as an emerging concern in hospitals. Mol. Biol. Rep., 2021, 48(10), 6987-6998.
[http://dx.doi.org/10.1007/s11033-021-06690-6] [PMID: 34460060]
[12]
Chakravarty, B. Genetic mechanisms of antibiotic resistance and virulence in Acinetobacter baumannii: Background, challenges and future prospects. Mol. Biol. Rep., 2020, 47(5), 4037-4046.
[http://dx.doi.org/10.1007/s11033-020-05389-4] [PMID: 32303957]
[13]
Murray, C.J.L.; Ikuta, K.S.; Sharara, F.; Swetschinski, L.; Robles, A.G.; Gray, A.; Han, C.; Bisignano, C.; Rao, P.; Wool, E.; Johnson, S.C.; Browne, A.J.; Chipeta, M.G.; Fell, F.; Hackett, S.; Haines-Woodhouse, G.; Kashef Hamadani, B.H.; Kumaran, E.A.P.; McManigal, B.; Achalapong, S.; Agarwal, R.; Akech, S.; Albertson, S.; Amuasi, J.; Andrews, J.; Aravkin, A.; Ashley, E.; Babin, F-X.; Bailey, F.; Baker, S.; Basnyat, B.; Bekker, A.; Bender, R.; Berkley, J.A.; Bethou, A.; Bielicki, J.; Boonkasidecha, S.; Bukosia, J.; Carvalheiro, C.; Castañeda-Orjuela, C.; Chansamouth, V.; Chaurasia, S.; Chiurchiù, S.; Chowdhury, F.; Clotaire Donatien, R.; Cook, A.J.; Cooper, B.; Cressey, T.R.; Criollo-Mora, E.; Cunningham, M.; Darboe, S.; Day, N.P.J.; De Luca, M.; Dokova, K.; Dramowski, A.; Dunachie, S.J.; Duong Bich, T.; Eckmanns, T.; Eibach, D.; Emami, A.; Feasey, N.; Fisher-Pearson, N.; Forrest, K.; Garcia, C.; Garrett, D.; Gastmeier, P.; Giref, A.Z.; Greer, R.C.; Gupta, V.; Haller, S.; Haselbeck, A.; Hay, S.I.; Holm, M.; Hopkins, S.; Hsia, Y.; Iregbu, K.C.; Jacobs, J.; Jarovsky, D.; Javanmardi, F.; Jenney, A.W.J.; Khorana, M.; Khusuwan, S.; Kissoon, N.; Kobeissi, E.; Kostyanev, T.; Krapp, F.; Krumkamp, R.; Kumar, A.; Kyu, H.H.; Lim, C.; Lim, K.; Limmathurotsakul, D.; Loftus, M.J.; Lunn, M.; Ma, J.; Manoharan, A.; Marks, F.; May, J.; Mayxay, M.; Mturi, N.; Munera-Huertas, T.; Musicha, P.; Musila, L.A.; Mussi-Pinhata, M.M.; Naidu, R.N.; Nakamura, T.; Nanavati, R.; Nangia, S.; Newton, P.; Ngoun, C.; Novotney, A.; Nwakanma, D.; Obiero, C.W.; Ochoa, T.J.; Olivas-Martinez, A.; Olliaro, P.; Ooko, E.; Ortiz-Brizuela, E.; Ounchanum, P.; Pak, G.D.; Paredes, J.L.; Peleg, A.Y.; Perrone, C.; Phe, T.; Phommasone, K.; Plakkal, N.; Ponce-de-Leon, A.; Raad, M.; Ramdin, T.; Rattanavong, S.; Riddell, A.; Roberts, T.; Robotham, J.V.; Roca, A.; Rosenthal, V.D.; Rudd, K.E.; Russell, N.; Sader, H.S.; Saengchan, W.; Schnall, J.; Scott, J.A.G.; Seekaew, S.; Sharland, M.; Shivamallappa, M.; Sifuentes-Osornio, J.; Simpson, A.J.; Steenkeste, N.; Stewardson, A.J.; Stoeva, T.; Tasak, N.; Thaiprakong, A.; Thwaites, G.; Tigoi, C.; Turner, C.; Turner, P.; van Doorn, H.R.; Velaphi, S.; Vongpradith, A.; Vongsouvath, M.; Vu, H.; Walsh, T.; Walson, J.L.; Waner, S.; Wangrangsimakul, T.; Wannapinij, P.; Wozniak, T.; Young Sharma, T.E.M.W.; Yu, K.C.; Zheng, P.; Sartorius, B.; Lopez, A.D.; Stergachis, A.; Moore, C.; Dolecek, C.; Naghavi, M. Global burden of bacterial antimicrobial resistance in 2019: A systematic analysis. Lancet, 2022, 399(10325), 629-655.
[http://dx.doi.org/10.1016/S0140-6736(21)02724-0 ] [PMID: 35065702]
[14]
Pakyz, A.L. The utility of hospital antibiograms as tools for guiding empiric therapy and tracking resistance. Pharmacotherapy, 2007, 27(9), 1306-1312.
[http://dx.doi.org/10.1592/phco.27.9.1306] [PMID: 17723084]
[15]
Xu, R.; Polk, R.E.; Stencel, L.; Lowe, D.K.; Guharoy, R.; Duggal, R.W.; Wiest, M.; Putney, K.S.; Flint, N.B. Antibiogram compliance in University Health System Consortium participating hospitals with Clinical and Laboratory Standards Institute guidelines. Am. J. Health Syst. Pharm., 2012, 69(7), 598-606.
[http://dx.doi.org/10.2146/ajhp110332] [PMID: 22441793]
[16]
Dikkatwar, M.; Vaghasiya, J. Development and application of WHONET software in hospital antibiogram. Clin. Epidemiol. Glob. Health, 2023, 24, 101424.
[http://dx.doi.org/10.1016/j.cegh.2023.101424]
[17]
Truong, W.R.; Hidayat, L.; Bolaris, M.A.; Nguyen, L.; Yamaki, J. The antibiogram: Key considerations for its development and utilization. JAC-Antimicrobial Resistance, 2021, 3(2), dlab060.
[http://dx.doi.org/10.1093/jacamr/dlab060] [PMID: 34223122]
[18]
Van Boeckel, T.P.; Gandra, S.; Ashok, A.; Caudron, Q.; Grenfell, B.T.; Levin, S.A.; Laxminarayan, R. Global antibiotic consumption 2000 to 2010: An analysis of national pharmaceutical sales data. Lancet Infect. Dis., 2014, 14(8), 742-750.
[http://dx.doi.org/10.1016/S1473-3099(14)70780-7 ] [PMID: 25022435]
[19]
Okeke, I.N.; Laxminarayan, R.; Bhutta, Z.A.; Duse, A.G.; Jenkins, P.; O’Brien, T.F.; Pablos-Mendez, A.; Klugman, K.P. Antimicrobial resistance in developing countries. Part I: recent trends and current status. Lancet Infect. Dis., 2005, 5(8), 481-493.
[http://dx.doi.org/10.1016/S1473-3099(05)70189-4] [PMID: 16048717]
[20]
Laxminarayan, R.; Duse, A.; Wattal, C.; Zaidi, A.K.M.; Wertheim, H.F.L.; Sumpradit, N.; Vlieghe, E.; Hara, G.L.; Gould, I.M.; Goossens, H.; Greko, C.; So, A.D.; Bigdeli, M.; Tomson, G.; Woodhouse, W.; Ombaka, E.; Peralta, A.Q.; Qamar, F.N.; Mir, F.; Kariuki, S.; Bhutta, Z.A.; Coates, A.; Bergstrom, R.; Wright, G.D.; Brown, E.D.; Cars, O. Antibiotic resistance—the need for global solutions. Lancet Infect. Dis., 2013, 13(12), 1057-1098.
[http://dx.doi.org/10.1016/S1473-3099(13)70318-9 ] [PMID: 24252483]
[21]
Nelson, M.L.; Dinardo, A.; Hochberg, J.; Armelagos, G.J. Brief communication: Mass spectroscopic characterization of tetracycline in the skeletal remains of an ancient population from Sudanese Nubia 350–550 CE. Am. J. Phys. Anthropol., 2010, 143(1), 151-154.
[http://dx.doi.org/10.1002/ajpa.21340] [PMID: 20564518]
[22]
Bassett, E.J.; Keith, M.S.; Armelagos, G.J.; Martin, D.L.; Villanueva, A.R. Tetracycline-labeled human bone from ancient Sudanese Nubia (A.D. 350). Science (80-. ), 1980, 209(4464), 1532-1534.
[http://dx.doi.org/10.1126/science.7001623]
[23]
Miller, W.R.; Munita, J.M.; Arias, C.A. Mechanisms of antibiotic resistance in enterococci. Expert Rev. Anti Infect. Ther., 2014, 12(10), 1221-1236.
[http://dx.doi.org/10.1586/14787210.2014.956092] [PMID: 25199988]
[24]
Aminov, R.I.; Mackie, R.I. Evolution and ecology of antibiotic resistance genes. FEMS Microbiol. Lett., 2007, 271(2), 147-161.
[http://dx.doi.org/10.1111/j.1574-6968.2007.00757.x ] [PMID: 17490428]
[25]
Kobayashi, T.; Nonaka, L.; Maruyama, F.; Suzuki, S. Molecular evidence for the ancient origin of the ribosomal protection protein that mediates tetracycline resistance in bacteria. J. Mol. Evol., 2007, 65(3), 228-235.
[http://dx.doi.org/10.1007/s00239-007-9006-z ] [PMID: 17676364]
[26]
Kumarasamy, K.K.; Toleman, M.A.; Walsh, T.R.; Bagaria, J.; Butt, F.; Balakrishnan, R.; Chaudhary, U.; Doumith, M.; Giske, C.G.; Irfan, S.; Krishnan, P.; Kumar, A.V.; Maharjan, S.; Mushtaq, S.; Noorie, T.; Paterson, D.L.; Pearson, A.; Perry, C.; Pike, R.; Rao, B.; Ray, U.; Sarma, J.B.; Sharma, M.; Sheridan, E.; Thirunarayan, M.A.; Turton, J.; Upadhyay, S.; Warner, M.; Welfare, W.; Livermore, D.M.; Woodford, N. Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: A molecular, biological, and epidemiological study. Lancet Infect. Dis., 2010, 10(9), 597-602.
[http://dx.doi.org/10.1016/S1473-3099(10)70143-2 ] [PMID: 20705517]
[27]
Aminov, R.I. A brief history of the antibiotic era: Lessons learned and challenges for the future. Front. Microbiol., 2010, 1, 134.
[http://dx.doi.org/10.3389/fmicb.2010.00134 ] [PMID: 21687759]
[28]
Jovcic, B.; Lepsanovic, Z.; Suljagic, V.; Rackov, G.; Begovic, J.; Topisirovic, L.; Kojic, M. Emergence of NDM-1 metallo-β-lactamase in Pseudomonas aeruginosa clinical isolates from Serbia. Antimicrob. Agents Chemother., 2011, 55(8), 3929-3931.
[http://dx.doi.org/10.1128/AAC.00226-11 ] [PMID: 21646490]
[29]
Behzadi, P.; García-Perdomo, H.A.; Autrán Gómez, A.M.; Pinheiro, M.; Sarshar, M. Editorial: Uropathogens, urinary tract infections, the host-pathogen interactions and treatment. Front. Microbiol., 2023, 14, 1183236.
[http://dx.doi.org/10.3389/fmicb.2023.1183236 ] [PMID: 37032879]
[30]
Molton, J.S.; Tambyah, P.A.; Ang, B.S.P.; Ling, M.L.; Fisher, D.A. The global spread of healthcare-associated multidrug-resistant bacteria: A perspective from Asia. Clin. Infect. Dis., 2013, 56(9), 1310-1318.
[http://dx.doi.org/10.1093/cid/cit020] [PMID: 23334810]
[31]
Cusack, T.P.; Ashley, E.A.; Ling, C.L.; Roberts, T.; Turner, P.; Wangrangsimakul, T.; Dance, D.A.B. Time to switch from CLSI to EUCAST? A Southeast Asian perspective. Clin. Microbiol. Infect., 2019, 25(7), 782-785.
[http://dx.doi.org/10.1016/j.cmi.2019.03.016] [PMID: 30922928]
[32]
Vasala, A.; Hytönen, V.P.; Laitinen, O.H. Modern tools for rapid diagnostics of antimicrobial resistance. Front. Cell. Infect. Microbiol., 2020, 10, 308.
[http://dx.doi.org/10.3389/fcimb.2020.00308] [PMID: 32760676]
[33]
She, R.C.; Bender, J.M. Advances in rapid molecular blood culture diagnostics: Healthcare impact, laboratory implications, and multiplex technologies. J. Appl. Lab. Med., 2019, 3(4), 617-630.
[http://dx.doi.org/10.1373/jalm.2018.027409] [PMID: 31639730]
[34]
Jin, W.Y.; Jang, S.J.; Lee, M.J.; Park, G.; Kim, M.J.; Kook, J.K.; Kim, D.M.; Moon, D.S.; Park, Y.J. Evaluation of VITEK 2, MicroScan, and phoenix for identification of clinical isolates and reference strains. Diagn. Microbiol. Infect. Dis., 2011, 70(4), 442-447.
[http://dx.doi.org/10.1016/j.diagmicrobio.2011.04.013] [PMID: 21767700]
[35]
van Belkum, A.; Bachmann, T.T.; Lüdke, G.; Lisby, J.G.; Kahlmeter, G.; Mohess, A.; Becker, K.; Hays, J.P.; Woodford, N.; Mitsakakis, K.; Moran-Gilad, J.; Vila, J.; Peter, H.; Rex, J.H.; Dunne, W.M., Jr Developmental roadmap for antimicrobial susceptibility testing systems. Nat. Rev. Microbiol., 2019, 17(1), 51-62.
[http://dx.doi.org/10.1038/s41579-018-0098-9] [PMID: 30333569]
[36]
MacDougall, C.; Polk, R.E. Antimicrobial stewardship programs in health care systems. Clin. Microbiol. Rev., 2005, 18(4), 638-656.
[http://dx.doi.org/10.1128/CMR.18.4.638-656.2005 ] [PMID: 16223951]
[37]
Dyar, O.J.; Huttner, B.; Schouten, J.; Pulcini, C. What is antimicrobial stewardship? Clin. Microbiol. Infect., 2017, 23(11), 793-798.
[http://dx.doi.org/10.1016/j.cmi.2017.08.026] [PMID: 28882725]
[38]
Veerararghavan, B. Hospital Infection Control Guidelines; Indian Council of Medical Research, 2016.
[39]
Pollack, L.A.; Srinivasan, A. Core elements of hospital antibiotic stewardship programs from the centers for disease control and prevention. Clin. Infect. Dis., 2014, 59(S3), S97-S100.
[http://dx.doi.org/10.1093/cid/ciu542]
[40]
Rohde, J.M.; Jacobsen, D.; Rosenberg, D.J. Role of the hospitalist in antimicrobial stewardship: A review of work completed and description of a multisite collaborative. Clin. Ther., 2013, 35(6), 751-757.
[http://dx.doi.org/10.1016/j.clinthera.2013.05.005] [PMID: 23747075]
[41]
Srinivasan, A. Engaging hospitalists in antimicrobial stewardship: The CDC perspective. J. Hosp. Med., 2011, 6(S1), S31-S33.
[http://dx.doi.org/10.1002/jhm.863] [PMID: 21225948]
[42]
Baker, D.W.; Hyun, D.; Neuhauser, M.M.; Bhatt, J.; Srinivasan, A. Leading practices in antimicrobial stewardship: Conference summary. Jt. Comm. J. Qual. Patient Saf., 2019, 45(7), 517-523.
[http://dx.doi.org/10.1016/j.jcjq.2019.04.006] [PMID: 31122789]
[43]
Hurst, A.L.; Child, J.; Pearce, K.; Palmer, C.; Todd, J.K.; Parker, S.K. Handshake stewardship. Pediatr. Infect. Dis. J., 2016, 35(10), 1104-1110.
[http://dx.doi.org/10.1097/INF.0000000000001245] [PMID: 27254036]
[44]
Barlam, T.F.; Cosgrove, S.E.; Abbo, L.M.; MacDougall, C.; Schuetz, A.N.; Septimus, E.J.; Srinivasan, A.; Dellit, T.H.; Falck-Ytter, Y.T.; Fishman, N.O.; Hamilton, C.W.; Jenkins, T.C.; Lipsett, P.A.; Malani, P.N.; May, L.S.; Moran, G.J.; Neuhauser, M.M.; Newland, J.G.; Ohl, C.A.; Samore, M.H.; Seo, S.K.; Trivedi, K.K. Implementing an antibiotic stewardship program: Guidelines by the infectious diseases society of america and the society for healthcare epidemiology of America. Clin. Infect. Dis., 2016, 62(10), e51-e77.
[http://dx.doi.org/10.1093/cid/ciw118] [PMID: 27080992]
[45]
Tamma, P.D.; Avdic, E.; Keenan, J.F.; Zhao, Y.; Anand, G.; Cooper, J.; Dezube, R.; Hsu, S.; Cosgrove, S.E. What is the more effective antibiotic stewardship intervention: Preprescription authorization or postprescription review with feedback? Clin. Infect. Dis., 2017, 64(5), 537-543.
[PMID: 27927861]
[46]
Patel, S.J.; Saiman, L.; Duchon, J.M.; Evans, D.; Ferng, Y.; Larson, E. Development of an antimicrobial stewardship intervention using a model of actionable feedback. Interdiscip. Perspect. Infect. Dis., 2012, 2012, 150367.
[47]
Antimicrobial Stewardship From Principles To Practice; British Society for Antimicrobial Chemotherapy, 2018.
[48]
Patel, S.J.; Saiman, L. Principles and strategies of antimicrobial stewardship in the neonatal intensive care unit. Semin. Perinatol., 2012, 36(6), 431-436.
[http://dx.doi.org/10.1053/j.semperi.2012.06.005 ] [PMID: 23177802]
[49]
Antimicrobial stewardship programmes in health-care facilities in low-and middle-income countries: a WHO practical toolkit; WHO 2019.
[50]
Dikkatwar, M.S.; Mansuri, F.; Chaudhari, M.; Marathe, A. Development of antibiogram for evaluation of antibiotic resistance pattern in tertiary care teaching hospital: A cross-sectional study; Researchsquare, 2020.
[http://dx.doi.org/10.21203/rs.3.rs-96884/v1]
[51]
ASHP statement on the pharmacist’s role in antimicrobial stewardship and infection prevention and control. Am. J. Health Syst. Pharm., 2010, 67(7), 575-577.
[http://dx.doi.org/10.2146/sp100001] [PMID: 20237387]
[52]
Siegel, J.D.; Rhinehart, E.; Jackson, M.; Chiarello, L. 2007 guideline for isolation precautions: preventing transmission of infectious agents in healthcare settings,” in 2007 Guideline for Isolation Precautions., 2019. Available from: https://www.cdc.gov/infectioncontrol/pdf/guidelines/isolation-guidelines-H.pdf
[53]
Parente, D.M.; Morton, J. Role of the pharmacist in antimicrobial stewardship. Med. Clin. North Am., 2018, 102(5), 929-936.
[http://dx.doi.org/10.1016/j.mcna.2018.05.009] [PMID: 30126581]
[54]
Algammal, A.; Hetta, H.F.; Mabrok, M.; Behzadi, P. Editorial: Emerging multidrug-resistant bacterial pathogens “superbugs”: A rising public health threat. Front. Microbiol., 2023, 14, 1135614.
[http://dx.doi.org/10.3389/fmicb.2023.1135614] [PMID: 36819057]

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