Institution
Center for Disease Dynamics, Economics & Policy
Nonprofit•Washington D.C., District of Columbia, United States•
About: Center for Disease Dynamics, Economics & Policy is a nonprofit organization based out in Washington D.C., District of Columbia, United States. It is known for research contribution in the topics: Population & Antibiotic resistance. The organization has 76 authors who have published 320 publications receiving 21403 citations.
Topics: Population, Antibiotic resistance, Drug resistance, Public health, Antimicrobial stewardship
Papers published on a yearly basis
Papers
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TL;DR: The survey results show that colistin is commonly underdosed, and clear guidance is needed on indications, dosing and antibiotic combinations to improve clinical outcomes and delay the emergence of resistance.
Abstract: Polymyxins (polymyxin B and colistin) are older bactericidal antibiotics that are increasingly used to treat infections caused by multidrug-resistant (MDR) Gram-negative bacteria. However, dosing and clinical use of these drugs vary widely. This survey was undertaken to reveal how polymyxins are used worldwide. Data were collected through a structured online questionnaire consisting of 24 questions regarding colistin usage patterns and indications as well as colistin dosage for adult patients. The questionnaire was disseminated in 2011 to relevant experts worldwide and was completed by 284 respondents from 56 different countries. Respondents from 11/56 countries (20%) had no access to colistin; 58/284 respondents (20.4%) reported that in 2010 they experienced that colistin was not available when needed. Formulations of polymyxins used were reported as: colistimethate sodium (48.6%); colistin sulfate (14.1%); both (1.4%); polymyxin B (1.4%); and unknown. Intravenous formulations were used by 84.2%, aerosolised or nebulised colistin by 44.4% and oral colistin for selective gut decontamination by 12.7%. Common indications for intravenous colistin were ventilator-associated pneumonia, sepsis and catheter-related infections with MDR Gram-negative bacteria. Only 21.2% of respondents used a colistin-loading dose, mainly in Europe and North America. This survey reveals that the majority of respondents use colistin and a few use polymyxin B. The survey results show that colistin is commonly underdosed. Clear guidance is needed on indications, dosing and antibiotic combinations to improve clinical outcomes and delay the emergence of resistance. Colistin should be considered a last-resort drug and its use should be controlled. International guidelines are urgently needed.
51 citations
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TL;DR: By 2030, over half of E. coli and K. pneumoniae invasive isolates could become resistant to third generation cephalosporins, according to a global trends of antimicrobial resistance estimate.
51 citations
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TL;DR: The Delhi Neonatal Infection Study followed up a cohort of 88 636 newborn infants for about 3 years in three large hospitals in Delhi, India, and represents one of the largest studies to date of neonatal sepsis and resistance in the Indian subcontinent.
50 citations
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Spanish National Research Council1, University of Seville2, University of Florence3, University of Amsterdam4, University of Verona5, University of British Columbia6, Imperial College London7, University of Edinburgh8, University of Antwerp9, Carlos III Health Institute10, Liverpool School of Tropical Medicine11, Karolinska Institutet12, Karolinska University Hospital13, University of Pittsburgh14, University of Geneva15, Swedish Research Council16, Canadian Institutes of Health Research17, McMaster University18, York University19, University of KwaZulu-Natal20, Center for Disease Dynamics, Economics & Policy21
TL;DR: Antibiotic use in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients during the COVID-19 pandemic has exceeded the incidence of bacterial coinfections and secondary infections suggesting inappropriate and excessive prescribing as discussed by the authors.
Abstract: Antibiotic use in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients during the COVID-19 pandemic has exceeded the incidence of bacterial coinfections and secondary infections, suggesting inappropriate and excessive prescribing. Even in settings with established antimicrobial stewardship (AMS) programmes, there were weaknesses exposed regarding appropriate antibiotic use in the context of the pandemic. Moreover, antimicrobial resistance (AMR) surveillance and AMS have been deprioritised with diversion of health system resources to the pandemic response. This experience highlights deficiencies in AMR containment and mitigation strategies that require urgent attention from clinical and scientific communities. These include the need to implement diagnostic stewardship to assess the global incidence of coinfections and secondary infections in COVID-19 patients, including those by multidrug-resistant pathogens, to identify patients most likely to benefit from antibiotic treatment and identify when antibiotics can be safely withheld, de-escalated or discontinued. Long-term global surveillance of clinical and societal antibiotic use and resistance trends is required to prepare for subsequent changes in AMR epidemiology, while ensuring uninterrupted supply chains and preventing drug shortages and stock outs. These interventions present implementation challenges in resource-constrained settings, making a case for implementation research on AMR. Knowledge and support for these practices will come from internationally coordinated, targeted research on AMR, supporting the preparation for future challenges from emerging AMR in the context of the current COVID-19 pandemic or future pandemics.
50 citations
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University of Liverpool1, University of Sydney2, World Organisation for Animal Health3, Paris Dauphine University4, Imperial College London5, Center for Disease Dynamics, Economics & Policy6, University of Oslo7, University of Exeter8, York University9, University of Oxford10, Boston University11, Harvard University12, Liverpool School of Tropical Medicine13, Mahidol University14, World Health Organization15, University of London16
TL;DR: This multidisciplinary paper proposes three hallmarks that can support robust international antibiotic policy that are Structural, Equitable and Tracked and describes these hallmarks and propose their consideration should aid the design and evaluation of international antibiotic policies with maximal benefit at both local and international scales.
Abstract: There is increasing concern globally about the enormity of the threats posed by antimicrobial resistance (AMR) to human, animal, plant and environmental health. A proliferation of international, national and institutional reports on the problems posed by AMR and the need for antibiotic stewardship have galvanised attention on the global stage. However, the AMR community increasingly laments a lack of action, often identified as an ‘implementation gap’. At a policy level, the design of internationally salient solutions that are able to address AMR’s interconnected biological and social (historical, political, economic and cultural) dimensions is not straightforward. This multidisciplinary paper responds by asking two basic questions: (A) Is a universal approach to AMR policy and antibiotic stewardship possible? (B) If yes, what hallmarks characterise ‘good’ antibiotic policy? Our multistage analysis revealed four central challenges facing current international antibiotic policy: metrics, prioritisation, implementation and inequality. In response to this diagnosis, we propose three hallmarks that can support robust international antibiotic policy. Emerging hallmarks for good antibiotic policies are: Structural, Equitable and Tracked. We describe these hallmarks and propose their consideration should aid the design and evaluation of international antibiotic policies with maximal benefit at both local and international scales.
49 citations
Authors
Showing all 83 results
Name | H-index | Papers | Citations |
---|---|---|---|
David L. Smith | 96 | 331 | 47666 |
Amit Verma | 70 | 497 | 16162 |
Ramanan Laxminarayan | 67 | 287 | 25009 |
Niranjan Kissoon | 63 | 512 | 36599 |
Eili Y. Klein | 35 | 136 | 5996 |
Daniel J. Morgan | 32 | 133 | 3950 |
Carlos A Guerra | 28 | 31 | 10649 |
Thomas P. Van Boeckel | 28 | 52 | 8106 |
Anup Malani | 27 | 117 | 2384 |
Daniel J. Morgan | 27 | 60 | 2156 |
Sumanth Gandra | 24 | 67 | 6229 |
Arnaud Le Menach | 22 | 32 | 2288 |
Arthorn Riewpaiboon | 21 | 91 | 1269 |
Elena Martinez | 17 | 39 | 1774 |
Susmita Chatterjee | 17 | 50 | 1693 |