Researchers from the University of Dundee have developed a new strategy for prescribing antibiotics that could reduce patient harm and help combat the rise in antibiotic resistance.

A new study found that a new prescribing protocol could significant reduce potential misuse of antibiotics.

The research followed over 500 patients with lower respiratory tract infections during the course of one year. The new prescribing protocol included automatic stop dates, with time limits on prescriptions depending on the severity of an infection, coupled with support from pharmacists to ensure that antibiotics were issued with stop dates that were clearly visible for patients.

During the first half of the 12-month trial, researchers monitored patients’ current duration of antibiotic use. In the second half, patients receiving antibiotics followed the new prescribing strategy. During both phases of this study, researchers monitored antibiotic side-effects, including new symptoms occurring during the period of antibiotic exposure that were potentially caused by the antibiotics. They also monitored patients’ length of stay in hospital and death rates.

The study found that when the new protocol was followed, there was a near 20 per cent reduction in antibiotic use and an associated 40 per cent reduction in antibiotic-related side-effects.

Dr Matthew Lloyd, lead author from the University’s School of Medicine, said, ‘The threat from growing resistance to antibiotics is increasing, which is in part attributable to inappropriately lengthy courses of antibiotics.

‘Our study aimed to implement a simple system for preventing patients taking antibiotics for longer than they should. The results were promising and found that through prescribing automatic stop dates and working with our multidisciplinary colleagues, we can help prevent this problem and reduce patient harm.’ University of Dundee

Research jointly conducted by investigators at Institut Gustave Roussy, Inserm, Institut Pasteur and INRA (French National Agronomic Research Institute) has led to a rather surprising discovery on the manner in which cancer chemotherapy treatments act more effectively with the help of the intestinal flora (also known as the intestinal microbiota). Indeed, the researchers have just shown that the efficacy of one of the molecules most often used in chemotherapy relies to an extent on its capacity to mobilise certain bacteria from the intestinal flora toward the bloodstream and lymph nodes. Once inside the lymph nodes, these bacteria stimulate fresh immune defences that then enhance the body

The Journal of Hospital Infection (JHI) has just released the awaited epic3 guidelines on infection prevention and control for a range of healthcare professionals. They are freely available online on ScienceDirect and on the journal’s website.
The guidelines were commissioned by the UK Department of Health and have been developed after a systematic and expert review of all the available scientific evidence. They update and supersede the previous guidelines on this topic published in 2007.
Infection prevention and control came to the public awareness after the rise of MRSA and C. difficile in particular in the middle of the last decade. Since the publication of the 2007 guidelines, more resistant organisms have emerged, some of which are now almost untreatable by antimicrobials. This is actually no great surprise, as the development of resistance to antibiotics is an inevitable consequence of evolution- microbes have been producing chemical weapons to destroy each other since the dawn of life on earth. Resistance means survival. There are no really new antimicrobial agents under development, and for the first time, we are facing a world where more bacterial infections may be untreatable. Contrary to popular belief, we always had several treatment options available to treat MRSA.
Microbiologist Dr Jenny Child, Editor in Chief of The Journal of Hospital Infection, said ‘It is difficult to stop the rise of increasingly resistant organisms. What we can do however is prevent them spreading between patients and becoming established among the resident microbial flora- the bacterial population in our hospitals. Infection prevention and control has never been more important than it is now.’
It is no coincidence that the very first of the seven key action points outlined in the UK 5-year Antimicrobial Resistance Strategy 2013-1018, produced earlier this year by the DoH and DEFRA, is about improving infection prevention and control.
In her Forward to the epic3 Guidelines, which will accompany the January 2014 printed issue of The Journal of Hospital Infection, Professor Dame Sally Davies, NHS England’s Chief Medical Officer, said, ‘In March 2013, my Annual Report on ‘Infection and the rise of antimicrobial resistance’ highlighted the need for healthcare professionals to understand and put into practice the principles of infection prevention and control in order to improve patient outcomes. These updated guidelines underpin and provide the knowledge base to inform this understanding’.
‘The guidelines provide the evidence base for many elements of clinical practice that are essential in minimizing the spread of antimicrobial-resistant organisms, and maintaining high standards of infection prevention and control that can be adapted for use locally by all healthcare practitioners. The principles set out in these guidelines also provide the evidence base to support elements of the implementation of the 5-year UK Antimicrobial Resistance Strategy,’ Davies added. EurekAlert

Certain pediatric surgeries carry such low risk of serious blood loss that clinicians can safely forgo expensive blood typing and blood stocking before such procedures, suggest the results of a small study by researchers at the Johns Hopkins Children