Fresh summary of Day 3 will help U to keep track of #AntimicrobialStewardship at #ECCMID when back home

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Day #3 was also a good day at #ECCMID2016. Also many things to remark from the #AntimimicrobialStewardship (AS) perspective for those who could not attend the conference and even for those who attended but want to keep track of #AS. So, let´s start.

If your ASP needs to prove significant economic outcomes (By the way, do you know many ASPs that doesn´t need?), anti fungal stewardship is one of the most efficient interventions. Dr Muñoz from Madrid, Spain and Dr. Thursky from Australia dealt with anti fungal stewardship at a very nice a meet-the-expert (ME-083) early in the morning.

 

Very interesting oral communications in the “New insights in the control of multi-resistant Gram-negatives” session (OS089). Of note, Evelina Taconelli´s SATURNs study (#O381) results. This is a big study in which over 10,000 patients were screened at least on admission an at discharge. Rectal colonization by ESBL-E rose from 11%, baseline, to 28% at discharge, at least in those patients who received antibiotics (if you follow the thread here, you´ll get some extra input). In this session, Bonten’s group from Netherlands presented nice study (#O380) trying to address what proportion of new ESBL-E detected during admission are hospital-acquired and how much of it is due to cross-transmission or to other reasons (e.g. antibiotic selection). A lot of modelling under the hood, but interesting, anyhow.

 

radarThe “Clinical trials in community-acquired pneumonia” (OS095) session came along with many remarkable presentations (see the whole list here) from the #AntimicrobialStewardship perspective. I´ll go for #O405 an oral presentation, again from Boten’s group, this time with a substudy of the landmark CAP trial (cluster-RCT published this year in the NEJM, mentioned in several sessions this ECCMID). Thinking out of the box, authors aimed to assess how would RADAR methodology have performed if the CAP trial was an antimicrobial stewardship intervention (b-lactam arm = intervention; Fluoroquinolone arm = control). As far as I know is one of the first times that it has been put into practice so I recommend that you keep this presentation under your radar because it will help you to understand RADAR foundation. Interestingly, global score (clinical & antibiotic parameters) favored the intervention, despite (mildly) worse clinical outcomes. Is that possible (methodological issue) or acceptable (ethical issue)? 

Some other interesting sessions to keep track of (I mean, to watch at home if you missed them) were:

 

To end up, here pu have Bojana Beovic´s, ESGAP president review of Day 3 posters on AS at ECCMID:

 

Today, a paper poster session was devoted to education and competencies in antimicrobial stewardship. The presented poster showed a mosaic of different curricula and cultural backgrounds defining the students’ and young doctors’ knowledge and perspectives on AMR-AMS. There is an impression that in many places, the education of health-care professionals lags behind the current urgent AMR situation.

 

  • Two posters addressed undergraduate students’ preparedness in relation to prudent antibiotic prescribing in Sweden (#P1304) and France (#P1303). The posters using the same methodology show great differences which seems to reflect the differences in curricula but also cultural differences that should be further explored.

 

  • The authors from UK looked at the implementation of the recently published competencies for antimicrobial prescribing and stewardship (#P1303). The results are quite encouraging, the courses include more than three quarters of the competencies statements.

 

  • Another group of UK authors looked at the specialty curricula in UK (#P1300): the coverage of AMS-AMR with exception of ID/CM was found to be very poor, which is especially worrisome for haematology, nephrology and intensive care.

 

  • Two studies, one from United Arab Emirates (#P1301) and the other from Southern EU countries (#P1302) showed that the students and residents are not aware of their own role in antibiotic prescribing stating that overprescribing is more a problem of other doctors than their own. Did you doubt about it?

 

 

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