International journal of antimicrobial agents
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Int. J. Antimicrob. Agents · Feb 2019
Similarities and differences in antimicrobial prescribing between major city hospitals and regional and remote hospitals in Australia.
Many regional and remote hospitals (RRHs) do not have the specialist services that usually support antimicrobial stewardship (AMS) programmes in major city hospitals. It is not known if this is associated with higher rates of inappropriate antimicrobial prescribing. The aim of this study was to identify similarities and differences in antimicrobial prescribing patterns between major city hospitals and RRHs in Australia. ⋯ To the authors' knowledge, this is the largest study to date comparing antimicrobial prescribing of RRHs with major city hospitals. A key finding was that antimicrobial prescribing was more frequently inappropriate for some high-risk infections treated in RRHs. Targeted strategies that support appropriate antimicrobial prescribing in RRHs are required.
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Int. J. Antimicrob. Agents · Feb 2019
In vitro activity of cefiderocol, a siderophore cephalosporin, against a recent collection of clinically relevant carbapenem-non-susceptible Gram-negative bacilli, including serine carbapenemase- and metallo-β-lactamase-producing isolates (SIDERO-WT-2014 Study).
Cefiderocol is a siderophore cephalosporin in development for treatment of infections caused by Gram-negative bacilli, including carbapenem-resistant and multidrug-resistant isolates. β-Lactamase carriage and in vitro activity of cefiderocol were determined against 1272 meropenem-non-susceptible isolates of Enterobacteriaceae, Pseudomonas aeruginosa and Acinetobacter baumannii collected as part of the SIDERO-WT-2014 surveillance study. Minimum inhibitory concentration (MIC) values for cefiderocol were ≤4 µg/mL against 97.7% of tested isolates, including 100% of IMP-positive (range, 1-2 µg/mL), OXA-58-positive (MIC90, 1 µg/mL), KPC-positive (MIC90, 2 µg/mL), VIM-positive (MIC90, 2 µg/mL), and OXA-48-like-positive (MIC90, 4 µg/mL) isolates; 99.3% of carbapenemase-negative isolates (MIC90, 1 µg/mL); 97.2% of OXA-23-positive isolates (MIC90, 1 µg/mL); 95.2% of OXA-24-positive isolates (MIC90, 1 µg/mL); 91.7% of GES-positive isolates (MIC90, 4 µg/mL); and 64.3% of NDM-positive isolates (MIC90, 8 µg/mL). ⋯ Cefiderocol MICs were also ≤4 µg/mL against 99.3% of 136 colistin-resistant Enterobacteriaceae collected as part of the SIDERO-WT-2014 study, including isolates carrying mcr-1 (MIC90, 2 µg/mL). Cefiderocol demonstrated potent in vitro activity against a collection of carbapenemase-producing and carbapenemase-negative meropenem-non-susceptible Gram-negative bacilli for which few treatment options are available, including the majority of metallo-β-lactamase producing isolates identified.