TY - JOUR
T1 - Identifying Targets for Antibiotic Use for the Management of Carbapenem-Resistant Acinetobacter baumannii (CRAb) in Hospitals—A Multi-Centre Nonlinear Time-Series Study
AU - Al-Hashimy, Zainab Said
AU - Conway, Barbara R.
AU - Al-Yaqoobi, Mubarak
AU - Khamis, Faryal
AU - Al Mawali, Ghalib Zahran
AU - Al Maashani, Aisha Mahad
AU - Al Hadhrami, Yaqoob Said
AU - Al Alawi, Said Salim
AU - Al Mamari, Mohammed Said
AU - Lattyak, William J.
AU - Lattyak, Elizabeth A.
AU - Aldiab, Motasem
AU - Gould, Ian
AU - López-Lozano, José María
AU - Aldeyab, Mamoon A.
N1 - Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2022/6/7
Y1 - 2022/6/7
N2 - Solutions are needed to inform antimicrobial stewardship (AMS) regarding balancing the access to effective antimicrobials with the need to control antimicrobial resistance. Theoretical and mathematical models suggest a non-linear relationship between antibiotic use and resistance, indicating the existence of thresholds of antibiotic use beyond which resistance would be triggered. It is anticipated that thresholds may vary across populations depending on host, environment, and organism factors. Further research is needed to evaluate thresholds in antibiotic use for a specific pathogen across different settings. The objective of this study is to identify thresholds of population antibiotic use associated with the incidence of carbapenem-resistant Acinetobacter baumannii (CRAb) across six hospital sites in Oman. The study was an ecological, multi-centre evaluation that involved collecting historical antibiotic use and CRAb incidence over the period from January 2015 to December 2019. By using non-linear time-series analysis, we identified different thresholds in the use of third-generation cephalosporins, piperacillin-tazobactam, aminoglycoside, and fluoroquinolones across participating hospitals. The identification of different thresholds emphasises the need for tailored analysis based on modelling data from each hospital. The determined thresholds can be used to set targets for each hospital AMS, providing a balance between access to these antibiotics versus controlling CRAb incidence.
AB - Solutions are needed to inform antimicrobial stewardship (AMS) regarding balancing the access to effective antimicrobials with the need to control antimicrobial resistance. Theoretical and mathematical models suggest a non-linear relationship between antibiotic use and resistance, indicating the existence of thresholds of antibiotic use beyond which resistance would be triggered. It is anticipated that thresholds may vary across populations depending on host, environment, and organism factors. Further research is needed to evaluate thresholds in antibiotic use for a specific pathogen across different settings. The objective of this study is to identify thresholds of population antibiotic use associated with the incidence of carbapenem-resistant Acinetobacter baumannii (CRAb) across six hospital sites in Oman. The study was an ecological, multi-centre evaluation that involved collecting historical antibiotic use and CRAb incidence over the period from January 2015 to December 2019. By using non-linear time-series analysis, we identified different thresholds in the use of third-generation cephalosporins, piperacillin-tazobactam, aminoglycoside, and fluoroquinolones across participating hospitals. The identification of different thresholds emphasises the need for tailored analysis based on modelling data from each hospital. The determined thresholds can be used to set targets for each hospital AMS, providing a balance between access to these antibiotics versus controlling CRAb incidence.
KW - Acinetobacter baumannii
KW - alcohol-based hand rub
KW - antibacterial agents
KW - antibiotic consumption
KW - antibiotic stewardship
KW - carbapenem-resistant Enterobacteriaceae
KW - hand sanitizers
KW - non-linear time-series analysis
KW - thresholds
UR - http://www.scopus.com/inward/record.url?scp=85132293531&partnerID=8YFLogxK
U2 - 10.3390/antibiotics11060775
DO - 10.3390/antibiotics11060775
M3 - Article
AN - SCOPUS:85132293531
VL - 11
JO - Antibiotics
JF - Antibiotics
SN - 2079-6382
IS - 6
M1 - 775
ER -