Antibiotic Policies: Fighting Resistance

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1 Antibiotic Policies: Fighting Resistance

3 Antibiotic Policies: Fighting Resistance Edited by Ian M Gould Aberdeen Royal Infirmary Foresterhill, Aberdeen Australia and Jos WM van der Meer Radboud University Nijmegen Medical Centre Nijmegen, The Netherlands

4 Ian M Gould Department of Medical Microbiology Aberdeen Royal Infirmary Foresterhill, Aberdeen Australia Jos WM van der Meer Department of General Internal Medicine & Nijmegen University Centre for Infectious Diseases Radboud University Nijmegen Medical Centre Nijmegen, The Netherlands ISBN-13: e-isbn-13: Library of Congress Control Number: Springer Science Business Media, LLC. All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer Science Business Media, LLC, 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights. Printed on acid-free paper springer.com

5 Contents List of Contributors Foreword Preface vii xi xiii 1. Consequences of Antimicrobial Chemotherapy: Overgrowth, Resistance, and Virulence Stephanie J. Dancer 2. The Process of Antibiotic Prescribing: Can It Be Changed? Jos W. M. van der Meer and Richard P. T. M. Grol 3. Cultural and Socioeconomic Determinants of Antibiotic Use Stephan Harbarth and Dominique L. Monnet 4. Electronic Prescribing Mical Paul, Roberto Cauda, and Leonard Leibovici 5. Prevalence Surveys of Antimicrobial Use in Hospitals: Purpose, Practicalities, and Pitfalls R. Andrew Seaton 6. Antibiotic Use in Hospitals in the United States SCOPE-MMIT Antimicrobial Surveillance Network Amy Pakyz and Ron Polk 7. New Hospital Initiatives in Fighting Resistance Fiona Cooke and Alison Holmes 8. Antimicrobial Resistance: Preventable or Inevitable? Problem of the Era from Two Perspectives Duygu Yazgan Aksoy, Mine Durusu Tanriover, and Serhat Unal v

6 vi Contents 9. Fighting Antimicrobial Resistance in the Mediterranean Region Michael A. Borg 10. Cystic Fibrosis Coping with Resistance Oana Ciofu and Neils Høiby 11. Community-Acquired Pneumonia Back to Basics Marc J. M. Bonten and Jan Jelrik Oosterheert 12. Hospital-Acquired Pneumonia: Diagnostic and Treatment Options Maria V. Torres, Patricia Muñoz, and Emilio Bouza 13. Optimizing Antimicrobial Chemotherapy in the ICU A Review Ian M. Gould 14. Risk Assessment for Methicillin-Resistant Staphylococcus aureus Evelind Tacconelli 15. What Do We Do with Methicillin-Resistant Staphylococcus aureus in Surgery? Giorgio Zanetti 16. Control of Healthcare-Associated Methicillin-Resistant Staphylococcus aureus Jan A. J. W. Kluytmans and Bram M. W. Diederen Index

7 Contributors Duygu Yazgan Aksoy Department of Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey Marc J. M. Bonten Department of Internal Medicine and Infectious Diseases, University Medical Centre, Utrecht, The Netherlands Michael A. Borg ARMed Project, St. Luke s Hospital, Guardamangia, Malta Emilio Bouza Department of Clinical Microbiology and Infectious Diseases, Hospital General, Universitario Gregorio Marañón, Universidad Complutense, Madrid, Spain Roberto Cauda Department of Infectious Disease, Gemelli Hospital, Università Cattolica del Sacro Cuore Medical School, Rome, Italy Oana Ciofu Institute of Medical Microbiology and Immunology, University of Copenhagen, Copenhagen, Denmark Fiona Cooke MRC Clinical Research Training Fellow, Imperial College London, London, United Kingdom, The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom Stephanie J. Dancer Department of Microbiolog, Southern General Hospital, Glasgow, Scotland vii

8 viii Contributors Bram M. W. Diederen Laboratory of Medical Microbiology and Immunology, St. Elisabeth Hospital, Tilburg, The Netherlands Ian M. Gould Department of Medical Microbiology, Aberdeen Royal Infirmary, Foresterhill, Aberdeen, Australia Richard P. T. M. Grol Department of General Practice, Centre for Quality of Care Research, Radboud University, Nijmegen, The Netherlands Stephan Harbarth Infection Control Program, University Hospitals of Geneva, Geneva, Switzerland Niels Høiby Institute of Medical Microbiology and Immunology, University of Copenhagen, Department of Clinical Microbiology and Danish Cystic Fibrosis Center, Rigshospitalet, Copenhagen, Denmark Alison Holmes Department of Infectious Diseases, Imperial College London and Hammersmith Hospitals NHS Trust, London, United Kingdom Jan A. J. W. Kluytmans Laboratory of Microbiology and Infection Control, Amphia Hospital, Breda, The Netherlands Leonard Leibovici Department of Medicine E, Rabin Medical Center, Beilinson Hospital, Petah Tiqwa, Israel, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel Dominique L. Monnet National Center for Antimicrobials and Infection Control, Statens Serum Institut, Copenhagen, Denmark Patricia Muñoz Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Universidad Complutense, Madrid, Spain Jan Jelrik Oosterheert Department of Internal Medicine and Infectious Diseases, University Medical Centre, Utrecht, The Netherlands

9 Contributors ix Amy Pakyz School of Pharmacy, Department of Pharmacy, Virginia Commonwealth University, Medical College of Virginia Campus, Richmond, VA, USA Mical Paul Department of Medicine E, Rabin Medical Center, Beilinson Hospital, Petah Tiqwa, Israel, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel Ron Polk School of Pharmacy, Department of Pharmacy, School of Medicine, Department of Internal Medicine, Virginia Commonwealth University, Medical College of Virginia Campus, Richmond, VA, USA R. Andrew Seaton Infectious Diseases Unit, Brownlee Centre, Gartnavel General Hospital, Glasgow, Scotland E. Tacconelli Department of Infectious Diseases, Catholic University, Rome, Italy, Division of Infectious Diseases, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA Mine Durusu Tanriover Department of Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey María V. Torres Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Universidad Complutense, Madrid, Spain Serhat Unal Department of Medicine, Section of Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey Jos W. M. van der Meer Department of General Internal Medicine & Nijmegen University Centre for Infectious Diseases, Radboud University, Nijmegen Medical Centre, Nijmegen, The Netherlands Giorgio Zanetti Division of Hospital Preventive Medicine and Service of Infectious Diseases, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland

11 Foreword In 1971, I started a fellowship in infectious diseases and medical microbiology at the Channing Laboratory of the Harvard Medical Service at Boston City Hospital. My mentor, Dr. Maxwell Finland, had encouraged me to return there from the Center for Disease Control (as CDC was known then), where I had studied infectious diseases epidemiology and hospital-associated infection epidemiology, with the idea that we would review the demographic patterns of bacteremia and several other infections during Dr. Finland s long tenure at the hospital. We did so, but I was surprised to find that he also invited me to help with the assessment of the success or failure of the programs to control antimicrobial use that he and colleagues had put into place at the hospital over several years. The paper describing that review finally was published in 1974, after a long and tortuous process of review at several journals. Several reviewers felt that such attempts to improve use amounted to interference with the patient s physician to do what was best. Others felt that such programs focused incorrectly on a subject other than treating the current patient. Fortunately, today, it is clear that antimicrobial resistance results in major part, but not entirely, from the ways that we use antimicrobial agents, and that the overall interests of patients in general, as well as those of society, are well served by efforts to use these drugs as well as possible. Many nations have established rubrics for this, and guidelines on such stewardship now have been published by professional societies such as the Infectious Diseases Society of America. The principle, then, now is well-established. The problem remains, however, as to the best way to accomplish this lofty goal. In the three decades that I have been involved in looking at this problem, two important guides stand out: 1. All attempts to deal with resistance must be local. The problems of multidrug-resistant bacteria facing a hospital in Manchester, U.K. may be quite different than those of a hospital in Manchester, New Hampshire, USA (and, in fact, may be quite different than those of a hospital just down the street from the one in Manchester, U.K.). Knowing local patterns of resistance is crucial to selection of the proper plans to improve antimicrobial use in each local setting. xi

12 xii Foreword 2. One size does not fit all. No single dictum or nostrum can be devised that will deal with the resistance patterns, resources, and other risk determinants for resistance in every healthcare institution. Rigid national guidelines that work in all regions do not exist. Rigid regional guidelines that work in all local areas do not exist. Rigid municipal guidelines that work in all healthcare institutions and settings in the city do not exist. Instead, efforts should focus as suggested by the recent guidelines on dealing with multidrug resistant organisms in U.S. healthcare settings from the Centers for Disease Control and Prevention (as CDC is known now). These recommendations stress that each institution must customize its own approach to improving drug use, to controlling transmission of resistant organisms within the institution, and to conducting the surveillance needed to guide these efforts. This volume, edited by Ian Gould and Jos van der Meer, appeals to me because it recognizes these two main principles in its advice to the worker in this field. The chapters come from many experts in many different countries who work in many different settings. They focus on practical issues of improving antimicrobial use, and consider several tools, old and new, useful in this quest. The authors speak from experience, as they work in their daily practice on the very issues that they address. All these features, plus the guiding hands of Drs. Gould and van der Meer, who have helped us understand these matters for many years, suggest that the reader will find this new compendium a valuable and practical resource. The area of improving antimicrobial use is one that will continue to vex us for many years. However, the goal of such efforts makes the journey worth the fret. Books such as these make the journey easier. John McGowan

13 Preface Possibly the main need for antibiotic policies is to control resistance. There is a large body of published literature on the ability of antibiotic policies to do this but robust evidence is harder to find. Often implementation is difficult, benefits are only short term or the situation is too complex in the first place for there to be any significant changes. This volume (and the previous one in the series) deals with these issues and also looks at many of the crucial issues of resistance in a clinical context, with an emphasis on MRSA; surely the greatest challenge to our antibiotic and infection control policies that modern healthcare systems have ever seen. Other fascinating chapters explore the psychology of prescribing, modern management techniques as an adjunct to antibiotic policies, and the less obvious downsides of antibiotic use. Lastly, several chapters from authors living in Mediterranean countries give a perspective from an area of the world with some of the greatest problems in antibiotic use and resistance. It is again a great pleasure for us to have been able to assemble such a distinguished group of international scientists to write definitive texts on these pressing problems. xiii

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