Antibiotic Stewardship during COVID-19

A special issue of Antibiotics (ISSN 2079-6382).

Deadline for manuscript submissions: closed (31 July 2021) | Viewed by 11422

Special Issue Editor


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Guest Editor
School of Medicines, Wayne State University, Detroit, MI, USA
Interests: medicine; clinical

Special Issue Information

Dear Colleagues,

Antibiotic stewardship has been a cornerstone for tackling the current global pandemic of antibiotic resistance. However, the COVID-19 pandemic has challenged us in every field of medicine, including the appropriate use of antibiotics. The parallel pandemic of antibiotic resistance cannot wait for COVID-19 to disappear. We have to implement stronger stewardship practices to ensure judicious antibiotic use, especially during these unprecedented times. Therefore, the main subject of this Special Issue includes Novel Antibiotic Stewardship methods that can be implemented during pandemics in various health care settings, including acute care hospitals and post-acute care.

Prof. Dr. Teena Chopra
Guest Editor

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Keywords

  • Antibiotic Resistance
  • Antibiotic Stewarship
  • COVID-19

Published Papers (3 papers)

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Review

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12 pages, 295 KiB  
Review
Potential Roles for Probiotics in the Treatment of COVID-19 Patients and Prevention of Complications Associated with Increased Antibiotic Use
by Ravina Kullar, Stuart Johnson, Lynne V. McFarland and Ellie J. C. Goldstein
Antibiotics 2021, 10(4), 408; https://doi.org/10.3390/antibiotics10040408 - 09 Apr 2021
Cited by 21 | Viewed by 4627
Abstract
Medical care for patients hospitalized with COVID-19 is an evolving process. Most COVID-19 inpatients (58–95%) received empiric antibiotics to prevent the increased mortality due to ventilator-associated pneumonia and other secondary infections observed in COVID-19 patients. The expected consequences of increased antibiotic use include [...] Read more.
Medical care for patients hospitalized with COVID-19 is an evolving process. Most COVID-19 inpatients (58–95%) received empiric antibiotics to prevent the increased mortality due to ventilator-associated pneumonia and other secondary infections observed in COVID-19 patients. The expected consequences of increased antibiotic use include antibiotic-associated diarrhea (AAD) and Clostridioides difficile infections (CDI). We reviewed the literature (January 2020–March 2021) to explore strategies to reduce these consequences. Antimicrobial stewardship programs were effective in controlling antibiotic use during past influenza epidemics and have also been shown to reduce healthcare-associated rates of CDI. Another potential strategy is the use of specific strains of probiotics shown to be effective for the prevention of AAD and CDI prior to the pandemic. During 2020, there was a paucity of published trials using these two strategies in COVID-19 patients, but trials are currently ongoing. A multi-strain probiotic mixture was found to be effective in reducing COVID-19-associated diarrhea in one trial. These strategies are promising but need further evidence from trials in COVID-19 patients. Full article
(This article belongs to the Special Issue Antibiotic Stewardship during COVID-19)
25 pages, 12725 KiB  
Review
Diarylureas: Repositioning from Antitumor to Antimicrobials or Multi-Target Agents against New Pandemics
by Alessia Catalano, Domenico Iacopetta, Michele Pellegrino, Stefano Aquaro, Carlo Franchini and Maria Stefania Sinicropi
Antibiotics 2021, 10(1), 92; https://doi.org/10.3390/antibiotics10010092 - 19 Jan 2021
Cited by 36 | Viewed by 3551
Abstract
Antimicrobials have allowed medical advancements over several decades. However, the continuous emergence of antimicrobial resistance restricts efficacy in treating infectious diseases. In this context, the drug repositioning of already known biological active compounds to antimicrobials could represent a useful strategy. In 2002 and [...] Read more.
Antimicrobials have allowed medical advancements over several decades. However, the continuous emergence of antimicrobial resistance restricts efficacy in treating infectious diseases. In this context, the drug repositioning of already known biological active compounds to antimicrobials could represent a useful strategy. In 2002 and 2003, the SARS-CoV pandemic immobilized the Far East regions. However, the drug discovery attempts to study the virus have stopped after the crisis declined. Today’s COVID-19 pandemic could probably have been avoided if those efforts against SARS-CoV had continued. Recently, a new coronavirus variant was identified in the UK. Because of this, the search for safe and potent antimicrobials and antivirals is urgent. Apart from antiviral treatment for severe cases of COVID-19, many patients with mild disease without pneumonia or moderate disease with pneumonia have received different classes of antibiotics. Diarylureas are tyrosine kinase inhibitors well known in the art as anticancer agents, which might be useful tools for a reposition as antimicrobials. The first to come onto the market as anticancer was sorafenib, followed by some other active molecules. For this interesting class of organic compounds antimicrobial, antiviral, antithrombotic, antimalarial, and anti-inflammatory properties have been reported in the literature. These numerous properties make these compounds interesting for a new possible pandemic considering that, as well as for other viral infections also for CoVID-19, a multitarget therapeutic strategy could be favorable. This review is meant to be an overview on diarylureas, focusing on their biological activities, not dwelling on the already known antitumor activity. Quite a lot of papers present in the literature underline and highlight the importance of these molecules as versatile scaffolds for the development of new and promising antimicrobials and multitarget agents against new pandemic events. Full article
(This article belongs to the Special Issue Antibiotic Stewardship during COVID-19)

Other

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9 pages, 1907 KiB  
Brief Report
Antibiotic Use during the COVID-19 Pandemic in a Tertiary Hospital with an Ongoing Antibiotic Stewardship Program
by Oryan Henig, Orli Kehat, Suzy E. Meijer, Amanda Chikly, Ahuva Weiss-Meilik, Eyal Egoz, Ronen Ben-Ami and Yael Paran
Antibiotics 2021, 10(9), 1056; https://doi.org/10.3390/antibiotics10091056 - 31 Aug 2021
Cited by 13 | Viewed by 2519
Abstract
During the recent pandemic, the fact that the clinical manifestation of COVID-19 may be indistinguishable from bacterial infection, as well as concerns of bacterial co-infection, have been associated with an increased use of antibiotics. The objective of this study was to assess the [...] Read more.
During the recent pandemic, the fact that the clinical manifestation of COVID-19 may be indistinguishable from bacterial infection, as well as concerns of bacterial co-infection, have been associated with an increased use of antibiotics. The objective of this study was to assess the effect of targeted antibiotic stewardship programs (ASP) on the use of antibiotics in designated COVID-19 departments and to compare it to the antibiotic use in the equivalent departments in the same periods of 2018 and 2019. Antibiotic consumption was assessed as days of treatment (DOT) per 1000 patient days (PDs). The COVID-19 pandemic was divided into three periods (waves) according to the pandemic dynamics. The proportion of patients who received at least one antibiotic was significantly lower in COVID-19 departments compared to equivalent departments in 2018 and 2019 (Wave 2: 30.2% vs. 45.6% and 44.9%, respectively; Wave 3: 30.5% vs. 47.8% and 50.1%, respectively, p < 0.001). The DOT/1000PDs in every COVID-19 wave was lower than during similar periods in 2018 and 2019 (179-282 DOT/1000PDs vs. 452-470 DOT/1000PDs vs. 426-479 DOT/1000PDs, respectively). Moreover, antibiotic consumption decreased over time during the pandemic. In conclusion, a strong ASP is effective in restricting antibiotic consumption, particularly for COVID-19 which is a viral disease that may mimic bacterial sepsis but has a low rate of concurrent bacterial infection. Full article
(This article belongs to the Special Issue Antibiotic Stewardship during COVID-19)
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