Antibiotic treatment for H. pylori is in trouble; antibiotic-resistant E. coli may not be caused by food. Plus more important research ICYMI, at-a-glance.
Antibiotic resistance still rising. Resistance to antibiotics regularly taken for Helicobactor pylori infection has more than doubled in 20 years, according to a study of 18 European countries. Resistance to clarithromycin increased to 21.6% last year from 9.9% in 1998. Increases were also seen for levofloxacin and metronidazole. High levels of resistance have been attributed to overconsumption of antibiotics for cold, flu, and other conditions as well as lack of institutional support for antibiotic resistance containment strategies. The research was presented on October 21 at United European Gastroenterology Week Barcelona 2019.
New class of antibiotics to fight resistance. Citing a need for new antibiotics against Gram-negative pathogens that are resistant to carbapenem and third-generation cephalosporins, Swiss researchers reported the discovery of a new family of synthetic antibiotics that possess broad-spectrum anti-Gram-negative antimicrobial activity. The antibiotics effectively kill Gram-negative bacteria by disrupting outer membrane synthesis. The study was published on October 23 in Nature.
Antibiotic-resistant E. coli caused by poor hygiene. The human-to-human oral-fecal route, not the food chain, is the likeliest route of transmission for human-adapted extended-spectrum Î²-lactamase-producing Escherichia coli isolates (ESBL-E coli). Authors suggested that efforts to stop the rise of ESBL-E coli in invasive infections should focus on disrupting oral-fecal transmission by good post-toilet hygiene and preventing and promptly treating UTIs. The study was published October 22 in The Lancet Infectious Diseases.
Outpatient settings "resistant" to first-line antibiotics. Patients received recommended first-line antibiotics in only 50% of visits to outpatient settings for pharyngitis, sinusitis, and acute otitis media. First-line antibiotics were prescribed in retail clinics in 70% of visits; emergency departments, 57%; urgent care centers, 49%; and offices, 50%. Rates of first-line therapy were higher for children vs adults. The authors suggested use of first-line therapy in at least 80% of visits for these conditions. The study was published in the October issue of Antimicrobial Agents and Chemotherapy.
Antibiotic use on trial. Because suspicion of UTI contributes to overuse and misuse of antibiotics in nursing homes, a clinical trial will compare the effects of 2 implementation strategies for a quality improvement toolkit to enhance recognition and management of UTIs. The trial will evaluate whether external facilitation (coaching, collaborative learning, and peer comparison feedback) will result in reduced urine testing and initiation of antibiotics for suspected UTI. The protocol was published on September 11 in JAMA Network Open.
New data on antibiotics, antibiotic resistance, and infectious disease point to spreading resistance to the key drugs taken for H. pylori infection, a new family of promising synthetic antibiotics, and poor hygiene vs bad food as a cause of antibiotic-resistant E. coli. Scroll through the slides below for brief summaries of the key findings from these and 3 more recently published studies.