European Antibiotic Awareness Day (EAAD): any impact on antibiotic consumption and public awareness in Slovenia?

The Impact of National Activities on Antibiotic Consumption in Hospitals and Different Departments over a 14-Year Period

The aim of this study was to assess the use of antibiotics in hospitals and different departments over 14 years (2006-2019) and the impact of various national activities related to this, including national audits of the use of antibiotics for systemic use. The consumption of antibiotics for systemic use (J01) from all Slovenian hospitals (n = 29) and five departments (internal medicine, surgery, ICU (medicine, surgery), paediatrics and gynaecology/obstetrics) was collected. Total hospital consumption was expressed as the number of defined daily doses (DDDs) per 1000 inhabitants per day (DID), the number of DDDs/100 bed days and the number of DDDs/100 admissions. Over 14 years, J01 hospital consumption increased by 13.8%, expressed in DDDs/100 bed days (p = 0.002). In 2019, compared to 2006, the consumption of J01, expressed in DDD/100 bed days, increased from 19.9% to 33.1% in all departments, except intensive care units. J01 consumption expressed in DDD/100 admissions increased by 7.0% to 39.4% in all but paediatric wards (where it decreased by 12.7%). In all years, we observed large variations in the consumption of antibiotics in departments of the same type. The effectiveness of audit interventions aimed at optimizing antibiotic consumption exhibited notable variation across hospitals, with specialized facilities generally demonstrating superior outcomes compared to general hospitals.

Correlation between Antibiotic Consumption and Resistance of Invasive Streptococcus pneumoniae

There is a lack of long-term studies that correlate different metrics of antibiotic consumption and resistance of invasive S. pneumoniae. The present study aims to investigate the correlation between national outpatients total antibiotic, penicillin and broad spectrum penicillins consumption expressed in daily doses per 1000 inhabitants per day (DID) with the ATC/DDDs, WHO version of 2019 (new version) and 2018 (old version), number of prescriptions per 1000 inhabitants per year (RxIDs) and number of packages per 1000 inhabitant per day (PIDs) with the resistance of invasive S. pneumoniae in Slovenia in the period from 2000 to 2018. The prevalence of penicillin resistance of invasive S. pneumoniae decreased by 47.13%, from 19.1% to 10.1%. Decline of resistance showed the highest correlation (R = 0.86) between RxIDs followed by PID (R = 0.85) and resistance of S. pneumoniae. Higher correlation between total use of antibiotics expressed in DID WHO version 2019 (R = 0.80) than for WHO version 2018 (R = 0.78) was found. Very high (R = 0.84) correlation between use of β-lactams expressed in PID, and RxIDs (R = 0.82) and reasonable (R = 0.59) correlation expressed in DIDs version 2019 was shown as well. The consumption of broad -spectrum penicillins (J01CA and J01CR02) expressed in PID (R = 0.72) and RxIDs (0.57) correlated significantly with the resistance of S. pneumoniae as well. A new finding of this study is that RxIDs correlated better with the resistance of S. pneumoniae than total consumption of antibiotics expressed in DID and significant correlations exist between use of broad-spectrum penicillins expressed in PID and RxIDs.

Antimicrobial Resistance in the Context of the Sustainable Development Goals: A Brief Review

The reduction in infectious disease morbidity and mortality may be attributed to a variety of factors; however, improved sanitation and public health, and the introduction of vaccines and antibiotics are among the most significant. The development of antimicrobial resistance (AMR) in bacterial pathogens is an expected consequence of evolutionary adaptation to these noxious agents and the widespread use of these drugs has significantly sped up this process. Infections caused by multidrug resistant pathogens are directly associated with worse clinical outcomes, longer hospital stays, excess mortality in the affected patients and an increasing burden and costs on the healthcare infrastructure. The Sustainable Development Goals (SDGs) were published in 2015 by the United Nations to serve as a global blueprint for a better, more equitable, more sustainable life on our planet. The SDGs contextualize AMR as a global public health and societal issue; in addition, the continuing emergence of AMR may limit the attainment on many SDGs. The aim of this mini-review is to provide insight on the interface between attainment of SDGs and the clinical problem of drug resistance in bacteria.

The value of health awareness days, weeks and months: A systematic review

OBJECTIVE

The aim of this systematic review was to analyze the value of awareness days, weeks, and months as found in peer-reviewed research and highlight any related trends.

METHODS

A systematic review was conducted across four electronic databases for articles published between 1970 and July 2020. The researchers reviewed articles which included awareness days, weeks, or months in the title or abstract and extracted articles which used quantitative analysis to assess the impact of such campaigns.

RESULTS

The 73 included articles were separated into categories based on outcome measure(s) with 12 articles included in more than one category. Of the 31 articles which examined online activity outcomes, the vast majority reported the awareness day, week, or month in question positively correlated with increased activity. Of the 14 articles focused on knowledge outcomes, those which focused on specific day, week, or month sub-interventions with targeted populations had relatively greater success. The 29 studies that examined the impact of awareness days, weeks, and months on health outcomes reported mixed results. Another twelve studies provided treatment insights based on convenience sample research conducted during awareness days, weeks, and months. The majority of articles across all outcome categories did not examine costs.

CONCLUSION

Although online activity seemed to generally increase during the awareness days, weeks, and months studied, the relationship between this increase and improved health behaviors and outcomes remains unclear. In addition, there is a paucity of research pertaining to the cost and cost effectiveness of such campaigns. Future research in this area needs to focus more on health outcome impacts and include an examination of cost effectiveness when possible.