By Patricia C. Henwood, M.D. The New England Journal of Medicine, July 4, 2019   “Half my patients died. They died from one disease, but so many diffe
By Prof Michael Levin, Aubrey J Cunnington, Clare Wilson, Prof Simon Nadel, Hans Joerg Lang, Nelly Ninis, Mignon McCulloch, Prof Andrew Argent, Helois
By Prof Wayne M Sullender, MD, Prof Karen B Fowler, Vivek Gupta, MD, Anand Krishnan, Debjani Ram Purakayastha, Raghuram Srungaram VLN, PhD, Kathryn E
By Yingfen Hsia, PhD,Brian R Lee, PhD, Ann Versporten, MPH, Yonghong Yang, PhD, Julia Bielicki, MD, Charlotte Jackson, PhD, Jason Newland, MD, Herman Goossens, PhD, Nicola Magrini, MD, Mike Sharland, MD on behalf of the GARPEC and Global-PPS networks The Lancet Global Health. To be published July 2019   Improving the quality of hospital antibiotic use is a major goal of WHO's global action plan to combat antimicrobial resistance. The WHO Essential Medicines List Access, Watch, and Reserve (AWaRe) classification could facilitate simple stewardship interventions that are widely applicable globally. We aimed to present data on patterns of paediatric AWaRe antibiotic use that could be used for local and national stewardship interventions. 1-day point prevalence survey antibiotic prescription data were combined from two independent global networks: the Global Antimicrobial Resistance, Prescribing, and Efficacy in Neonates and Children and the Global Point Prevalence Survey on Antimicrobial Consumption and Resistance networks. We included hospital inpatients aged younger than 19 years receiving at least one antibiotic on the day of the survey. The WHO AWaRe classification was used to describe overall antibiotic use as assessed by the variation between use of Access, Watch, and Reserve antibiotics, for neonates and children and for the commonest clinical indications. Of the 23 572 patients included from 56 countries, 18 305 were children (77·7%) and 5267 were neonates (22·3%). Access antibiotic use in children ranged from 7·8% (China) to 61·2% (Slovenia) of all antibiotic prescriptions. The use of Watch antibiotics in children was highest in Iran (77·3%) and lowest in Finland (23·0%). In neonates, Access antibiotic use was highest in Singapore (100·0%) and lowest in China (24·2%). Reserve antibiotic use was low in all countries. Major differences in clinical syndrome-specific patterns of AWaRe antibiotic use in lower respiratory tract infection and neonatal sepsis were observed between WHO regions and countries. There is substantial global variation in the proportion of AWaRe antibiotics used in hospitalised neonates and children. The AWaRe classification could potentially be used as a simple traffic light metric of appropriate antibiotic use. Future efforts should focus on developing and evaluating paediatric antibiotic stewardship programmes on the basis of the AWaRe index. GARPEC was funded by the PENTA Foundation. GARPEC-China data collection was funded by the Sanming Project of Medicine in Shenzhen (SZSM2015120330). bioMérieux provided unrestricted funding support for the Global-PPS. Access article here    
By Barnaby Young, Sapna Sadarangani, Sen Yew Haur, Chee Fu Yung, Ian Barr, John Connolly, Mark Chen, Annelies Wilder-Smith Clinical Infectious Disease
By Daniel M Weinberger, Joshua L Warren, Tine Dalby, Eugene D Shapiro, Palle Valentiner-Branth, Hans-Christian Slotved, Zitta Barrella Harboe Clinical
By Alison Kent, Ashley Makwana, Carmen L Sheppard, Sarah Collins, Norman K Fry, Paul T Heath, Mary Ramsay, Shamez N Ladhani Clinical Infectious Diseas
By Nirma Khatri Vadlamudi, Anna Chen, Fawziah Marra Clinical Infectious Diseases, To be Published July 1, 2019   A notable reduction of the pneumococc
By Sabelle Jallow, Yasmeen Agosti, Prudence Kgagudi, Megan Vandecar, Clare L Cutland, Eric A F Simões, Marta C Nunes, Melinda S Suchard, Shabir A Madh
By James E Gern, Wai Ming Lee, Cheri A Swenson, Kazuyuki Nakagome, Iris Lee, Michele Wolff, Kristine Grindle, Steven Sigelman, Stephen B Liggett, Alki