Comparison of Antibiotic Prescribing in Health Care Settings in the US

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Comparison of Antibiotic Prescribing in Health Care Settings in the US

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July 17, 2018

A study published yesterday in JAMA Internal Medicine compares the rates of antibiotic prescribing in various outpatient settings and finds that not only are antibiotic prescriptions commonly written for patients with upper respiratory tract conditions without appropriate indication, but antibiotics are prescribed at retail clinics and urgent care centers 2 to 3 times more frequently than at other outpatient sites. A related commentary considers the possible motivations behind this and offers promising approaches to reducing the inappropriate use of antibiotics.

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Esmita Charani

She is an honorary Associate Professor at the University of Cape Town, a visiting Researcher at Haukeland University Hospital, Bergen, Norway, and an Adjunct Professor at Amrita Institute of Medical Sciences, Kerala, India, where she is involved in helping implement and investigate national antibiotic stewardship programmes.

After completing her post-graduate training in Cambridge University Hospitals and ten years of experience as a clinical pharmacist in hospitals, Esmita began her research career. In her academic career the focus of her research has been behaviour change interventions in the field of antimicrobial stewardship, and the application of social science research methods to develop contextually relevant solutions. She is an investigator on an NIHR Invention for Innovation award investigating the development and use of a point-of-care personalised clinical decision support tool for antimicrobial prescribing, and is co-investigator on the ESRC award: “Optimising antibiotic use along surgical pathways: addressing antimicrobial resistance and improving clinical outcomes” (in England, Scotland, Rwanda, India & South Africa; 2017-2021).

Her work in antimicrobial resistance (AMR) has been recognised through an Academy of Medical Sciences UK-India AMR Visiting Professor award. She is an expert advisor to the Commonwealth Pharmacy Association and a Global Health Fellow with the Office of the Chief Pharmaceutical Officer, England. She is involved in mentoring and supporting clinical pharmacists to implement antimicrobial stewardship interventions across different healthcare settings and economies. Her doctoral thesis investigated antimicrobial stewardship in India, Norway, France, Burkina Faso and England. She is also the Research Lead for Practice, Design and Engineering at the NIHR Health Protection Research Unit for Healthcare Associated Infections and Antimicrobial Resistance within the Faculty of Medicine at Imperial College London.
Esmita completed her Masters (MPharm Hons) in Pharmacy at University College London, her MSc in Infectious Diseases at the London School of Hygiene and Tropical Medicine, and read for her PhD at Imperial College London.

Oral Abstract Presentations (05): One Health

Chair
Mohamed Sirdar - ISID, South Africa

Speakers:

Climate change-driven vector-borne diseases spread to temperate climate territories: The frying pan theory
Miguel Angel Jimenez-Clavero – Animal Health Research Center (CISA-INIA), CSIC, Spain

Plasmid profile analysis of escherichia coli isolates recovered from the beef production chain
Libby Onyeka – Michael Okpara University Of Agriculture, Umudike, Nigeria

Innovative methodological approach to assess dengue transmission: findings from the SERODEN study in Africa
Anna Vicco – Imperial College London, Italy

Seroprevalence of dengue in the Democratic Republic of Congo, Ghana and Senegal: results of the SERODEN study
Anthony Afum-adjei Awuah – Kumasi Centre For Collaborative Research In Tropical Medicine, Ghana

First seroprevalence study of West Nile Virus (WNV) infection in blood donors after abrupt increase in West Nile Neuroinvasive Disease (WNND) cases in Southern Italy in 2023
Francesca Centrone – Hygiene Unit, AOUC Policlinico of Bari, Italy

Current Knowledge of Exposure to Tick-borne Pathogens among Rural Population in Cambodia
Janin Nouhin – Institut Pasteur Du Cambodge, Cambodia

Impact of the LGBT+ rights on reporting cases and deaths of Mpox globally: Relationships with the LGBT+ rights index during 2022-2024 epidemics
Alfonso J. Rodriguez-Morales – Faculty of Medicine, Fundacion Universitaria Autonoma de las Americas, Colombia

One Health intervention for elimination of animal to human disease transmission of Anthrax in an endemic district of Odisha: A baseline and endline study
Debaprasad Parai – ICMR-Regional Medical Research Centre, Bhubaneswar, India

Relationships between morbidity and mortality from Mpox and the human development index (HDI) globally during 2022-2024 epidemics
Alfonso J. Rodriguez-Morales – Faculty of Medicine, Fundacion Universitaria Autonoma de las Americas, Colombia

Unraveling Algerian bat coronaviruses: from initial detection to genome recovery and co-infection discovery
Safia Zeghbib – National Laboratory Of Virology: University Of Pécs, Hungary

Deadly dengue epidemic outbreak in Burkina Faso in 2023
Armel Poda - Ministry of Health and Public Hygiene, Burkina Faso

Oral Abstract Presentations (02): HAIs, Antimicrobials & Bacteremia

Chair
Prof Neelika Malavige

Speakers

Electronic Pillbox-enabled Self-administered Therapy Versus Standard Directly Observed Therapy for Tuberculosis Medication Adherence and Treatment Outcomes in Ethiopia: a Multicenter Randomized Controlled Trial
Manyazewal Tsegahun – Addis Ababa University, Ethiopia

Redox-responsive peptidosomes: A promising strategy for expanding vancomycin antibiotic spectrum and efficacy against resistant bacterial infections
Calvin Omolo – United States International University-africa, Kenya

Transient Expression of Recombinant Antimicrobial Peptide Meucin18 in Nicotiana tabacum and its Antimicrobial Susceptibility Testing
Parthiban Subramanian – Bharathiar University, India

Integrating Deep Learning with Computational Methods for Dual Inhibition of Mycobacterium tuberculosis Pantothenate Kinase and CTP Synthetase: A Novel Approach to Combat Multi-Drug Resistance
Prakash Jha – University of Delhi, India

Species distribution, antibiotic susceptibility and clinical characteristics in Enterococcal bacteremia; experience from South India
Vettakkara Kandy Muhammed Niyas – Kimshealth, Thiruvananthapuram, India

Epidemiological assessment of trends and health inequalities in rates of Group C and G Streptococcal bacteraemia in England, 2015 to 2022
Jamie Thomas Rudman – Ukhsa, UK

The hidden burden of enteric infections in British Columbia, Canada, 2005-2014
Eleni Galanis – University of British Columbia, Canada

Impact of hospital participation in national surveillance in prevention of surgical site infection, England
Theresa Lamagni – UK Health Security Agency, UK

Tracking the Evolution and Antibiotic Resistance Patterns of Streptococcus pneumoniae in Indian Adult Populations through High-Throughput Genome Sequencing
Varun Shamanna – Central Research Laboratory, India

Improving Infection Prevention and Control Systems using Quality Improvement Initiatives in selected Health Facilities in Akwa Ibom State, Nigeria
Usen Daniel – Akwa Ibom State Ministry of Health, Nigeria

Esmita Charani

Esmita completed her Masters (MPharm Hons) in Pharmacy at University College London, her MSc in Infectious Diseases at the London School of Hygiene and Tropical Medicine, and read for her PhD at Imperial College London.

Yenew Kebede Tebeje

Dr Yenew Kebede Tebeje is a medical microbiologist and public health expert with 20 years of clinical, teaching, laboratory science, research, capacity building, and programme design and management experience. His achievements include building laboratory systems in low-income countries, human resource capacity development, and development of policy frameworks and guidelines that impact laboratory programmes in Africa. Dr Tebeje currently serves as Head of Division of Laboratory Systems at Africa CDC where he leads programmes to strengthen public health laboratory systems and networks in Africa. In this capacity, he coordinates the establishment and strengthening of regional integrated surveillance and laboratory networks, creation of frameworks for cross-border specimen transportation, geo-mapping of laboratory functions, implementation of biosafety and biosecurity standards, use of point of care technologies and connected diagnostics to strengthen surveillance at community level, and implementation of laboratory quality management systems. He also leads initiatives by Africa CDC and partners to advance the use of laboratory diagnostics for universal health coverage and implementation of health security in Africa. Before joining Africa CDC, Dr Tebeje worked for more than 12 years as Technical Officer and later as Branch Chief for Laboratory at the US CDC in Ethiopia, where he provided strategic leadership for one of the most successful laboratory systems development programmes of the US CDC. Dr Tebeje worked as assistant lecturer, lecturer and later as assistant professor at Gondar College of Medical Science, University of Gondar. He was recognized several times for his outstanding contributions, including the Mission Honor Award, Meritorious Honor Award and US CDC Center for Global Health Director’s Award. He has written lecture notes on microbiology, immunology and parasitology and authored and co-authored more than 30 articles in peer-reviewed journals. Dr Tebeje holds a Doctor of Medicine degree from Gondar College of Medical Sciences, a master’s degree in medical microbiology from Addis Ababa University, and a Master of Public Health degree from the University of Gondar.

Natalia Pshenichnaya

Natalia Pshenichnaya graduated from medical university in 1991 and finished her internship in infectious diseases in 1993. In 1996, she received her Ph.D. In 2006, she received her D.Sci. in infectious diseases, and in 2011, she became a diploma Professor in infectious diseases. From 1996 to 2019, Natalia worked as an assistant professor, associate Professor Professor, and head of the Infectious Diseases and Epidemiology department at the Rostov State Medical University. From 2011 to 2012, she acted as the WHO project officer for "Climate Change and Health" in WHO CO in Russia. From 2019 to 2020, she worked at the National Medical Research Center of Phthisiopulmonology and Infectious Diseases as the Head of the International Department in Moscow, Russia.

Since June 2020, she has been working as Deputy Director of the clinic and analytic work at the Central Research Institute of Epidemiology of The Federal Service for the Oversight of Consumer Protection and Welfare (Rospotrebnadzor) in Moscow, Russia. She is also a Professor in the Department of Infectious Diseases at Moscow Regional Research Clinical Institute and an infectious diseases consultant at the Infectious Diseases Hospital #2 in Moscow.

Since 2004, she has been a ProMED-mail RUS moderator for the International Society for Infectious Diseases. Since 2007, she has been involved in WHO activity as a short-term consultant (Influenza, Severe Acute Respiratory Infections, Crimean-Congo Hemorrhagic Fever, IHR, IPC, COVID-19). Since 2017, she has acted as Associate Editor of the Annals of Clinical Microbiology and Antimicrobials and since 2019 - a Russian Academy of Science expert. Natalia was a member of the WHO-China joint technical mission to China to support response operation for the COVID-19 outbreak February 2020, Russian military-medical humanitarian mission on COVID-19 in Bergamo (Lombardia province), Italy, 22 March-10 April 2020; WHO GOARN technical and assessment mission on COVID-19 and WHO IPC and clinical management mission on COVID-19 in Tajikistan (May-September 2020), Rospotrebnadzor technical and consultative missions on COVID-19 in Kyrgyzstan (July and August 2020), South Africa (December 2021), typhoid fever in Republic of Congo (August, 2023).

Natalia's areas of scientific interest are influenza and other acute respiratory infections, Crimean-Congo Hemorrhagic Fever, West Nile Fever, other zoonotic diseases, acute diarrhea, infectious diseases in travelers, viral hepatitis, etc.

Alison Holmes

Alison has a longstanding clinical and research career in global infectious diseases, with particular interests in antibiotic use, antimicrobial resistance (AMR), epidemiology, and public health within healthcare and has served on the Executive Committee of the ISID, chairing the Education and the Publications Committee and introducing the Emerging Leaders initiative. She is a Professor of Infectious Diseases at Imperial College, a Fellow of the UK’s Academy of Medical Sciences, and a National Institute of Health Research (NIHR) Senior Investigator. Professor Holmes leads a large multidisciplinary research group and network with solid international collaborations. She is the Director of the NIHR Health Protection Research Unit in Healthcare Associated Infections (HCAI) and AMR and the Centre of Antimicrobial Optimisation at Imperial College. She is an Associate Medical Director in the National Health Service, leading a multi-professional service, and a senior ID consultant.

In addition to her work in infectious diseases, she has served as a medical advisor to VSO, UK, and was involved in refugee health, health, and human rights. She was an expert member of the Governmental Advisory Committee on AMR and HCAI for nine years. Professor Holmes now chairs the Technical Advisory Group for the Fleming Fund. She sits on various WHO expert groups and committees and sits on or chairs numerous national and international scientific advisory boards, funding panels, and editorial boards.

Alison spent much of her life overseas. She attended Cambridge University as an undergraduate and then went to St George’s Medical School in London. She worked in communicable diseases and tropical medicine in Oxford, gained her DTM&H from London, and was awarded an ID fellowship to spend at Boston University, where her research was conducted in the Maxwell Finland Laboratories and where she gained an MPH in International Health from Harvard School of Public Health. Professor Holmes serves on the Finance Committee and the Nomination and Remuneration Committee.