1st December 2023

Explore the latest Editors’ picks from Journal of Antimicrobial Chemotherapy (JAC) and JAC-Antimicrobial Resistance (JAC-AMR). This month, two different studies look at the effect of COVID-19 on antimicrobial prescribing, therapeutic drug monitoring reveals the importance of considering obesity in ceftazidime dosing, and a survey of students in Zambia highlights high levels of self-medication with antibiotics. Also, find out how cholesterol-lowering drugs could help to treat invasive fungal infections.

Wenjuan Cong and others, Prevalence of antibiotic prescribing in COVID-19 patients in China and other low- and middle-income countries during the pandemic (December 2019—March 2021): a systematic review and meta-analysis. Journal of Antimicrobial Chemotherapy 2023; dkad302, https://doi.org/10.1093/jac/dkad302

Inappropriate antibiotic prescribing in COVID-19 patients during the early stages of the pandemic may have contributed to antimicrobial resistance, but little is known about prescribing in most low- and middle-income countries during that time. In this systematic review, Cong et al. found high antibiotic prescription rates in hospitalised COVID-19 patients, particularly in pregnant women and the elderly, and rates of bacterial infection were much higher than those reported in high-income countries.

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Michael M Tadros and others, Antimicrobial prescribing in a secondary care setting during the COVID-19 pandemic. JAC-Antimicrobial Resistance 2023; dlad117, https://doi.org/10.1093/jacamr/dlad117

Tadros et al. conducted a Global Point Prevalence Survey at two hospitals in Northern Ireland to compare antimicrobial prescribing before and during the COVID-19 pandemic. The pandemic had no significant effect on prescribing patterns, reflecting efforts to comply with antimicrobial stewardship programmes and guidelines.

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Patricia Correia and others, Towards optimization of ceftazidime dosing in obese ICU patients: the end of the ‘one-size-fits-all’ approach? Journal of Antimicrobial Chemotherapy 2023; dkad339, https://doi.org/10.1093/jac/dkad339

Personalised antibiotic prescribing is important for both patient outcomes and to prevent the selection of resistance. Correia et al. investigated how obesity and renal function affect ceftazidime plasma concentrations and dosing regimen in ICU patients. They found that obese ICU patients needed significantly higher ceftazidime doses to achieve the target range and suggest that regimens may need to be tailored according to weight and glomerular filtration rate.

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Steward Mudenda and others, Antimicrobial stewardship: knowledge, attitudes and practices regarding antimicrobial use and resistance among non-healthcare students at the University of Zambia. JAC-Antimicrobial Resistance 2023; dlad116, https://doi.org/10.1093/jacamr/dlad116

In a survey of non-healthcare students in Zambia, Mudenda et al. found moderate scores for knowledge, attitudes and practices towards antimicrobial use and resistance but also a high rate of self-medication. They advise that antimicrobial stewardship education should be extended to non-healthcare programmes in universities and colleges.

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Catriona Halliday and others, Exploring synergy between azole antifungal drugs and statins for Candida auris. Journal of Antimicrobial Chemotherapy 2023; dkad303, https://doi.org/10.1093/jac/dkad303

Statins, a class of drugs used to lower blood cholesterol levels, have been reported to show antifungal activity in vitro. In this study, Halliday et al. tested statin/azole combinations against clinical isolates of Candida auris and found synergistic effects in up to 90%. In particular, voriconazole/fluvastatin showed a 16-fold reduction in voriconazole MIC, and synergy in 67%. Statins could be a promising option to counter azole resistance in this emerging pathogen.

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