28th September 2023

Check out the Editors’ picks from Journal of Antimicrobial Chemotherapy and JAC-Antimicrobial Resistance. This month, we have insights into antibiotic prescribing, including the impact of the COVID-19 pandemic on European consumption, metrics for benchmarking usage in farms and baseline data from hospitals in Bhutan. Plus, read a systematic review of molnupiravir treatment for COVID-19 and a concerning report of Klebsiella pneumoniae resistant to novel antibiotics emerging in Italy.

Community antibiotic consumption decreased in Europe during the COVID-19 pandemic. Vermeulen et al. explored this in more detail and identified that a sharp reduction in usage occurred immediately after the start of the outbreak and was sustained in 2021, mainly driven by reduced use of penicillins, other β-lactams and macrolides, lincosamides and streptogramins.


Peers Davies and others, Comparison of multiple international metrics for benchmarking antibiotic usage (ABU) using UK beef and sheep data. Journal of Antimicrobial Chemotherapy 2023; dkad259, https://doi.org/10.1093/jac/dkad259

Benchmarking antibiotic usage in farms is important for stewardship but requires reliable, accurate metrics—especially if farm rankings are used to regulate international trade access or linked to financial subsidies or penalties. In this study, Davies et al. found good agreement between several metrics of antibiotic use in sheep and beef cattle farms, providing reassurance that a chosen metric can correctly classify a high proportion of farms.


Mingyao Sun and others, Molnupiravir for the treatment of non-severe COVID-19: a systematic review and meta-analysis of 14 randomized trials with 34 570 patients. Journal of Antimicrobial Chemotherapy 2023; Volume 78, Issue 9, Pages 2131–2139, https://doi.org/10.1093/jac/dkad216

In this systematic review and meta-analysis, Sun et al. examined evidence from 14 randomized controlled trials and found that patients with mild or moderate COVID-19 are likely to benefit from molnupiravir treatment. Molnupiravir reduced the risk of hospital admission, risk of mechanical ventilation, and time to symptom resolution or clinical improvement, with no significant adverse events.


Federica Bovo and others, Clonal dissemination of Klebsiella pneumoniae resistant to cefiderocol, ceftazidime/avibactam, meropenem/vaborbactam and imipenem/relebactam co-producing KPC and OXA-181 carbapenemase. JAC-Antimicrobial Resistance 2023; Volume 5, Issue 4, dlad099, https://doi.org/10.1093/jacamr/dlad099

Bovo et al. describe the changing epidemiology of carbapenemase-producing Enterobacterales in northern Italy and report the emergence of MDR Klebsiella pneumoniae resistant to novel antibiotics, including ceftazidime/avibactam, meropenem/vaborbactam, imipenem/relebactam and cefiderocol.


Pem Chuki and others, Antibiotic use and quality indicators of antibiotic prescription in Bhutan: a point prevalence survey using the Australian National Antimicrobial Prescribing Survey tool. JAC-Antimicrobial Resistance 2023, Volume 5, Issue 4, dlad100, https://doi.org/10.1093/jacamr/dlad100

Chuki et al. carried out a point prevalence survey in four major hospitals in Bhutan to provide baseline information on antibiotic prescription and its quality indicators. While prevalence, indications and drug choices were similar to those in neighbouring countries, they identified documentation, surgical prophylaxis and adherence to guideline recommendations as key targets for antimicrobial stewardship interventions.


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