ArticleBMJ open2016
How to measure the impacts of antibiotic resistance and antibiotic development on empiric therapy: new composite indices.
Article in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 26 citations in OpenAlex.
- Article
- A Nonprofit Drug Development Model Is Part of the Antimicrobial Resistance (AMR) Solution.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Article
- Recent Developments in Phenotypic and Molecular Diagnostic Methods for Antimicrobial Resistance Detection inDiagnostics (Basel, Switzerland) · 2022Review
- A review: antimicrobial resistance data mining models and prediction methods study for pathogenic bacteria.The Journal of antibiotics · 2021Review
- resistancebank.org, an open-access repository for surveys of antimicrobial resistance in animals.Scientific data · 2021Article
- Metallo-β-lactamase and AmpC genes in Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa isolates from abattoir and poultry origin in Nigeria.BMC microbiology · 2021Article
- Antimicrobial resistance amongPeerJ · 2021Article
- Antimicrobial Resistance Risk Assessment Models and Database System for Animal-Derived Pathogens.Antibiotics (Basel, Switzerland) · 2020Article
- Article
- Mathematical basis for the assessment of antibiotic resistance and administrative counter-strategies.PloS one · 2020Article
- A nonlinear time-series analysis approach to identify thresholds in associations between population antibiotic use and rates of resistance.Nature microbiology · 2019Article
- Feasibility of informing syndrome-level empiric antibiotic recommendations using publicly available antibiotic resistance datasets.Wellcome open research · 2019Article
- Effect of cardiolipin on the antimicrobial activity of a new amphiphilic aminoglycoside derivative on Pseudomonas aeruginosa.PloS one · 2018Article
- Benefits and unintended consequences of antimicrobial de-escalation: Implications for stewardship programs.PloS one · 2017Article
Corrections and comments
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Authors and funding
6 authors at 5 institutions in 1 country.
Funding
Abstract
objectivesWe aimed to construct widely useable summary measures of the net impact of antibiotic resistance on empiric therapy. Summary measures are needed to communicate the importance of resistance, plan and evaluate interventions, and direct policy and investment. DESIGN, SETTING AND
participantsAs an example, we retrospectively summarised the 2011 cumulative antibiogram from a Toronto academic intensive care unit. OUTCOME MEASURES: We developed two complementary indices to summarise the clinical impact of antibiotic resistance and drug availability on empiric therapy. The Empiric Coverage Index (ECI) measures susceptibility of common bacterial infections to available empiric antibiotics as a percentage. The Empiric Options Index (EOI) varies from 0 to 'the number of treatment options available', and measures the empiric value of the current stock of antibiotics as a depletable resource. The indices account for drug availability and the relative clinical importance of pathogens. We demonstrate meaning and use by examining the potential impact of new drugs and threatening bacterial strains.
conclusionsIn our intensive care unit coverage of device-associated infections measured by the ECI remains high (98%), but 37-44% of treatment potential measured by the EOI has been lost. Without reserved drugs, the ECI is 86-88%. New cephalosporin/β-lactamase inhibitor combinations could increase the EOI, but no single drug can compensate for losses. Increasing methicillin-resistant Staphylococcus aureus (MRSA) prevalence would have little overall impact (ECI=98%, EOI=4.8-5.2) because many Gram-positives are already resistant to β-lactams. Aminoglycoside resistance, however, could have substantial clinical impact because they are among the few drugs that provide coverage of Gram-negative infections (ECI=97%, EOI=3.8-4.5). Our proposed indices summarise the local impact of antibiotic resistance on empiric coverage (ECI) and available empiric treatment options (EOI) using readily available data. Policymakers and drug developers can use the indices to help evaluate and prioritise initiatives in the effort against antimicrobial resistance.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.