Post by The Lancet Infectious Diseases

🔥A new study assesses trends in antibiotic use and survival among patients with difficult-to-treat resistant (DTR) Gram-negative infections in US hospitals following the advent of newer antibiotics 📢 In a retrospective cohort study using the PINC-AI Healthcare Database, Morgan Walker and colleagues linked clinical, prescribing, and microbiological data for 5065 adult inpatient encounters across 262 US hospitals between 2016 and 2023 to examine real-world uptake of newer antibiotics (ceftolozane–tazobactam, ceftazidime–avibactam, meropenem–vaborbactam, imipenem–relebactam, omadacycline, and cefiderocol), availability of susceptibility tests for them, and survival outcomes. They found that, despite increased availability of newer antibiotics and their corresponding susceptibility tests, adjusted mortality for DTR Gram-negative infections did not change over the study period: 0.1% per year for DTR Enterobacterales (95% CI –1.1 to 1.4), −0.7% for Pseudomona aeruginosa (−1.7 to 0.3), and −0.4% for Acinetobacter baumannii (−1.8 to 0.9). Moreover, 84% of patients in 2023 received in-vitro discordant initial antibiotic therapy. 🔦 The study shows that even with expanded access to newer antibiotics and susceptibility testing, mortality and use of discordant empirical therapy remained high in patients with DTR Gram-negative infections in US hospitals as of 2023. These findings underscore the need for strengthened antibiotic stewardship and improved access to rapid diagnostic testing to enable early pathogen identification and timely initiation of appropriate therapy, hopefully translating newer antibiotic availability into better patient outcomes. Read the full paper here: https://bit.ly/4tmKyPI #AntibioticResistance #DTRGramNegative #RapidDiagnostics #AntimicrobialStewardship #RealWorldEvidence Morgan Walker, Christina Yek, Sadia Sarzynski, Sarah Warner, anthony Anthony D. Harris, Jonathan Baghdadi, Katherine Goodman, John Powers, Michael Klompas, Chanu Rhee, MD, MPH, Bruce Swihart, Sameer Kadri, for the NIH Antimicrobial Resistance Outcomes Research Initiative (NIH-ARORI)