It’s #MedSafetyWeek 💊⚕️and a good opportunity to remind ourselves about #antimicrobial ADRs 💥 @UMCGlobalSafety https://www.who-umc.org/medsafetyweek/  a short 🧵1/n…
#Abx are one of the most commonly prescribed therapeutic agent and, of course, carry side effects like all medicines⚠️ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6025009/ 2/n…
Comprehension of Top 200 Prescribed Drugs in the US as a Resource for Pharmacy Teaching, Training...

Pharmacists have access to a plethora of information related to drugs. Online compendia concerning top 200 prescribed drugs are readily-accessible, comparatively-easy to search. While these resources...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6025009/
#Abx are not a benign drug class @pranita_tamma et al @JAMAInternalMed showed that 20% inpatients experienced at least 1 #Abx associated ADR ☹️ https://ja.ma/2HYQf4Q  3/n...
Adverse Events and Antibiotic Use in Hospitalized Patients

This cohort study describes the incidence of antibiotic-associated adverse drug events for adult inpatients receiving systemic antibiotic therapy.

https://ja.ma/2HYQf4Q
Again, in this emergency dept study, almost 20% of medication-related admissions were due to #abx 🤕 https://academic.oup.com/cid/article/47/6/735/324852#.X6HZiLoRBJs.twitter 4/n…
Emergency Department Visits for Antibiotic-Associated Adverse Events

Abstract. Background.Drug-related adverse events are an underappreciated consequence of antibiotic use, and the national magnitude and scope of these events ha

https://academic.oup.com/cid/article/47/6/735/324852#.X6HZiLoRBJs.twitter
C.difficile! need I say more? 😮Another @JAMAInternalMed study “…ward-level antibiotic prescribing is associated with a statistically significant and clinically relevant increase in C difficile risk…” https://ja.ma/3enWV8C  @DFisman 5/n...
Clostridium difficile Infection

This retrospective cohort study supports the use of antibiotic stewardship as a means of preventing Clostridium difficile infection.

https://ja.ma/3enWV8C
Certain #abx are implicated in CDI more than others: clindamycin/ciprofloxacin(quinolones)/cephalosporins/coamox THE 4⃣ C’s! https://aac.asm.org/content/57/5/2326 @DFisman 6/n...
Meta-Analysis of Antibiotics and the Risk of Community-Associated Clostridium difficile Infection

The rising incidence of Clostridium difficile infection (CDI) could be reduced by lowering exposure to high-risk antibiotics. The objective of this study was to determine the association between...

https://aac.asm.org/content/57/5/2326
And this Scottish study shows how reducing the use of these agents impacts positively on CDI in hospital ⬇️ @SAPGAbx https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(16)30397-8/fulltext#.X6HjpIcRdzA.twitter 7/n…
Effect of a national 4C antibiotic stewardship intervention on the clinical and molecular epidemi...

Limiting population use of 4C antibiotics reduced selective pressures favouring multidrug-resistant epidemic ribotypes and was associated with substantial declines in total C difficile infections in...

https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(16)30397-8/fulltext#.X6HjpIcRdzA.twitter
BUT reporting antimicrobial ADRs (NB allergy) needs careful thought! 🤔As described by @BRxAD & co, inappropriate #abx allergy labels drive broad spec/2nd line rxing + costs https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5842048/ 8/n…
Potential Negative Effects of Antimicrobial Allergy Labelling on Patient Care: A Systematic Review

Antimicrobial allergy labels, either self-reported or placed in a patient’s medical record, are common, but in many cases they are not associated with a true immunoglobulin E–mediated allergic...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5842048/
In a world where #abx rxing is unfortunately increasing, 😞perhaps the biggest #ADR of them all ( #AMR) is also on the rise @ProfHGoossens https://www.pnas.org/content/115/15/E3463 9/n...
Global increase and geographic convergence in antibiotic consumption between 2000 and 2015

Antibiotic resistance, driven by antibiotic consumption, is a growing global health threat. Our report on antibiotic use in 76 countries over 16 years provides an up-to-date comprehensive assessment...

https://www.pnas.org/content/115/15/E3463
…and just to emphasise #abx use is inextricably associated with #AMR ↔️ https://pubmed.ncbi.nlm.nih.gov/24405683/  @ProfHGoossens 10/n…
A systematic review and meta-analysis of the effects of antibiotic consumption on antibiotic...

Using a large set of studies we found that antibiotic consumption is associated with the development of antibiotic resistance. A subsequent meta-analysis, with a subsample of the studies, generated...

https://pubmed.ncbi.nlm.nih.gov/24405683/
#Antimicrobials are (arguably) the only drug class where individual use has wider societal implications in propagating #AMR…but more about that over next few weeks 😉 @EAAD_EU #WAAW2020 🦠💊
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