RESUMO
The impact of the COVID-19 pandemic on antimicrobial stewardship is a cause for serious concern. There is evidence of increased antibiotic usage in many settings and fears of over-use, especially of broad-spectrum antibiotics in patients with COVID-19, raising concerns about potential impact on antimicrobial resistance globally. At the same time, the pandemic has impacted the provision of education and training throughout the health and education sectors, during a period when health services and staff were under unprecedented pressure. All-Wales Antimicrobial Resistance Educators (AWARE) is an interprofessional network of healthcare professionals whose roles include provision of antimicrobial stewardship education in National Health Service health boards across Wales. The aim of this report was to use AWARE project data to study the impact of the pandemic on the provision of antimicrobial stewardship education and training in healthcare settings in Wales in 2020, compared to 2019. Overall, the number of staff reached by education increased by 10%, despite the number of educational sessions falling by 26% and the number of hours of teaching by 43%. Rapid switch to virtual education allowed fewer, shorter, educational sessions, allowing more staff to be reached.
Assuntos
Gestão de Antimicrobianos , COVID-19 , Humanos , Pandemias , Medicina Estatal , Relações Interprofissionais , Antibacterianos , Serviços de Saúde , Reino UnidoRESUMO
ABSTRACT: The field of ophthalmic drug delivery is undergoing rapid changes not only in the evolution of pharmacologic agents but also in the novel drug delivery vehicles. The ocular surface has limitations to drug penetration because of the presence of tight junctions between basal epithelial cells, which limits the amount of drug that can be absorbed after topical instillation. In addition, nasolacrimal drainage reduces the precorneal residence time significantly. Contact lenses (CLs) have been considered as possible carriers for topical medications because they reside on the ocular surface for a sufficient length of time, and pharmacologic agents may be copolymerized with hydrogels allowing controlled drug diffusion. This strategy reduces the frequency of dosage while improving compliance. Modification of drug delivery vehicles is essential to allow sustained release of the drug from a polymeric complex, facilitate stability and residence time of the drug on the precorneal tear film, and improve penetration into biologic membranes. This review focuses on updates in CL-based and non-CL-based strategies in ophthalmic drug delivery.
Assuntos
Lentes de Contato , Sistemas de Liberação de Medicamentos , Córnea , Hidrogéis , Soluções Oftálmicas , LágrimasRESUMO
Multidrug-resistant Staphylococcus aureus is a serious public health problem with high fatality rates and difficult treatment. Conventional antimicrobials are limited in their effectiveness against MRSA due to developing resistance mechanisms and protective biofilms. Nanomaterials present a potential alternative since they offer targeted drug delivery and synergetic effects of nanoconjugates, eradicate biofilms, and use photothermal and photodynamic therapies. Furthermore, the discovery of nanovaccines holds the potential for enhancing immune responses against multidrugresistant S. aureus. Nanoparticles show considerable promise in the battle against multidrugresistant S. aureus, but significant obstacles remain, including determining their possible toxicity, scalability, and cost-effectiveness for widespread clinical application. However, by overcoming these barriers, nanomaterial-based techniques provide a viable route for tackling multidrug resistance in S. aureus, opening the path for a future in which successful therapies are within reach.