An evaluation of the five rights antibiotic safety before and during COVID-19 at an NHS Foundation Trust in the United Kingdom.

INTRODUCTION: Antimicrobial Resistance (AMR) poses a significant global health threat, with AMR-related deaths projected to reach 10 million annually by 2050. The COVID-19 pandemic has further exacerbated this crisis. This study focuses on evaluating the 'Five Rights of Antibiotic Safety' in an NHS Foundation Trust in England, assessing the impact of the COVID-19 pandemic on antibiotic prescribing and Antimicrobial Stewardship (AMS) practices in 2019 and 2020. METHODS: A cross-sectional retrospective study was conducted, focusing on adult patients aged 25 and older admitted to the NHS Foundation Trust and prescribed antibiotics for respiratory tract infections in 2019 and 2020. The study involved a retrospective review of 640 patient records, using descriptive analysis to evaluate the adherence to the 'Five Rights of Antibiotics' and assess the impact of COVID-19 on antibiotic safety practices. RESULTS: The study observed significant shifts in antibiotic prescribing practices during the study period. There was an increase in instances of inappropriate dosing and route of administration, alongside a slight improvement in prescribing durations. The study also noted a stable rate of appropriate antibiotic selection according to antimicrobial guidelines, indicating a concerning rise in inappropriate prescribing patterns during the COVID-19 pandemic. CONCLUSION: The study revealed notable changes in antibiotic prescribing practices during the COVID-19 pandemic, advocating the importance of robust AMS to ensure appropriate use of antibiotics. The findings highlight the need for enhanced AMS educational initiatives and systematic oversight to combat AMR and protect public health in future health crises.

Antimicrobial stewardship implementation before and during the COVID-19 pandemic in the acute care settings: a systematic review.

INTRODUCTION: Antibiotics are widely administered for various indications, leading to increased antimicrobial resistance (AMR) in acute care hospitals. Since the onset of the COVID-19 pandemic, Antimicrobial Stewardship (AMS) effective strategies should be used to maintain the rational use of antibiotics and decrease the threat of Antimicrobial Resistance (AMR). AIM: This systematic literature review aims to investigate the AMS intervention Before-the-pandemic (BP) and During-the-pandemic (DP) from the literature. DESIGN AND SETTING: Systematic literature review of primary studies on AMS implementation in acute care settings. METHODS: Relevant studies published between 2000 and March 2021 were obtained from Medline (via PubMed), OVID, CINAHL, International Pharmaceutical Abstracts, Psych Info, Scopus, Web of Science, Cochrane Library, OpenGrey, and Google Scholar, using a comprehensive list of search terms. Public Health England (PHE) toolkit was agreed upon as a gold standard for the AMS implementation. RESULTS: There were 8763 articles retrieved from the databases. Out of these, 13 full-text articles met the inclusion criteria for the review. The AMS implementation was identified in the included studies into AMS strategies (Core strategies & Supplemental strategies), and AMS measures BP and DP. CONCLUSION: This Systematic literature review summarises AMS implementation strategies and measures all over the previous 20 years of research. There are many lessons learnt from COVID-19 pandemic. The proper selection of the AMS implementation strategies and measures appeared to be effective in maintaining the appropriate use of antibiotics and decreasing the AMR threat, especially during the COVID-19 pandemic. Further studies are required to provide empirical data to evaluate the AMS implementation and identify which of these strategies and measures were effective BP and DP. In order to be prepared for any emergency/crisis or future pandemics.

National pharmacy associations in the commonwealth: current scenario and future needs to maximise effective contributions of the pharmacy profession towards universal health coverage.

BACKGROUND: The Commonwealth Pharmacists Association (CPA) is a charity representing pharmacists across the Commonwealth, with the vision of empowering and collaboratively develop the profession and fully utilise the potential of pharmacists to strengthen health systems through supporting better access to, quality and use of medicines and related services. Commonwealth comprises predominantly of low- and middle-income countries, where limited data often exists in pharmacy practice. There is a recognised need across the Commonwealth to focus on developing, implementing and fully utilising pharmacy professional services to progress universal health coverage and achieve the sustainable development goals, particularly in low and middle-income countries; however, currently a knowledge gap exists in understanding the national priorities in Commonwealth nations. CPA is ideally positioned to access to these nations. The aim of this study was thus to explore the priorities and focus areas of NPAs across the Commonwealth and create evidence for a needs-based approach to inform the support that the Commonwealth pharmacists association can collaboratively and strategically provide to its members to progress towards shared goals. METHODS: Data were collected virtually on Zoom by conducting interviews using a semi-structured interview guide developed for this study with CPA councillors representing NPAs or their equivalents if no official body existed. An inductive, reflexive, thematic analysis was performed for data analysis. RESULTS: In total, 30 councillors were interviewed from 30 low- and medium-income countries. The three main overarching priority areas identified across respective Commonwealth nations developing extended pharmacy services, improving pharmacy education, and developing and redefining the role of NPAs. CONCLUSIONS: This novel study highlights the collective priorities for the pharmacy profession across the low and middle-income countries of the Commonwealth and the urgent need for supporting NPAs around the three identified overarching priority areas. The mapped-out priorities will inform an evidence-based approach for the CPA to better support NPAs in their mission through advocacy and practitioner development, to fully harness pharmacists' unique skill set and maximise their contribution to progressing universal health coverage.

The Need for Ongoing Antimicrobial Stewardship during the COVID-19 Pandemic and Actionable Recommendations.

The coronavirus disease (COVID-19) pandemic, which has significant impact on global health care delivery, occurs amid the ongoing global health crisis of antimicrobial resistance. Early data demonstrated that bacterial and fungal co-infection with COVID-19 remain low and indiscriminate use of antimicrobials during the pandemic may worsen antimicrobial resistance It is, therefore, essential to maintain the ongoing effort of antimicrobial stewardship activities in all sectors globally.

C-Abl Inhibition; A Novel Therapeutic Target for Parkinson's Disease.

Parkinson's disease (PD) is the most prevalent movement disorder in the world. The major pathological hallmarks of PD are death of dopaminergic neurons and the formation of Lewy bodies. At the moment, there is no cure for PD; current treatments are symptomatic. Investigators are searching for neuroprotective agents and disease modifying strategies to slow the progress of neurodegeneration. However, due to lack of data about the main pathological sequence of PD, many drug targets failed to provide neuroprotective effects in human trials. Recent evidence suggests the involvement of C-Abelson (c-Abl) tyrosine kinase enzyme in the pathogenesis of PD. Through parkin inactivation, alpha synuclein aggregation, and impaired autophagy of toxic elements. Experimental studies showed that (1) c-Abl activation is involved in neurodegeneration and (2) c-Abl inhibition shows neuroprotective effects and prevents dopaminergic neuronal' death. Current evidence from experimental studies and the first in-human trial shows that c-Abl inhibition holds the promise for neuroprotection against PD and therefore, justifies the movement towards larger clinical trials. In this review article, we discussed the role of c-Abl in PD pathogenesis and the findings of preclinical experiments and the first in-human trial. In addition, based on lessons from the last decade and current preclinical evidence, we provide recommendations for future research in this area.