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“One health” plan for an appropriate use of antimicrobial drugs
Universita degli Studi di Catania
Department of Clinical and Experimental Medicine, University of Catania c/o Unit of Infectious Diseases, AO Garibaldi-Nesima, ARNAS Garibaldi, Via Palermo 636, 95122 Catania (CT)
Prof. Bruno Cacopardo
Prof. Bruno Cacopardo
Type of Research Project
- Clinical Project without Laboratory work
What is the background of the project?
Bacterial resistances are an important problem of public health in the whole world. Moreover, they are directly accountable for an increase in morbidity, mortality and costs of a hospitalization. Bacterial resistance has been developed faster during the last few years, especially in hospitals and centers of healthcare, where antimicrobials usage is higher and selective pressure more effective. An important part in the onset of new resistances is carried out by intensive care and surgery units. In this setting, drug choice according to synergy of action, de-escalation therapy, antimicrobial cycling and restriction of their use are crucial in determining a quick resolution of a bacterial infection and decrease of the onset and spread of resistances. Therefore, a strategy of antimicrobial stewardship is of utmost importance to determine a decrease in hospital expenses.
What is the aim of the project?
Primary objectives - Improve the clinical outcome in terms of: o Quicker diagnosis, o Decrease of the mortality rate caused by healthcare acquired infection, o Reduction of adverse effects and toxicities due to an inappropriate antimicrobial therapy.
What techniques and methods are used?
STEP 1 - Implementation of a multi-disciplinary team, - Employment of a 'super-specialist', an expert in antimicrobial therapy, - Activity of consultation in each ward of the hospital, - Partnership with fellow physicians within the wards with higher infectivologic risk and microbiologists, - Partnership with ID specialists, microbiologists, hospital pharmacists and health management. STEP 2 - Monitoring of the ecologic system of the hospital and its variability, - Continuous training of each and every specialist involved in antimicrobial stewardship, - Decision making process optimization. Research activities will focus on data collection and data analysis: data of patients will be analyzed trough group and discriminant analysis, multidimensional scaling techniques, correlations. Models used are part of multivariate statistics.
What is the role of the student?
- The student will mainly observe
- If the project is clinical
- the student will be allowed to work with patients
- The tasks will be done under supervision
What are the tasks expected to be accomplished by the student?
Being flanked with an experienced tutor, the students will learn how to manage situations where antimicrobial resistence is involved. They will also learn how to read an antimicrobial sensitivity test and how to choose the best antimicrobial in each situation. The students are supposed to attend regularly the research internship, to be cooperative. It will be important to participate willingly to the activities, maybe giving new point of view to the tutor. The students will be involved in analysis of data and statistical evaluation and they will also help the tutor in clinical evaluation of the patients involved.
Will there be any theoretical teaching provided (preliminary readings, lectures, courses, seminars etc)
Theoretical teaching will be provided under the form of lectures and seminars on antimicrobials, antimicrobial resistance and microbiology.
What is expected from the student at the end of the research exchange? What will be the general outcome of the student?
- No specific outcome is expected
What skills are required of the student? Is there any special knowledge or a certain level of studies needed?
Are there any legal limitations in the student’s involvement
Type of students accepted
This project accepts: - Medical students - Graduated students (less than 6 months) - Pre-Medical students from the American-British system
- 1. Tacconelli E; Sifakis F; Harbarth S; Schrijver R; van Mourik M; Voss A; Sharland M; Rajendran N; Rodríguez-Baño J; Group E-N; Bielicki J; de Kraker M; Gandra S; Gastmeier P; Gilchrist K; Gikas A; Gladstone B; Goossens H; Jafri H; Kahlmeter G; Leus F; Luxemburger C; Malhotra-Kumar S; Marasca G; McCarthy M; Navarro M; Nuñez-Nuñez M; Oualim A; Price J; Robert J; Sommer H; von Cube M; Vuong C; Wiegand I; Witschi A; Wolkewitz M. Surveillance for control of antimicrobial resistance. Lancet Infect Dis. 2018;18(3):e99-e106. doi:10.1016/s1473-3099(17)30485-1
- 2. Augie BM; McInerney PA; van Zyl RL; Miot J. Educational antimicrobial stewardship programs in medical schools: a scoping review protocol. Jbi Database Syst Rev Implement Reports. 2019:1. doi:10.11124/jbisrir-d-19-00142.
- 3. Rice LB. Antimicrobial Stewardship and Antimicrobial Resistance. Med Clin N Am. 2018;102(5):805-818. doi:10.1016/j.mcna.2018.04.004
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