News survey for June 08, 2022

Gender bias may influence acceptance of antibiotic stewardship efforts

In a single-center study, researchers reported that gender bias may play a role in whether recommendations for stewardship of antibiotics by pharmacists are accepted by hospital physicians. Infection control and hospital epidemiology.

To examine the role of gender in accepting supervision recommendations, researchers retrospectively evaluated the efficacy of the ROAD (reduce overuse of antibiotics upon discharge) of a home intervention at an academic medical center in Michigan. The intervention consists of an antibiotic timeout (a structured conversation to review the appropriateness of offloading the antibiotics) during the pharmacist’s rounds with physicians. The primary study outcome was the percentage of recommendations given by pharmacists that were accepted by hospital physicians.

During the intervention period (May to October 2019), pharmacists performed 295 antibiotic appointments: 158 administered by 12 women and 137 administered by 8 men. Pharmacists recommended a change of antibiotics in 82 deadlines (27.8%), of which 51 (62.2%) were accepted. Compared with male pharmacists, pharmacists were less likely to recommend an antibiotic change (19.0% vs. 38.0%). Pharmacists were also significantly less likely to accept the recommendation (33.3% vs. 78.8%). Thus, timeouts by female versus male pharmacists were less likely to cause a change of antibiotics (6.3% versus 29.9%).

After adjusting for patient characteristics, pharmacist gender remained significantly associated with whether recommended changes were acceptable (adjusted odds ratio [aOR], 0.10; 95% confidence interval [CI]0.03 to 0.36 for female versus male pharmacists) and whether timeout resulted in a change of antibiotic (aOR, 0.15; 95% CI, 0.07 to 0.33).

The study authors say that while the findings need to be confirmed in larger studies, the implication that gender bias may play a role in clinicians’ acceptance of antibiotic stewardship recommendations could have “profound effects” on whether antibiotic stewardship interventions reach to patients and improve their outcomes, and could also influence other pharmaceutical interventions. They also noted that women make up 56% of clinical pharmacists, and the number is growing.

They concluded that, “Given this growth and the importance of pharmacists in areas beyond supervision (eg, matchmaking of medications, transitions of care, patient counseling), there is an urgent need to study and mitigate any biases that may exist.”
June 7 Infect Hospital Control Epidemiol study

The CDC reported 28 cases of unexplained hepatitis C in children; The global total is growing

In a regular update today, the U.S. Centers for Disease Control and Prevention (CDC) reported another 28 cases of unexplained hepatitis in children that health officials are investigating, bringing the national total to 274. to 39.

The CDC said many recent cases are retrospective, with investigations covering diseases dating back to October 2021. No specific cause has been identified, but the potential role of adenovirus is a strong lead, and scientists are still weighing other potential causes, such as COVID-19 or exposure to toxins.

At a press conference for the World Health Organization today, Director-General Tedros Adhanom Ghebreyesus said, more than 700 probable cases have been reported from 34 countries, with another 112 under investigation. He said at least 38 children required a liver transplant and 10 died.

“The World Health Organization receives reports of unexplained hepatitis in children every year, but a few countries have indicated that the rates they are seeing are higher than expected,” he said.
CDC June 8 Update
June 8 Tedros briefing speech

Avian influenza is infecting more domestic and wild birds in the United States

Federal veterinary officials reported two other outbreaks of highly pathogenic avian influenza in poultry, one of which struck a large layer farm in Colorado.

In a recent update, the USDA Animal and Plant Health Inspection Service (APHIS) said the most recent outbreak in Colorado occurred in Weld County, about 60 miles north of Denver. The facility houses approximately 1.93 million birds. The other outbreak occurred in a backyard flock in North Dakota at a site in McHenry County, about 35 miles east of Minot, that harbors 30 birds.

The outbreak of the disease in poultry in the United States, which began in February, has slowed. To date, the outbreak has resulted in the loss of 39.8 million birds in 36 states.

In related developments, detections of H5N1 virus continued in wild birds, and the Animal Public Health Service (APHIS) today reported 56 more cases, bringing the total number to 1,422. Most of them were from Midwestern states, including Minnesota, North Dakota and South Dakota Wisconsin. There were also a few in other states, including Colorado, Illinois, Indiana, and Vermont. Most raptors and waterfowl have been found dead, but there have also been some discoveries in crows.
USDA Poultry Avian Flu Updates
USDA APHIS Wild Bird Flu Update

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