To assess antimicrobial stewardship and national implementation measures currently in place for optimizing antimicrobial use and for slowing the spread of AMR, authors invited public health experts from 138 LMICs to participate in a Global Survey of Experts on Antimicrobial Resistance (GSEAR). Key coverage measures, as reported by experts, were compared across countries and also juxtaposed with estimates collected in the 2020-21 WHO-organized Tripartite AMR Country Self-Assessment Survey (TrACSS). A total of 352 completed surveys from 118 LMICs were analysed. Experts in 67% of the surveyed countries reported a national action plan (NAP) on AMR, 64% reported legislative policies on antimicrobial use, 58% reported national training programs for health professionals, and 10% reported national monitoring systems for antimicrobials. 51% of LMICs had specific targeted policies to limit the sale and use of protected or reserve antibiotics. While 72% of LMICs had prescription requirements for accessing antibiotics, getting antibiotics without a prescription was reported to be possible in practice in 74% of LMICs. On average, country efforts reported in TrACSS were substantially higher than those seen in GSEAR. Increased national efforts in the areas of enforcement and monitoring of antibiotic use as well as regular monitoring of national efforts are urgently needed to reduce inappropriate antibiotic use in LMICs and to slow the spread of AMR globally.

During the SARS-CoV-2 pandemic, Italy witnessed a rise in healthcare-associated infections (HAIs), with GNBs involved in a substantial proportion of cases. Concerningly, carbapenem-resistant GNBs (CR-GNBs) have increased worldwide, posing therapeutic challenges. A retrospective multicentre study analysing data from over 299,000 patients admitted to Italian ICUs from 2013 to 2022. The study revealed an average of 1.5 infections per patient, with HAIs peaking during the pandemic years. Ventilator associated pneumonia (VAP) emerged as the most common HAI, with Klebsiella spp. and P. aeruginosa predominating. Alarmingly, CR-GNBs accounted for a significant proportion of infections, particularly in VAP, bloodstream infections, and intra-abdominal infections. Authors findings underscore the pressing need for enhanced infection control measures, particularly in the ICU setting, to mitigate the rising prevalence of CR-GNBs and their impact on patient outcomes. The study provides valuable insights into the epidemiology of HAIs in Italian ICUs and highlights the challenges posed by CR-GNBs, especially in the context of the SARS-CoV-2 pandemic, which exacerbated the issue and may serve as a crucial example for the management of future viral pandemics.

Pfizer’s Emblaveo approved in EU for multidrug-resistant infection treatment Pfizer has announced that the European Commission (EC) has granted marketing authorisation for Emblaveo (aztreonam-avibactam) for the treatment of adult patients with complicated intra-abdominal infections (cIAI), hospital-acquired pneumonia (HAP), including ventilator-associated pneumonia (VAP) and complicated urinary tract infections (cUTI), including pyelonephritis. The drug is also indicated for the treatment of infections from aerobic Gram-negative organisms in adult patients who have limited treatment options. This approval follows results from the previously reported phase 3 programme, which included the REVISIT and ASSEMBLE trials, assessing the safety, efficacy and tolerability of Emblaveo in treating serious infections due to Gram-negative bacteria. The results demonstrated that the drug is effective and well-tolerated, and no new safety findings were reported compared to aztreonam alone. This marketing authorisation is valid in all 27 EU member states, as well as Iceland, Liechtenstein and Norway. Marketing authorisation applications for the drug are expected to be submitted in other countries imminently. Y. Carmeli head of the National Institute for Antibiotic Resistance and Infection Control, Tel Aviv Medical Center, Israel, and an investigator in the REVISIT study, added: “For healthcare teams treating patients with serious Gram-negative bacterial infections, the prospect of running out of effective treatment options is a daunting but very real threat. The approval of Emblaveo is welcome news for the infectious disease community and provides new hope to critically ill patients affected by AMR.”

GSK has announced that it has pledged £45m to the Fleming Initiative, becoming the first founding partner of the innovative and collaborative approach to tackle antimicrobial resistance (AMR).The initiative, led by the Imperial College Healthcare NHS Trust and Imperial College London, UK, intends to ‘bring together world-class scientific, technology, policy and behavioural science expertise with clinical experience in a global network of centres to find, test and scale solutions to AMR’, according to the company’s press release. GSK’s £45m is intended to be used on approved projects that aim to utilise new technology, such as artificial intelligence (AI) to better understand and use scientific data, identify new treatment options, understand how surveillance approaches can improve detection of infections, and improve our understanding of how drug-resistant infections are transmitted, as well as how they can be prevented. There will also be a strong focus on diagnostics, education and public engagement to reduce AMR, with a particular emphasis on countries most severely impacted by AMR where poverty, climate change and health inequality exacerbate the issues it can cause. E. Walmsley, chief executive officer of GSK, commented: “This will be an important collaboration for GSK building on our longstanding commitment to tackling AMR and our focus on disease prevention. The Fleming Initiative will bring together global resources and expertise from across different sectors to better understand the factors contributing to this growing threat and most importantly, drive action and solutions. We are proud to be a founding partner, and hope others will join us to support this urgent priority.” Prof. T. Orchard, chief executive of Imperial College Healthcare NHS Trust, said: “Antimicrobial resistance remains one of the biggest challenges we face in the NHS and other healthcare systems around the world. The support of a global biopharma company with a proven history in treatment for infectious disease is a major boost to our goal to find new solutions and interventions for tackling drug resistant infections“.