Screening for multi-drug-resistant Gram-negative bacteria : what is effective and justifiable?
Effectiveness is a key criterion in assessing the justification of antibiotic resistance interventions. Depending on an intervention's effectiveness, burdens and costs will be more or less justified, which is especially important for large scale population-level interventions with high running costs and pronounced risks to individuals in terms of wellbeing, integrity and autonomy. In this paper, we assess the case of routine hospital screening for multi-drug-resistant Gram-negative bacteria (MDRGN) from this perspective. Utilizing a comparison to screening programs for Methicillin-Resistant Staphylococcus aureus (MRSA) we argue that current screening programmes for MDRGN in low endemic settings should be reconsidered, as its effectiveness is in doubt, while general downsides to screening programs remain. To accomplish justifiable antibiotic stewardship, MDRGN screening should not be viewed as a separate measure, but rather as part of a comprehensive approach. The program should be redesigned to focus on those at risk of developing symptomatic infections with MDRGN rather than merely detecting those colonised.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:38 |
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| Enthalten in: |
Monash bioethics review - 38(2020), Suppl 1 vom: 30. Dez., Seite 72-90 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Nijsingh, Niels [VerfasserIn] |
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| Links: |
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| Themen: |
Antibiotic resistance |
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| Anmerkungen: |
Date Completed 16.08.2021 Date Revised 16.08.2021 published: Print Citation Status MEDLINE |
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| doi: |
10.1007/s40592-020-00113-1 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM309398991 |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Effectiveness is a key criterion in assessing the justification of antibiotic resistance interventions. Depending on an intervention's effectiveness, burdens and costs will be more or less justified, which is especially important for large scale population-level interventions with high running costs and pronounced risks to individuals in terms of wellbeing, integrity and autonomy. In this paper, we assess the case of routine hospital screening for multi-drug-resistant Gram-negative bacteria (MDRGN) from this perspective. Utilizing a comparison to screening programs for Methicillin-Resistant Staphylococcus aureus (MRSA) we argue that current screening programmes for MDRGN in low endemic settings should be reconsidered, as its effectiveness is in doubt, while general downsides to screening programs remain. To accomplish justifiable antibiotic stewardship, MDRGN screening should not be viewed as a separate measure, but rather as part of a comprehensive approach. The program should be redesigned to focus on those at risk of developing symptomatic infections with MDRGN rather than merely detecting those colonised | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Antibiotic resistance | |
| 650 | 4 | |a Colonisation | |
| 650 | 4 | |a Hospital screening | |
| 650 | 4 | |a Public health ethics | |
| 650 | 4 | |a Risk | |
| 650 | 4 | |a Symptomatic infection | |
| 700 | 1 | |a Munthe, Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Lindblom, Anna |e verfasserin |4 aut | |
| 700 | 1 | |a Åhrén, Christina |e verfasserin |4 aut | |
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