Pharmacists at University of Alberta develop a national web-based antibiogram tool

Pharmacists at University of Alberta have developed a national web-based antibiogram tool, with region-specific information that allows clinicians to access local antimicrobial susceptibility data more easily. The tool is based on antibiograms that were collected directly from online publications or web applications (e.g., Firstline) or by directly contacting health authorities and individual hospitals. An antibiogram is a summary of antimicrobial susceptibilities in bacterial isolates tested by a microbiology laboratory. Antibiograms should be used to guide selection of empiric therapy against a particular pathogen, to optimize outcomes and prevent further antimicrobial resistance. Ideally, antibiograms should differentiate by care setting because resistance rates can vary considerably among care sites, even in the same region. Once culture-derived susceptibilities are available, they should be used to adjust therapy if needed. Read: International study shows just how well vaccine mandates worked Enhanced knowledge of local resistance rates has the potential to reduce inappropriate antibiotic use. However, clinicians may have difficulty in accessing accurate local antimicrobial resistance data to guide their prescribing decisions. To help overcome this obstacle, the authors created a free, accessible, user-friendly online tool to provide easy access to information about the resistance patterns in various regions and hospitals across Canada. The tool provides access to 588 antibiograms from various regions across Canada (presented on an interactive map). To locate susceptibility data for a specific region, clinicians can select the region or location (“pin”) on the map, or navigate using a drop-down menu. The map specifically illustrates regional fluoroquinolone susceptibilities to Escherichia coli, but other antibiotic/organism pairs are often also available from the resources listed. The authors note that this tool may provide particular benefit to clinicians in regions where antibiogram data are more difficult to obtain (e.g., in rural areas). The data will be updated as resources allow, but the authors caution that the tool may not provide the most current antibiogram susceptibility data. Where available, links to data updated by provincial health authorities/private lab services are included to assist clinicians in accessing the most up to date information. The authors use a typical patient case in a community pharmacy to illustrate the utility of the antibiogram tool. A 30-year-old man with a urinary tract infection (UTI) presents with a prescription for ciprofloxacin 500 mg oral twice daily for seven days The pharmacist recalls that E. coli is the most prevalent pathogen in UTIs, but is uncertain whether ciprofloxacin is the most appropriate antimicrobial for this patient. After checking references, the pharmacist finds that ciprofloxacin is recommended as empiric therapy for a UTI only when the local resistance rates are lower than 10%. The pharmacist accesses the antibiogram tool and refers to the antibiogram for the local area, which indicates that only 72% of local E. coli isolates are susceptible to ciprofloxacin. As more than 10% of E. coli are resistant to ciprofloxacin in the local area, the pharmacist (with prescribing authority) decides to adapt the prescription to another agent with more reliable susceptibility. The patient returns to the pharmacy one week later to report that his symptoms have resolved and he did not experience any adverse effects with the therapy. Reference 1. Zeggil T, Dobbyn D, Kudrowich B, et al. Development of a national web-based antibiogram tool. CPJ 2022; Published online June 8, 2022. (accessed June 16, 2022).

Pharmacists at University of Alberta develop a national web-based antibiogram tool

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