Never prescribe an antibiotic alone: there’s Maiday
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It’s called Maiday, and it recalls Mayday, the alarm sounded by ships in distress. And that’s the meaning: because Maiday, where central id stands for infectious diseases, is a project wanted by Sita, the Italian Society of Antifective Therapy, and is the first digital platform, active 24 hours a day, 7 days a week, which provides a second opinion to doctors within 48 hours of the request. Subsequently, with a weekly webinar, all those who have requested advice will be able to talk and discuss clinical cases and the most suitable interventions, with the advice of expert infectious disease specialists.
Antibiotic resistance is now top priority
by Elvira Naselli
An attempt to curb drug resistance that has now become a global alarm. “We gave too aggressive therapies when they weren’t needed – he said Pierluigi Viale, Sita vice president and director of Infectious Diseases at the Sant’Orsola Malpighi Polyclinic in Bologna – committing a real epidemiological crime: prescribing a therapy longer than three days for cystitis means not only not having a better result but selecting resistant strains. We were slaves to the 7 times table, prescribing antibiotics for 7 or 14 days. Well, it doesn’t make sense, we need to aim for more contained therapies that take into account the individual patient”.
A task force against ‘super microbes’, thus defeating antibiotic resistance
by Simone Valesini
Contained therapies, wise use of drugs and greater awareness of who prescribes them. “Unfortunately, there is now resistance even against the most powerful drugs such as carbapenems – he underlines Matthew Bassetti, president of Sita and director of the Infectious Diseases Clinic at the San Martino Irccs Polyclinic in Genoa – a bit like our last bulwark against bacteria and for this reason treating it becomes increasingly demanding. Italy is in second place in Europe for drug resistance after Romania and Greece, and it is not a good record considering that estimates tell us that between 15 and 20 thousand people die from infections that do not respond to drugs in hospital settings and the same number outside . This is why we need to raise awareness among citizens, pharmacists and even doctors. Because if it is obvious that the most fragile patients are more exposed – cancer patients, hospitalized in intensive care, transplant recipients – it does not mean that the resistance is limited to them. On the contrary, unfortunately they also affect patients who may find themselves in hospital due to a moped accident or having their appendix removed and remain for a few days. And it also affects those who are out of hospital, for example in recurring cystitis: at the fourth episode a year the bacterium has become resistant”.
Against bacteria we will use gold
by Tina Simoniello
Returning to Maiday, which was created thanks to Shionogi’s unconditional contribution, the platform is a kind of “cultural tool”. A second level consultancy on the management of the therapy of a patient with infection. Necessary because – underlines Viale – there are no guidelines, nor strong evidence and everyone works a bit on their own. “Sharing cases means helping colleagues in difficulty – continues Bassetti – also offering multidisciplinary answers, as Covid has taught us to do. In practice, the colleague sends his patient’s data, presents them on call and can get support from those who have more experience. We started last week and we think it’s a very useful tool.”
Fluoroquinolone antibiotics, AIFA’s warning: “Risky if prescribed outside the recommendations”
A reasoned response in a tactical war with no holds barred. “Our weapons are not enough – reasons Viale – the populations of bacteria are much faster than us in responding to stress, they have less difficulty developing resistance than we do in finding new drugs. Our weapons are never optimal but improving the culture of use is important and Maiday has the ambitious aim of creating a scientific community, a sort of permanent consultation of the antimicrobial culture to share the methods of approach. The meaning is never to prescribe an antibiotic alone, the platform serves to try to resolve doubts and offer new methods of use. It would also make sense to think of antibiotic packs with the number of pills needed for therapy, and no more. And differentiated Drg for hospitalizations in case of antibiotic resistance”. Which cost a lot but are not considered”.
Untraceable amoxicillin, appeal by pediatricians to Aifa
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