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  • 1. Andremont, Antoine
    et al.
    Bonten, Marc
    Kluytmans, Jan
    Carmeli, Yehuda
    Cars, Otto
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Infektionssjukdomar.
    Harbarth, Stephan
    Fighting bacterial resistance at the root: need for adapted EMEA guidelines2011Inngår i: Lancet. Infectious diseases (Print), ISSN 1473-3099, E-ISSN 1474-4457, Vol. 11, nr 1, s. 6-8Artikkel i tidsskrift (Annet vitenskapelig)
  • 2.
    Dorlo, Thomas P. C.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Farmaceutiska fakulteten, Institutionen för farmaceutisk biovetenskap. Univ Utrecht, Div Pharmacoepidemiol & Clin Pharmacol, Utrecht, Netherlands..
    Ostyn, Bart A.
    Inst Trop Med, B-2000 Antwerp, Belgium..
    Uranw, Surendra
    BP Koirala Inst Hlth Sci, Dharan, Nepal..
    Dujardin, Jean-Claude
    Inst Trop Med, B-2000 Antwerp, Belgium..
    Boelaert, Marleen
    Inst Trop Med, B-2000 Antwerp, Belgium..
    Treatment of visceral leishmaniasis: pitfalls and stewardship2016Inngår i: Lancet. Infectious diseases (Print), ISSN 1473-3099, E-ISSN 1474-4457, Vol. 16, nr 7, s. 777-778Artikkel i tidsskrift (Fagfellevurdert)
  • 3.
    Hasan, Badrul
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Infektionssjukdomar.
    Drobni, Peter
    Drobni, Mirva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Infektionssjukdomar.
    Alam, Munirul
    Olsen, Björn
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Infektionssjukdomar.
    Dissemination of NDM-12012Inngår i: Lancet. Infectious diseases (Print), ISSN 1473-3099, E-ISSN 1474-4457, Vol. 12, nr 2, s. 99-100Artikkel i tidsskrift (Fagfellevurdert)
  • 4.
    Högberg, Liselotte Diaz
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Muller, Arno
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Zorzet, Anna
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Monnet, Dominique L.
    Cars, Otto
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Antibiotic use worldwide2014Inngår i: Lancet. Infectious diseases (Print), ISSN 1473-3099, E-ISSN 1474-4457, Vol. 14, nr 12, s. 1179-1180Artikkel i tidsskrift (Fagfellevurdert)
  • 5. Laxminarayan, Ramanan
    et al.
    Duse, Adriano
    Wattal, Chand
    Zaidi, Anita K. M.
    Wertheim, Heiman F. L.
    Sumpradit, Nithima
    Vlieghe, Erika
    Levy Hara, Gabriel
    Gould, Ian M.
    Goossens, Herman
    Greko, Christina
    So, Anthony D.
    Bigdeli, Maryam
    Tomson, Goeran
    Woodhouse, Will
    Ombaka, Eva
    Peralta, Arturo Quizhpe
    Qamar, Farah Naz
    Mir, Fatima
    Kariuki, Sam
    Bhutta, Zulfigar A.
    Coates, Anthony
    Bergstrom, Richard
    Wright, Gerard D.
    Brown, Eric D.
    Cars, Otto
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Infektionssjukdomar.
    Antibiotic resistance-the need for global solutions2013Inngår i: Lancet. Infectious diseases (Print), ISSN 1473-3099, E-ISSN 1474-4457, Vol. 13, nr 12, s. 1057-1098Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The causes of antibiotic resistance are complex and include human behaviour at many levels of society; the consequences affect everybody in the world. Similarities with climate change are evident. Many efforts have been made to describe the many different facets of antibiotic resistance and the interventions needed to meet the challenge. However, coordinated action is largely absent, especially at the political level, both nationally and internationally. Antibiotics paved the way for unprecedented medical and societal developments, and are today indispensible in all health systems. Achievements in modern medicine, such as major surgery, organ transplantation, treatment of preterm babies, and cancer chemotherapy, which we today take for granted, would not be possible without access to effective treatment for bacterial infections. Within just a few years, we might be faced with dire setbacks, medically, socially, and economically, unless real and unprecedented global coordinated actions are immediately taken. Here, we describe the global situation of antibiotic resistance, its major causes and consequences, and identify key areas in which action is urgently needed.

  • 6.
    Lönngren, Vincent
    et al.
    Lunds universitet.
    Holst, Elisabet
    Ljunggren, Bo
    Larval papulonodular dermatitis treated with topical tiabendazole.2010Inngår i: Lancet. Infectious diseases (Print), ISSN 1473-3099, E-ISSN 1474-4457, Vol. 10, nr 7, s. 504-Artikkel i tidsskrift (Fagfellevurdert)
  • 7. Mölstad, S.
    et al.
    Erntell, M.
    Hanberger, H.
    Melander, E.
    Norman, C.
    Skoog, G.
    Lundborg, C. Stålsby
    Söderström, A.
    Torell, Erik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Infektionssjukdomar.
    Cars, Otto
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Infektionssjukdomar.
    Sustained reduction of antibiotic use and low bacterial resistance: 10-year follow-up of the Swedish Strama programme2008Inngår i: Lancet. Infectious diseases (Print), ISSN 1473-3099, E-ISSN 1474-4457, Vol. 8, nr 2, s. 125-132Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Increasing use of antibiotics and the spread of resistant pneumococcal clones in the early 1990s alarmed the medical profession and medical authorities in Sweden. Strama (Swedish Strategic Programme for the Rational Use of Antimicrobial Agents and Surveillance of Resistance) was therefore started in 1994 to provide surveillance of antibiotic use and resistance, and to implement the rational use of antibiotics and development of new knowledge. Between 1995 and 2004, antibiotic use for outpatients decreased from 15.7 to 12.6 defined daily doses per 1000 inhabitants per day and from 536 to 410 prescriptions per 1000 inhabitants per year. The reduction was most prominent in children aged 5-14 years (52%) and for macrolides (65%). During this period, the number of hospital admissions for acute mastoiditis, rhinosinusitis, and quinsy (peritonsillar abscess) was stable or declining. Although the epidemic spread in southern Sweden of penicillin-resistant Streptococcus pneumoniae was curbed, the national frequency increased from 4% to 6%. Resistance remained low in most other bacterial species during this period. This multidisciplinary, coordinated programme has contributed to the reduction of antibiotic use without measurable negative consequences. However, antibiotic resistance in several bacterial species is slowly increasing, which has led to calls for continued sustained efforts to preserve the effectiveness of available antibiotics.

  • 8. Nation, Roger L
    et al.
    Li, Jian
    Cars, Otto
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Infektionssjukdomar.
    Couet, William
    Dudley, Michael N
    Kaye, Keith S
    Mouton, Johan W
    Paterson, David L
    Tam, Vincent H
    Theuretzbacher, Ursula
    Tsuji, Brian T
    Turnidge, John D
    Framework for optimisation of the clinical use of colistin and polymyxin B: the Prato polymyxin consensus2015Inngår i: Lancet. Infectious diseases (Print), ISSN 1473-3099, E-ISSN 1474-4457, Vol. 15, nr 2, s. 225-234Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    In the face of diminishing therapeutic options for the treatment of infections caused by multidrug-resistant, Gram-negative bacteria, clinicians are increasingly using colistin and polymyxin B. These antibiotics became available clinically in the 1950s, when understanding of antimicrobial pharmacology and regulatory requirements for approval of drugs was substantially less than today. At the 1st International Conference on Polymyxins in Prato, Italy, 2013, participants discussed a set of key objectives that were developed to explore the factors affecting the safe and effective use of polymyxins, identify the gaps in knowledge, and set priorities for future research. Participants identified several factors that affect the optimum use of polymyxins, including: confusion caused by several different conventions used to describe doses of colistin; an absence of appropriate pharmacopoeial standards for polymyxins; outdated and diverse product information; and uncertainties about susceptibility testing and breakpoints. High-priority areas for research included: better definition of the effectiveness of polymyxin-based combination therapy compared with monotherapy via well designed, randomised controlled trials; examination of the relative merits of colistin versus polymyxin B for various types of infection; investigation of pharmacokinetics in special patient populations; and definition of the role of nebulised polymyxins alone or in combination with intravenous polymyxins for the treatment of pneumonia. The key areas identified provide a roadmap for action regarding the continued use of polymyxins, and are intended to help with the effective and safe use of these important, last-line antibiotics.

  • 9.
    Paul, Mical
    et al.
    Rambam Hlth Care Campus, Inst Infect Dis, IL-3109601 Haifa, Israel;Technion Israel Inst Technol, Fac Med, Haifa, Israel.
    Daikos, George L.
    Laikon Gen Hosp, Dept Med 1, Athens, Greece;Univ Athens, Athens, Greece.
    Durante-Mangoni, Emanuele
    Univ Campania L Vanvitelli, Internal Med, Naples, Italy;AORN Colli Monaldi Hosp, Naples, Italy.
    Yahav, Dafna
    Beilinson Med Ctr, Infect Dis Unit, Petah Tiqwa, Israel;Tel Aviv Univ, Sackler Fac Med, Ramat Aviv, Israel.
    Carmeli, Yehuda
    Tel Aviv Univ, Sackler Fac Med, Ramat Aviv, Israel;Tel Aviv Sourasky Med Ctr, Div Epidemiol & Prevent Med, Tel Aviv, Israel.
    Benattar, Yael Dishon
    Rambam Hlth Care Campus, Inst Infect Dis, IL-3109601 Haifa, Israel;Univ Haifa, Cheryl Spencer Dept Nursing, Haifa, Israel.
    Skiada, Anna
    Laikon Gen Hosp, Dept Med 1, Athens, Greece;Univ Athens, Athens, Greece.
    Andini, Roberto
    Univ Campania L Vanvitelli, Internal Med, Naples, Italy;AORN Colli Monaldi Hosp, Naples, Italy.
    Eliakim-Raz, Noa
    Beilinson Med Ctr, Infect Dis Unit, Petah Tiqwa, Israel;Beilinson Med Ctr, Dept Med E, Rabin Med Ctr, Petah Tiqwa, Israel;Tel Aviv Univ, Sackler Fac Med, Ramat Aviv, Israel.
    Nutman, Amir
    Tel Aviv Univ, Sackler Fac Med, Ramat Aviv, Israel;Tel Aviv Sourasky Med Ctr, Div Epidemiol & Prevent Med, Tel Aviv, Israel.
    Zusman, Oren
    Beilinson Med Ctr, Dept Med E, Rabin Med Ctr, Petah Tiqwa, Israel;Tel Aviv Univ, Sackler Fac Med, Ramat Aviv, Israel.
    Antoniadou, Anastasia
    Univ Athens, Athens, Greece;Attikon Univ, Gen Hosp, Dept Med 4, Athens, Greece.
    Pafundi, Pia Clara
    Univ Campania L Vanvitelli, Internal Med, Naples, Italy;AORN Colli Monaldi Hosp, Naples, Italy.
    Adler, Amos
    Tel Aviv Sourasky Med Ctr, Microbiol Lab, Tel Aviv, Israel.
    Dickstein, Yaakov
    Rambam Hlth Care Campus, Inst Infect Dis, IL-3109601 Haifa, Israel.
    Pavleas, Ioannis
    Laikon Gen Hosp, Intens Care Unit, Athens, Greece.
    Zampino, Rosa
    Univ Campania L Vanvitelli, Internal Med, Naples, Italy;AORN Colli Monaldi Hosp, Naples, Italy.
    Daitch, Vered
    Beilinson Med Ctr, Dept Med E, Rabin Med Ctr, Petah Tiqwa, Israel;Tel Aviv Univ, Sackler Fac Med, Ramat Aviv, Israel.
    Bitterman, Roni
    Rambam Hlth Care Campus, Inst Infect Dis, IL-3109601 Haifa, Israel.
    Zayyad, Hiba
    Rambam Hlth Care Campus, Inst Infect Dis, IL-3109601 Haifa, Israel.
    Koppel, Fidi
    Rambam Hlth Care Campus, Inst Infect Dis, IL-3109601 Haifa, Israel.
    Levi, Inbar
    Tel Aviv Sourasky Med Ctr, Div Epidemiol & Prevent Med, Tel Aviv, Israel.
    Babich, Tanya
    Beilinson Med Ctr, Dept Med E, Rabin Med Ctr, Petah Tiqwa, Israel;Tel Aviv Univ, Sackler Fac Med, Ramat Aviv, Israel.
    Friberg, Lena E
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Farmaceutiska fakulteten, Institutionen för farmaceutisk biovetenskap.
    Mouton, Johan W.
    Erasmus MC, Dept Med Microbiol & Infect Dis, Rotterdam, Netherlands.
    Theuretzbacher, Ursula
    Ctr Antiinfect Agents, Vienna, Austria.
    Leibovici, Leonard
    Beilinson Med Ctr, Dept Med E, Rabin Med Ctr, Petah Tiqwa, Israel;Tel Aviv Univ, Sackler Fac Med, Ramat Aviv, Israel.
    Colistin alone versus colistin plus meropenem for treatment of severe infections caused by carbapenem-resistant Gram-negative bacteria: an open-label, randomised controlled trial2018Inngår i: Lancet. Infectious diseases (Print), ISSN 1473-3099, E-ISSN 1474-4457, Vol. 18, nr 4, s. 391-400Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Colistin-carbapenem combinations are synergistic in vitro against carbapenem-resistant Gram-negative bacteria. We aimed to test whether combination therapy improves clinical outcomes for adults with infections caused by carbapenem-resistant or carbapenemase-producing Gram-negative bacteria.

    Methods: A randomised controlled superiority trial was done in six hospitals in Israel, Greece, and Italy. We included adults with bacteraemia, ventilator-associated pneumonia, hospital-acquired pneumonia, or urosepsis caused by carbapenem-non-susceptible Gram-negative bacteria. Patients were randomly assigned (1:1) centrally, by computer-generated permuted blocks stratified by centre, to intravenous colistin (9-million unit loading dose, followed by 45 million units twice per day) or colistin with meropenem (2-g prolonged infusion three times per day). The trial was open-label, with blinded outcome assessment. Treatment success was defined as survival, haemodynamic stability, improved or stable Sequential Organ Failure Assessment score, stable or improved ratio of partial pressure of arterial oxygen to fraction of expired oxygen for patients with pneumonia, and microbiological cure for patients with bacteraemia. The primary outcome was clinical failure, defined as not meeting all success criteria by intention-to-treat analysis, at 14 days after randomisation. This trial is registered at ClinicalTrials.gov, number NCT01732250, and is closed to accrual.

    Findings: Between Oct 1, 2013, and Dec 31, 2016, we randomly assigned 406 patients to the two treatment groups. Most patients had pneumonia or bacteraemia (355/406, 87%), and most infections were caused by Acinetobacter baumannii (312/406, 77%). No significant difference between colistin monotherapy (156/198, 79%) and combination therapy (152/208, 73%) was observed for clinical failure at 14 days after randomisation (risk difference -5.7%, 95% CI -13.9 to 2.4; risk ratio [RR] 0.93, 95% CI 0.83-1.03). Results were similar among patients with A baumannii infections (RR 0.97, 95% CI 0.87-1.09). Combination therapy increased the incidence of diarrhoea (56 [27%] vs 32 [16%] patients) and decreased the incidence of mild renal failure (37 [30%] of 124 vs 25 [20%] of 125 patients at risk of or with kidney injury).

    Interpretation: Combination therapy was not superior to monotherapy. The addition of meropenem to colistin did not improve clinical failure in severe A baumannii infections. The trial was unpowered to specifically address other bacteria.

  • 10.
    Pini, Alessandro
    et al.
    European Ctr Dis Prevent & Control, European Programme Intervent Epidemiol Training, Stockholm, Sweden;Publ Hlth Agcy Sweden, S-17182 Solna, Sweden.
    Stenbeck, Magnus
    Publ Hlth Agcy Sweden, S-17182 Solna, Sweden;Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden.
    Galanis, Ilias
    Publ Hlth Agcy Sweden, S-17182 Solna, Sweden.
    Kallberg, Henrik
    Publ Hlth Agcy Sweden, S-17182 Solna, Sweden.
    Danis, Kostas
    European Ctr Dis Prevent & Control, European Programme Intervent Epidemiol Training, Stockholm, Sweden;Publ Hlth Inst, Sante Publ France, Paris, France.
    Tegnell, Anders
    Publ Hlth Agcy Sweden, S-17182 Solna, Sweden.
    Wallensten, Anders
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper. Publ Hlth Agcy Sweden, S-17182 Solna, Sweden.
    Socioeconomic disparities associated with 29 common infectious diseases in Sweden, 2005-14: an individually matched case-control study2019Inngår i: Lancet. Infectious diseases (Print), ISSN 1473-3099, E-ISSN 1474-4457, Vol. 19, nr 2, s. 165-176Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background Although the association between low socioeconomic status and non-communicable diseases is well established, the effect of socioeconomic factors on many infectious diseases is less clear, particularly in high-income countries. We examined the associations between socioeconomic characteristics and 29 infections in Sweden. Methods We did an individually matched case-control study in Sweden. We defined a case as a person aged 18-65 years who was notified with one of 29 infections between 2005 and 2014, in Sweden. Cases were individually matched with respect to sex, age, and county of residence with five randomly selected controls. We extracted the data on the 29 infectious diseases from the electronic national register of notified infections and infectious diseases (SmiNet). We extracted information on country of birth, educational and employment status, and income of cases and controls from Statistics Sweden's population registers. We calculated adjusted matched odds ratios (amOR) using conditional logistic regression to examine the association between infections or groups of infections and place of birth, education, employment, and income. Findings We included 173 729 cases notified between Jan 1, 2005, and Dec 31, 2014 and 868 645 controls. Patients with invasive bacterial diseases, blood-borne infectious diseases, tuberculosis, and antibiotic-resistant infections were more likely to be unemployed (amOR 1.59, 95% CI 1.49-1.70; amOR 3.62, 3.48-3.76; amOR 1.88, 1.65-2.14; and amOR 1.73, 1.67-1.79, respectively), to have a lower educational attainment (amOR 1.24, 1.15-1.34; amOR 3.63, 3.45-3.81; amOR 2.14, 1.85-2.47; and amOR 1.07, 1.03-1.12, respectively), and to have a lowest income (amOR 1.52, 1.39-1.66; amOR 3.64, 3.41-3.89; amOR 3.17, 2.49-4.04; and amOR 1.2, 1.14-1.25, respectively). By contrast, patients with food-borne and water-borne infections were less likely than controls to be unemployed (amOR 0.74, 95% CI 0.72-0.76), to have lower education (amOR 0.75, 0.73-0.77), and lowest income (amOR 0.59, 0.58-0.61). Interpretation These findings indicate persistent socioeconomic inequalities in infectious diseases in an egalitarian high-income country with universal health care. We recommend using these findings to identify priority interventions and as a baseline to monitor programmes addressing socioeconomic inequalities in health.

  • 11.
    Tängdén, Thomas
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Pulcini, Céline
    Lorraine Univ, EA 4360, APEMAC, Nancy, France.
    Aagaard, Helle
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Balasegaram, Manica
    Global Antibiot R&D Partnership, Drugs Neglected Dis Initiat, Geneva, Switzerland.
    Hara, Gabriel Levy
    Hosp Carlos G Durand, Unit Infect Dis, Buenos Aires, DF, Argentina.
    Nathwani, Dilip
    British Soc Antimicrobial Chemotherapy, Birmingham, W Midlands, England.
    Sharland, Mike
    St Georges Univ, Paediat Infect Dis Res Grp, London, England.
    Theuretzbacher, Ursula
    Ctr Antiinfect Agents, Vienna, Austria.
    Cars, Otto
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Unavailability of old antibiotics threatens effective treatment for common bacterial infections2018Inngår i: Lancet. Infectious diseases (Print), ISSN 1473-3099, E-ISSN 1474-4457, Vol. 18, nr 3, s. 242-244Artikkel i tidsskrift (Annet vitenskapelig)
  • 12.
    Årdal, Christine
    et al.
    Norwegian Inst Publ Hlth, Div Infect Control & Environm Hlth, N-0403 Oslo, Norway..
    Baraldi, Enrico
    Uppsala universitet, Teknisk-naturvetenskapliga vetenskapsområdet, Tekniska sektionen, Institutionen för teknikvetenskaper, Industriell teknik.
    Ciabuschi, Francesco
    Uppsala Univ, Dept Business Studies, Uppsala, Sweden..
    Outterson, Kevin
    Boston Univ, Sch Law, Boston, MA 02215 USA.;CARB X, Boston, MA USA..
    Rex, John H.
    CARB X, Boston, MA USA..
    Piddock, Laura J. V.
    Univ Birmingham, Inst Microbiol & Infect, Birmingham, W Midlands, England..
    Findlay, David
    GlaxoSmithKline, London, England..
    To the G20: incentivising antibacterial research and development2017Inngår i: Lancet. Infectious diseases (Print), ISSN 1473-3099, E-ISSN 1474-4457, Vol. 17, nr 8, s. 799-801Artikkel i tidsskrift (Annet vitenskapelig)
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