Document Detail

Impact of limited cephalosporin use on prevalence of methicillin-resistant Staphylococcus aureus in the intensive care unit.
MedLine Citation:
PMID:  20071286     Owner:  NLM     Status:  MEDLINE    
Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a leading pathogen causing nosocomial infections. Many studies have shown that the restricted use of antibacterials is associated with a decline in resistance. To establish whether an intervention protocol designed to limit the use of cephalosporins can lower mRSA infection rates and impact on Gram-negative bacteria susceptibility in an intensive Care Unit (ICU), we conducted a prospective, non-randomized, before-after intervention study in an 18-bed ICU in Genoa, Italy. The intervention was a hospital antibiotic control policy and the observation was routine monitoring for nosocomial infections and antibiotic use, recording periodically the incidence density and MRSA prevalence. The intervention included a new antibiotic guideline that restricted the use of cephalosporins for all ICU inpatients. The analysis showed that the intervention determined a significant reduction in cephalosporin usage (-70.3%), while fluoroquinolones, mainly ciprofloxacin, increased after introduction of the antibiotic policy (+46.5%). A significant reduction in the percentage of MRSA infections (-30%) and heterogeneous susceptibility patterns in Klebsiella pneumoniae and Pseudomonas aeruginosa were noted.
M Bassetti; E Righi; F Ansaldi; M P Molinari; B Rebesco; J L McDermott; R Fasce; M Mussap; G Icardi; F Bobbio Pallavicini; C Viscoli
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Journal of chemotherapy (Florence, Italy)     Volume:  21     ISSN:  1973-9478     ISO Abbreviation:  J Chemother     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2010-01-14     Completed Date:  2010-03-09     Revised Date:  2011-03-17    
Medline Journal Info:
Nlm Unique ID:  8907348     Medline TA:  J Chemother     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  633-8     Citation Subset:  IM    
Infectious Diseases Division, S. Martino Hospital and University of Genoa School of Medicine, Genoa, Italy.
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MeSH Terms
Anti-Bacterial Agents / administration & dosage
Cephalosporins / administration & dosage*
Cross Infection / epidemiology,  prevention & control
Drug Resistance, Microbial*
Infection Control / methods*
Intensive Care Units
Klebsiella pneumoniae / drug effects
Methicillin-Resistant Staphylococcus aureus*
Pseudomonas aeruginosa / drug effects
Staphylococcal Infections / epidemiology*,  prevention & control*
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Cephalosporins
Comment In:
J Chemother. 2010 Dec;22(6):431; author reply 432   [PMID:  21303754 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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