Impact of limited cephalosporin use on prevalence of methicillin-resistant Staphylococcus aureus in the intensive care unit

Matteo Bassetti, E. Righi, F. Ansaldi, M. P. Molinari, B. Rebesco, J. L. Mcdermott, R. Fasce, M. Mussap, G. Icardi, F. Bobbio Pallavicini, C. Viscoli

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)633-638
Number of pages6
JournalJournal of Chemotherapy
Volume21
Issue number6
Publication statusPublished - Dec 2009

Keywords

  • Antibiotics
  • Cephalosporins
  • ICU
  • K. pneumoniae
  • MRSA
  • P. Aeruginosa
  • Restriction

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Infectious Diseases
  • Oncology
  • Pharmacology
  • Medicine(all)

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