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Decreased antimicrobial resistance after changes in antibiotic use
1Methodist Hospital of Indiana, Indianapolis 46206-1367, USA.
Pharmacotherapy
|August 24, 1999
Summary
Antimicrobial resistance control strategies, including reduced cephalosporin use, significantly decreased Vancomycin-resistant enterococci (VRE) and Methicillin-resistant Staphylococcus aureus (MRSA) at one hospital. This highlights effective interdisciplinary collaboration in combating resistant bacteria.
Area of Science:
- Infectious Diseases
- Hospital Epidemiology
- Antimicrobial Stewardship
Background:
- Vancomycin-resistant enterococci (VRE) and Methicillin-resistant Staphylococcus aureus (MRSA) are increasingly prevalent in healthcare settings beyond large medical centers.
- Identifying sources of VRE and MRSA colonization is challenging due to patient movement across care continuum.
- Rising numbers of VRE and MRSA pose a significant threat to patient care.
Purpose of the Study:
- To evaluate the impact of control strategies on VRE and MRSA incidence.
- To identify factors contributing to the reduction of antimicrobial-resistant bacteria.
Main Methods:
- Implementation of specific control strategies at a hospital.
- Monitoring VRE and MRSA isolate rates from 1994 onwards.
- Analysis of antibiotic administration patterns, specifically cephalosporins versus piperacillin-tazobactam.
Main Results:
- A significant decline in VRE from 16% to 5% was observed.
- MRSA isolates decreased from 35% to 23%.
- These reductions coincided with a shift from cephalosporins to piperacillin-tazobactam and enhanced interdisciplinary collaboration.
Conclusions:
- Effective control of VRE and MRSA is achievable through targeted strategies.
- Interdisciplinary teamwork among healthcare professionals is crucial for successful antimicrobial resistance management.
- Adjusting antibiotic prescribing, favoring piperacillin-tazobactam over cephalosporins, contributed to reduced VRE and MRSA rates.