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Influences of alternate therapy protocol and continuous infectious disease consultation on antibiotic susceptibility
H Akalin1, F Kahveci, C Ozakin
1Uludağ University, School of Medicine, Department of Microbiology and Infectious Diseases, 16 059 Görükle, Bursa, Turkey. halis@uludag.edu.tr
Abstract:
In this study, the effects of alternate use of imipenem and cefoperazone/sulbactam(CFP/Sul) on antibiotic resistance in the intensive care unit (ICU) were investigated. Between 1 April 1993 and 1 April 1994, the infectious diseases consultant saw patients when required and there was no alternative therapy for antibiotics. For the following 2 years, the same consultant followed up each patient from admission to discharge by daily visits to the ICU and an alternative therapy protocol was initiated. The most common microorganisms were found to be Acinetobacter baumannii and Staphylococcus aureus, followed by Pseudomonas aeruginosa and Klebsiella pneumoniae, respectively, in the two periods. This study demonstrated that sensitivity rates of imipenem, ciprofloxacin and aminoglycosides were improved as a result of this protocol.
Insights
Alternate antibiotic therapy in the intensive care unit (ICU) improved bacterial sensitivity. This strategy enhanced the effectiveness of key antibiotics against common ICU pathogens.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Antimicrobial Stewardship
Background:
- Antibiotic resistance is a growing threat in intensive care units (ICUs).
- Effective antibiotic strategies are crucial for managing infections in critically ill patients.
- The study investigated the impact of a specific antibiotic rotation protocol.
Purpose of the Study:
- To evaluate the effect of alternating imipenem and cefoperazone/sulbactam (CFP/Sul) on antibiotic resistance patterns.
- To assess the impact of a structured antibiotic stewardship protocol on microbial sensitivity.
- To determine changes in the susceptibility of common ICU pathogens to various antibiotics.
Main Methods:
- A comparative study design was employed, comparing two periods with different antibiotic management strategies.
- The first period involved on-demand antibiotic consultation, while the second implemented a daily follow-up and alternative therapy protocol.
- Microorganism identification and antibiotic sensitivity testing were performed for common ICU isolates.
Main Results:
- The implementation of the alternative therapy protocol led to improved sensitivity rates for imipenem, ciprofloxacin, and aminoglycosides.
- Acinetobacter baumannii and Staphylococcus aureus were the most prevalent microorganisms identified.
- Pseudomonas aeruginosa and Klebsiella pneumoniae were also frequently observed pathogens.
Conclusions:
- The alternate use of imipenem and cefoperazone/sulbactam, as part of a structured protocol, can enhance antibiotic effectiveness.
- Antimicrobial stewardship programs involving active patient follow-up are beneficial in combating antibiotic resistance in ICUs.
- Improved sensitivity to commonly used antibiotics was observed following the protocol implementation.