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Updated: Jun 27, 2025
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A Protocol to Characterize the Morphological Changes of Clostridium difficile in Response to Antibiotic Treatment
Published on: May 25, 2017
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Characterizing Antibiotic Regimen Modification Behavior, Patient Characteristics, and Outcomes for Patients with
Jason Yamaki1,2, Mirna Mikhail1, Richard Beuttler1
1Department of Pharmacy Practice, Chapman University School of Pharmacy (CUSP), Irvine, CA 92618, USA.
Antibiotics (Basel, Switzerland)
|April 26, 2024
Summary
Antibiotic regimen modifications are common in acute care for Gram-negative infections. Despite frequent changes, no difference in clinical outcomes was observed, highlighting the need for early identification of resistant organisms.
Area of Science:
- Infectious Diseases
- Clinical Pharmacy
- Antimicrobial Stewardship
Background:
- Limited data exists on antibiotic regimen modification frequency in acute care settings.
- Gram-negative organisms resistant to extended-spectrum cephalosporins pose a significant challenge.
- Early identification and management of resistant infections are crucial.
Purpose of the Study:
- To determine the frequency of antibiotic regimen modifications in patients with complicated Gram-negative infections.
- To analyze patient and treatment characteristics associated with modifications.
- To evaluate the impact of modifications on clinical outcomes.
Main Methods:
- Retrospective study of 400 patients admitted to Hoag Memorial Hospital (January 2019 - March 2021).
- Inclusion criteria: complicated infection, Gram-negative organism resistant or potentially resistant to extended-spectrum cephalosporins (AmpC producers).
- Data collected on infection sources, organisms, modification details, and clinical outcomes.
Main Results:
- 72% of patients experienced antibiotic regimen modifications (1-6 changes per patient).
- Common modification reasons: lack of patient response (14%), reviewed history (9%), decompensation (7%).
- Predominant organisms: Pseudomonas spp. (38%) and ESBL-producing organisms (34%).
Conclusions:
- Frequent antibiotic regimen modifications are standard practice for resistant Gram-negative infections in acute care.
- No significant difference in clinical outcomes was associated with these modifications.
- The findings underscore the need for novel antibiotics and improved early detection of patients at risk for resistant organisms.
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