Journal of Antimicrobial Chemotherapy (2001) 48, 535-540
© 2001 The British Society for Antimicrobial Chemotherapy
Departmental consumption of antibiotic drugs and subsequent resistance: a quantitative link
a Departments of Medicine, c Pharmacy Service, d Management, e Laboratory of Microbiology and f Infectious Diseases Unit, Rabin Medical Center, Beilinson Campus, Petah-Tiqva; b Sackler Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Tel-Aviv, Israel
Objective: To look for a quantitative model linking departmental consumption of antibiotic drugs to the subsequent isolation of resistant hospital-acquired coliform pathogens.
Materials and methods: Included in the study were all patients with hospital-acquired bloodstream infections caused by a coliform pathogen, detected in six departments of internal medicine of one university hospital during the period 1991–1996, who had not been hospitalized in the month before the infection (n = 394). Departmental consumption of antibiotics in the year before the infection [expressed as defined daily dosages (DDD)/100 patient days], antibiotic treatment given to the individual patient before the infection, the day of hospital stay on which the infection occurred, and the department and the calendar year were all included in a logistic model to predict the isolation of a resistant pathogen. We looked at five drugs: gentamicin, amikacin, cefuroxime, ceftazidime and ciprofloxacin.
Results: Five logistic models were fitted for the resistance to each of the antibiotic drugs. The multivariable-adjusted odds ratios for a pathogen resistant to the specific antibiotic were 1.03 [95% confidence interval (CI) 0.70–1.50] for gentamicin, 1.80 (95% CI 1.00–3.24) for amikacin, 1.12 (95% CI 1.02–1.23) for cefuroxime, 1.45 (95% CI 1.19–1.76) for ceftazidime and 1.06 (95% CI 0.57–1.97) for ciprofloxacin, per 1 DDD/100 patient days.
Conclusions: The departmental consumption of cephalosporin drugs and amikacin in six autonomous departments of medicine in the same hospital was associated with a measurable and statistically significant increase in the probability of infection caused by a resistant pathogen.
* Correspondence address. Department of Internal Medicine E, Beilinson Campus, 49100 Petah-Tiqva, Israel. Tel: +972-3-9376501; Fax: +972-3-9376505; E-mail: leibovic{at}post.tau.ac.il
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  M. Freundlich, R. W. Thomsen, L. Pedersen, H. West, and H. C. Schonheyder Aminoglycoside treatment and mortality after bacteraemia in patients given appropriate empirical therapy: a Danish hospital-based cohort study J. Antimicrob. Chemother., November 1, 2007; 60(5): 1115 - 1123. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Shetka, J. Pastor, and P. Phelps Evaluation of the defined daily dose method for estimating antiinfective use in a university hospital Am. J. Health Syst. Pharm., November 1, 2005; 62(21): 2288 - 2292. [Full Text] [PDF]
|
|
|
|
 |
|
 P T Donnan, L Wei, D T Steinke, G Phillips, R Clarke, A Noone, F M Sullivan, T M MacDonald, and P G Davey Presence of bacteriuria caused by trimethoprim resistant bacteria in patients prescribed antibiotics: multilevel model with practice and individual patient data BMJ, May 29, 2004; 328(7451): 1297. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Garcia-Rey, L. Aguilar, F. Baquero, J. Casal, and J. E. Martin Pharmacoepidemiological Analysis of Provincial Differences between Consumption of Macrolides and Rates of Erythromycin Resistance among Streptococcus pyogenes Isolates in Spain J. Clin. Microbiol., August 1, 2002; 40(8): 2959 - 2963. [Abstract] [Full Text] [PDF]
|
|