JAC Advance Access originally published online on December 1, 2004
Journal of Antimicrobial Chemotherapy 2005 55(1):57-60; doi:10.1093/jac/dkh510
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JAC vol.55 no.1 © The British Society for Antimicrobial Chemotherapy 2004; all rights reserved
Fluoroquinolone consumption and resistance in haematology–oncology patients: ecological analysis in two university hospitals 1999–2002
1 Center for Infectious Diseases and Travel Medicine, Department of Medicine, 4 Department of Haematology-Oncology and 5 Institute of Environmental Medicine and Hospital Epidemiology, University Hospital, Hugstetter Strasse 55, D-79106 Freiburg; 2 Section of Infectious Diseases and Clinical Immunology and 3 Department of Haematology-Oncology, University Hospital and Medical Center; 6 Section of Hospital Hygiene, Department of Medical Microbiology and Hygiene, University of Ulm, Ulm, Germany
* Corresponding author. Tel: +49-761-270-1819; Fax: +49-761-270-1820; Email: info{at}if-freiburg.de
Objectives: To compare rates of in vitro fluoroquinolone resistance of bacterial isolates obtained from inpatients of two haematology–oncology services with high and low fluoroquinolone consumption.
Methods: Two hospitals with consistently high (A) and low (B) fluoroquinolone use in their haematology–oncology services between the years 1999 and 2002 were identified in a hospital antibiotic use surveillance project. Rates of in vitro resistance to fluoroquinolones in inpatients of the services were determined for Escherichia coli and coagulase-negative staphylococcal bloodstream isolates, and also for Pseudomonas aeruginosa and Staphylococcus aureus isolates from any site.
Results: Fluoroquinolone resistance of E. coli was significantly higher in hospital A than in hospital B, but there was no such correlation between fluoroquinolone use and resistance rates for P. aeruginosa and staphylococci.
Conclusion: The impact of antibiotic consumption on the prevalence of resistance may differ widely between different pathogens. Interventions using ecological analyses of the relationship between hospital antibiotic use and resistance need to consider pathogen-specific dynamics in the emergence and control of bacterial resistance.
Keywords: antibiotic use , Escherichia coli , fluoroquinolone resistance , antibiotic policy , drug utilization , febrile neutropenia , resistance epidemiology , staphylococci
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