OBJECTIVE: To evaluate the impact of an intensive care unit (ICU) antibiotic-use policy on the microbial resistance in nosocomial infections and costs. DESIGN: Comparative study before and after policy implementation. SETTINGS: An eleven-bed ICU in a general hospital. PATIENTS: All patients admitted for at least 48 h during a 5year period (1994-1998). INTERVENTIONS: In 1995, implementation of an antibiotic-use policy. MEASUREMENTS AND MAIN RESULTS: Patients' general characteristics, incidence of nosocomial infections, antibiotic-selective pressure (the number of days of antibiotic treatment for 1,000 days of presence in the ICU), presence and types of multi-resistant micro-organisms and costs linked to antibiotic use were recorded before (1994) and after implementation of the policy (1995-1998). For each year, patients' general characteristics and the incidence of nosocomial infections were the same. Costs linked to antibiotics use showed a progressive reduction (100% for 1994, 81% for 1995, 65% for 1998). Antibiotic-selective pressure diminished (from 940 days of antibiotic use per 1,000 days (1994) to 610 (1998), p<10(-5)). A statistically significant reduction in nosocomial infections due to antimicrobial resistant micro-organisms was observed (from 37% (1994) to 15% (1998) of nosocomial infections, p<10(-5)) after 3 years of implementation of the policy, essentially due to a reduction in methicillin-resistant Staphylococcus aureus and ceftriaxone-resistant Enterobacteriaceae. Nosocomial infections due to ceftazidime-resistant Pseudomonas species or extended-spectrum ss-lactamase Enterobacteriaceae showed no reduction. CONCLUSIONS: Antibiotic-use policy allowed a reduction in antibiotic-selective pressure, costs linked to antibiotics and selective reduction of nosocomial infections due to antimicrobial resistant micro-organisms.
OBJECTIVE: To evaluate the impact of an intensive care unit (ICU) antibiotic-use policy on the microbial resistance in nosocomial infections and costs. DESIGN: Comparative study before and after policy implementation. SETTINGS: An eleven-bed ICU in a general hospital. PATIENTS: All patients admitted for at least 48 h during a 5year period (1994-1998). INTERVENTIONS: In 1995, implementation of an antibiotic-use policy. MEASUREMENTS AND MAIN RESULTS:Patients' general characteristics, incidence of nosocomial infections, antibiotic-selective pressure (the number of days of antibiotic treatment for 1,000 days of presence in the ICU), presence and types of multi-resistant micro-organisms and costs linked to antibiotic use were recorded before (1994) and after implementation of the policy (1995-1998). For each year, patients' general characteristics and the incidence of nosocomial infections were the same. Costs linked to antibiotics use showed a progressive reduction (100% for 1994, 81% for 1995, 65% for 1998). Antibiotic-selective pressure diminished (from 940 days of antibiotic use per 1,000 days (1994) to 610 (1998), p<10(-5)). A statistically significant reduction in nosocomial infections due to antimicrobial resistant micro-organisms was observed (from 37% (1994) to 15% (1998) of nosocomial infections, p<10(-5)) after 3 years of implementation of the policy, essentially due to a reduction in methicillin-resistant Staphylococcus aureus and ceftriaxone-resistant Enterobacteriaceae. Nosocomial infections due to ceftazidime-resistant Pseudomonas species or extended-spectrum ss-lactamase Enterobacteriaceae showed no reduction. CONCLUSIONS: Antibiotic-use policy allowed a reduction in antibiotic-selective pressure, costs linked to antibiotics and selective reduction of nosocomial infections due to antimicrobial resistant micro-organisms.
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Authors: J Garnacho-Montero; A Gutiérrez-Pizarraya; A Escoresca-Ortega; Y Corcia-Palomo; Esperanza Fernández-Delgado; I Herrera-Melero; C Ortiz-Leyba; J A Márquez-Vácaro Journal: Intensive Care Med Date: 2013-09-12 Impact factor: 17.440
Authors: Tyler J Loftus; Scott C Brakenridge; Frederick A Moore; Stephen J Lemon; Linda L Nguyen; Stacy A Voils; Janeen R Jordan; Chasen A Croft; R Stephen Smith; Phillip A Efron; Alicia M Mohr Journal: Surg Infect (Larchmt) Date: 2016-09-16 Impact factor: 2.150
Authors: Pierre Damas; Jean-Luc Canivet; Didier Ledoux; Mehran Monchi; Pierrette Melin; Monique Nys; Patrick De Mol Journal: Intensive Care Med Date: 2005-11-25 Impact factor: 17.440
Authors: M Méan; P Pavese; J P Vittoz; L Foroni; C Decouchon; J P Stahl; P François Journal: Eur J Clin Microbiol Infect Dis Date: 2006-12 Impact factor: 3.267