BRASS C, COHEN I, ANIELLO S, BOOTH F, FENNER J; Interscience Conference on Antimicrobial Agents and Chemotherapy (41st : 2001 : Chicago, Ill.).
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2001 Dec 16-19; 41: abstract no. K-1129.
Kaleida Health, Buffalo, NY
Development of antibiotic resistance is a universal concern that is becoming an increasingly difficult problem. One control method proposed is to rotate the empiric choice of antibiotics at some predefined interval. The hypothesized benefit is that bacterial resistance would be more difficult to develop, or persist, if antibiotic pressure on the bacterial flora is changes on a regular basis. METHODS: At the Buffalo General Hospital/Kaleida Health Surgical Intensive Care Unit, we have rotated the empiric choice of antibiotics for nosocomial pneumonia(Pn) and intra-abdominal sepsis(IA) every six months for a 3 year period ending 6/30/00. These six cycles have rotated imipenem/cilistatin and piperacillin/tazobactam with or without an aminoglycoside. Endpoints tracked include: unit antibiogram data, APACHE II, clinical and bacterial outcomes, resistance development, and length of stay. Protocol compliance(>99%) was promoted by the multidisciplinary service but was at the discretion of surgical attending. RESULTS: 518 patients have been enrolled on protocol and 241 completed protocol over the 3 year period. Outcomes between cycles (shown in table 1 [table: see text]) have been equivalent. However, there has been a shorter LOS with Piperacillin/Tazobactam as well as less resistant GNB. There have been minimal declines in sensitivities for most bacteria (Table 2 [table: see text]). At this juncture, antibiotic cycling has been a successful method to forestall the development of antibiotic resistance.
Publication Types:
Keywords:
- Aminoglycosides
- Anti-Bacterial Agents
- Bacteria
- Cross Infection
- Drug Resistance
- Humans
- Imipenem
- Intensive Care
- Intensive Care Units
- Penicillanic Acid
- Piperacillin
- tazobactam
Other ID:
UI: 102269413
From Meeting Abstracts