The impact of an antibiotic cycling program on empirical therapy for gram-negative infections.

The impact of an antibiotic cycling program on empirical therapy for gram-negative infections. Research Abstract Details 

Research Abstract Table of Contents

Jump to the:

The impact of an antibiotic cycling program on empirical therapy for gram-negative infections. Abstract Text:

Liana R Merz,David K Warren,Marin H Kollef,Scott K Fridkin,Victoria J Fraser,

BACKGROUND: Antimicrobial-resistant organisms are an emerging problem in the ICU. Therapy cycling empiric antibiotics between various classes may influence bacterial resistance patterns. Understanding the impact of cycling on the appropriate treatment of suspected Gram-negative infections is important. METHODS: Data were prospectively collected on patients who were admitted to a 19-bed medical ICU (MICU). A total of 1,172 patients were admitted to the MICU for > 48 h and were evaluated during a 28.5-month period. After 4.5 months of baseline data collection, an antibiotic-cycling protocol was implemented, using four different antibiotic classes with Gram-negative activity that were cycled every 3 to 4 months. Therapy was considered to be inappropriate if the subsequent bacterial isolate was resistant to the empiric drug used. RESULTS: There were 59 bloodstream infections (BSIs), 17 ventilator-associated pneumonias (VAPs), and 101 urinary tract infections (UTIs) involving Gram-negative bacteria among 139 patients. Fifty-five infections (31%) were due to Gram-negative bacteria resistant to one or more antibiotic agents (BSIs, 18 [30%]; VAPs, 4 [23%]; and UTIs, 33 [33%]). Fifteen patients received inappropriate empiral therapy for 18 resistant Gram-negative infections (BSIs, 7 [39%]; VAPs, 3 [75%]; UTIs, 8 [24%]). Patients receiving inappropriate therapy were more likely to die (10 patients [67%] vs 40 patients [32%], respectively; p < 0.01). There was no difference in the receipt of appropriate empirical antibiotic therapy during the baseline compared to cycling (infectious episodes, 15% vs 10%, respectively; p = 0.4). CONCLUSIONS: Antimicrobial resistance occurred in almost 30% of ICU infections involving Gram-negative bacteria. Antibiotic cycling was not associated with significant changes in the receipt of appropriate empirical antimicrobial therapy for the treatment of ICU infections.

The impact of an antibiotic cycling program on empirical therapy for gram-negative infections. Publishing Authors By Initials

LR Merz,DK Warren,MH Kollef,SK Fridkin,VJ Fraser,

For similar organic chemicals: amides: lactams: beta-lactams research abstracts see: organic chemicals: amides: lactams: beta-lactams research

PUBMED ID PMID:

MEDLINE DATE:

The impact of an antibiotic cycling program on empirical therapy for gram-negative infections. Journal Published:

PUBLICATION TYPE: Research Support, U.S. Gov't,

Journal: Chest

VOLUME: 130

Page Numbers: 1672-8

Journal Abbreviation: Chest

ISSN: 0012-3692

DAY: 3

MONTH: Dec

YEAR: 2006

The impact of an antibiotic cycling program on empirical therapy for gram-negative infections. Information

Number of References:

LANGUAGE: eng

NlmUniqueID: 231335

The impact of an antibiotic cycling program on empirical therapy for gram-negative infections. Keywords Mesh Terms:

KEYWORDS: beta-Lactams

MESH TERMS: administration & dosage

Chemical & Substance for Abstract: The impact of an antibiotic cycling program on empirical therapy for gram-negative infections. Information

Substance Name: beta-Lactams

Registry Number: 0

Grant and Affiliation Information for The impact of an antibiotic cycling program on empirical therapy for gram-negative infections.

AFFILIATION: Division of Infectious Diseases, Washington University School of Medicine, Box 8051, 660 S Euclid Ave., Saint Louis, MO 63110, USA. lmerz@im.wustl.edu

Country: United States

AGENCY: United States PHS

GRANT: UR8/CCU 715087

ACRONYM: AI

MEDLINETA: Chest

REFSOURCE:

DATABASENAME:

ACCESSION NUMBER:

Number Hits: 0

The impact of an antibiotic cycling program on empirical therapy for gram-negative infections Related Publications

• Characterization of a spliced exon product of herpes simplex type-1 latency-associated transcript in productively infected cells.
• Circumstances of patient falls and injuries in 9 hospitals in a midwestern healthcare system.
• Comparing self-reported disease outcomes, diet, and lifestyles in a national cohort of black and white Seventh-day Adventists.
• Confocal quantification of cis-regulatory reporter gene expression in living sea urchin.
• Differences in protein mobility between pioneer versus follower growth cones.
• Effect of glutathione S-transferase polymorphisms and proximity to hazardous waste sites on time to systemic lupus erythematosus diagnosis: results from the Roxbury lupus project.
• Effects of fortified milk consumption on regional bone mineral accrual in Chinese girls.
• Effects of milk supplementation on cortical bone gain in Chinese girls aged 10-12 years.
• Epidemiology of methicillin-resistant Staphylococcus aureus colonization in a surgical intensive care unit.
• Estimating selection pressures from limited comparative data.
• Evaluation of Clostridium difficile-associated disease pressure as a risk factor for C difficile-associated disease.
• Factors influencing the effectiveness of research ethics committees.
• Feasibility of running clinics to collect biological specimens in a nationwide cohort study--Adventist Health Study-2.
• Genetic counselling in some common paediatric diseases.
• ICD-9 codes and surveillance for Clostridium difficile-associated disease.
• Impact of a methicillin-resistant Staphylococcus aureus active surveillance program on contact precaution utilization in a surgical intensive care unit.
• Injectable and macroporous calcium phosphate cement scaffold.
• Interplasmid transposition demonstrates piggyBac mobility in vertebrate species.
• Intra-articular glucocorticoid injection: an unusual cause of transient hypophosphataemia.
• Modulation of Abeta generation by small ubiquitin-like modifiers does not require conjugation to target proteins.
• Organizational research with impact: working backwards.
• Outcome of glenn anastomosis for heterotaxy syndrome with single ventricle.
• Patient safety event reporting in critical care: a study of three intensive care units.
• Prevalence of Clostridium difficile environmental contamination and strain variability in multiple health care facilities.
• Promoting science-based careers through student-directed learning.
• Severity of Clostridium difficile-associated disease (CDAD) in allogeneic stem cell transplant recipients: evaluation of a CDAD severity grading system.
• The alliance for cellular signaling plasmid collection: a flexible resource for protein localization studies and signaling pathway analysis.
• The impact of an antibiotic cycling program on empirical therapy for gram-negative infections.
• Transduction of brain by herpes simplex virus vectors.
• Translation research: where do we go from here?