Selection of resistance during sequential use of preferential antibiotic classes.
In: Intensive Care Medicine, Jg. 32 (2006), Heft 1, S. 67-74
Online
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Zugriff:
Objective: To determine the effect of antibiotic class pressure on the susceptibility of bacteria during sequential periods of antibiotic homogeneity. Design and Setting: Prospective study in a mixed ICU with three separated subunits of eight, eight, and ten beds. Patients and Participants: The study examined the 1,721 patients with a length of stay longer than 2 days. Interventions: Three different antibiotic regimens were used sequentially over 2 years as first-choice empirical treatment: cephalosporins, fluoroquinolone, or a penicillin-beta-lactamase inhibitor combination. Each regimen was applied for 8 months in each subunits of the ICU, using "latin square" design. Results: We treated 731 infections in 546 patients (32% of patients staying more than 48 h). There were 25.5 ICU-acquired infections per 1,000 patient-days. Infecting pathogens and colonizing bacteria were found in 2,739 samples from 1,666 patients (96.8%). No significant change in global antibiotic susceptibility was observed over time. However, a decrease in the susceptibility of several species was observed for antibiotics used as the first-line therapy in the unit. Selection pressure of antibiotics and occurrence of resistance during treatment was documented within an 8-month rotation period. Conclusions: Antibiotic use for periods of several months induces bacterial resistance in common pathogens. [ABSTRACT FROM AUTHOR]
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Selection of resistance during sequential use of preferential antibiotic classes.
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Autor/in / Beteiligte Person: | Damas, Pierre ; Canivet, Jean-Luc ; Ledoux, Didier ; Monchi, Mehran ; Melin, Pierrette ; Nys, Monique ; De Mol, Patrick |
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Zeitschrift: | Intensive Care Medicine, Jg. 32 (2006), Heft 1, S. 67-74 |
Veröffentlichung: | 2006 |
Medientyp: | academicJournal |
ISSN: | 0342-4642 (print) |
DOI: | 10.1007/s00134-005-2805-z |
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