Effects of Antibiotic Cycling Policy on Incidence of Healthcare-Associated MRSA and Clostridioides difficile Infection in Secondary Healthcare Settings

Details

• Alternative Title:
  Emerg Infect Dis
• Personal Author:
  Conlon-Bingham, Geraldine Mary ; Aldeyab, Mamoon ; Scott, Michael ; Kearney, Mary Patricia ; Farren, David ; Gilmore, Fiona ; McElnay, James
• Description:
  This quasi-experimental study investigated the effect of an antibiotic cycling policy based on time-series analysis of epidemiologic data, which identified antimicrobial drugs and time periods for restriction. Cyclical restrictions of amoxicillin/clavulanic acid, piperacillin/tazobactam, and clarithromycin were undertaken over a 2-year period in the intervention hospital. We used segmented regression analysis to compare the effect on the incidence of healthcare-associated Clostridioides difficile infection (HA-CDI), healthcare-associated methicillin-resistant Staphylococcus aureus (HA-MRSA), and new extended-spectrum β-lactamase (ESBL) isolates and on changes in resistance patterns of the HA-MRSA and ESBL organisms between the intervention and control hospitals. HA-CDI incidence did not change. HA-MRSA incidence increased significantly in the intervention hospital. The resistance of new ESBL isolates to amoxicillin/clavulanic acid and piperacillin/tazobactam decreased significantly in the intervention hospital; however, resistance to piperacillin/tazobactam increased after a return to the standard policy. The results question the value of antibiotic cycling to antibiotic stewardship.
• Subjects:
  Amoxicillin-Potassium Clavulanate Combination Anti-Bacterial Agents Antimicrobial Stewardship Beta-Lactamases Clostridium Infections Cross Infection Drug Resistance, Bacterial Hospitals Humans Incidence Methicillin-Resistant Staphylococcus Aureus Northern Ireland Research Staphylococcal Infections

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• Source:
  Emerg Infect Dis. 25(1):52-62
• Pubmed ID:
  30561306
• Pubmed Central ID:
  PMC6302607
• Document Type:
  Journal Article
• Place as Subject:
  Ireland
• Location:
  Europe
• Volume:
  25
• Issue:
  1
• Collection(s):
  Emerging Infectious Diseases
• Main Document Checksum:
  urn:sha256:458d5e2114338d7a75409d06f47cb5bfbf266a9fd5524d79efaa8a951973f55c
• Download URL:
  https://stacks.cdc.gov/view/cdc/80428/cdc_80428_DS1.pdf
• File Type:
  [PDF - 1.75 MB ]