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

Geraldine Mary Conlon-Bingham, Mamoon Aldeyab, Michael Scott, Mary Patricia Kearney, David Farren, Fiona Gilmore, James McElnay

Research output: Contribution to journalArticle

Abstract

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.

LanguageEnglish
Pages52-62
Number of pages11
JournalEmerging Infectious Diseases
Volume25
Issue number1
DOIs
Publication statusPublished - 1 Jan 2019
Externally publishedYes

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Methicillin-Resistant Staphylococcus aureus
Coinfection
Anti-Bacterial Agents
Delivery of Health Care
Amoxicillin-Potassium Clavulanate Combination
Incidence
Clarithromycin
beta-Lactamases
Cross Infection
Regression Analysis
Infection
Pharmaceutical Preparations
tazobactam drug combination piperacillin

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Conlon-Bingham, Geraldine Mary ; Aldeyab, Mamoon ; Scott, Michael ; Kearney, Mary Patricia ; Farren, David ; Gilmore, Fiona ; McElnay, James. / Effects of Antibiotic Cycling Policy on Incidence of Healthcare-Associated MRSA and Clostridioides difficile Infection in Secondary Healthcare Settings. In: Emerging Infectious Diseases. 2019 ; Vol. 25, No. 1. pp. 52-62.
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Effects of Antibiotic Cycling Policy on Incidence of Healthcare-Associated MRSA and Clostridioides difficile Infection in Secondary Healthcare Settings. / Conlon-Bingham, Geraldine Mary; Aldeyab, Mamoon; Scott, Michael; Kearney, Mary Patricia; Farren, David; Gilmore, Fiona; McElnay, James.

In: Emerging Infectious Diseases, Vol. 25, No. 1, 01.01.2019, p. 52-62.

Research output: Contribution to journalArticle

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