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.
Original language | English |
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Pages (from-to) | 52-62 |
Number of pages | 11 |
Journal | Emerging Infectious Diseases |
Volume | 25 |
Issue number | 1 |
DOIs | |
Publication status | Published - 1 Jan 2019 |
Externally published | Yes |
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Mamoon Al Deyab
- Department of Pharmacy - Senior Lecturer in Pharmacy Practice/Clinical Pharmacy
- School of Applied Sciences
- Pharmaceutical Policy and Practice Research Centre - Member
Person: Academic