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Implementation of antibiotic rotation protocol improves antibiotic susceptibility profile in a surgical intensive care unit.

Publication ,  Journal Article
Bennett, KM; Scarborough, JE; Sharpe, M; Dodds-Ashley, E; Kaye, KS; Hayward, TZ; Vaslef, SN
Published in: J Trauma
August 2007

BACKGROUND: Antibiotic rotation has been proposed as a way to potentially reduce the development of antimicrobial resistant bacteria in intensive care units. We assessed the effect of an antibiotic rotation protocol on the antibiotic susceptibility profiles of three clinically relevant gram-negative microorganisms within our surgical intensive care unit (SICU). METHODS: Our SICU implemented an antibiotic rotation protocol in 2003. Four antibiotics (piperacillin/tazobactam, imipenem/cilastin, ceftazidime, and ciprofloxacin) were rotated as the primary antibiotic used to treat suspected gram-negative infections every month, with the four-drug cycle being repeated every 4 months. Antibiotic susceptibility data for three microorganisms (Pseudomonas aeruginosa, Escherichia coli, and Klebsiella pneumoniae) were collected for the year before (2002) and the year after (2004) the implementation of the rotation protocol. Changes in antimicrobial susceptibility rates were analyzed for the three microorganisms. As a comparison, a similar analysis was conducted for microorganisms isolated from our medical intensive care unit, where no antibiotic rotation protocol was implemented. RESULTS: Implementation of an antibiotic rotation protocol in our SICU resulted in a significant increase in the percentage of P. aeruginosa isolates sensitive to ceftazidime (67% in 2002 vs. 92% in 2004, p = 0.002) and piperacillin/tazobactam (78% in 2002 vs. 92% in 2004, p = 0.043). Isolates from the medical intensive care unit did not demonstrate an increase in antimicrobial susceptibility. In fact, the susceptibility of E. coli to piperacillin/tazobactam decreased during this time period (p = 0.047). CONCLUSIONS: Implementation of an antibiotic rotation protocol in our SICU resulted in overall improvement in the antibiotic susceptibility profile of gram-negative microorganisms relative to our medical intensive care unit, where such a protocol was not used.

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Published In

J Trauma

DOI

EISSN

1529-8809

Publication Date

August 2007

Volume

63

Issue

2

Start / End Page

307 / 311

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Tazobactam
  • Sensitivity and Specificity
  • Retrospective Studies
  • Probability
  • Piperacillin
  • Penicillanic Acid
  • Microbial Sensitivity Tests
  • Male
  • Intensive Care Units
 

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Bennett, K. M., Scarborough, J. E., Sharpe, M., Dodds-Ashley, E., Kaye, K. S., Hayward, T. Z., & Vaslef, S. N. (2007). Implementation of antibiotic rotation protocol improves antibiotic susceptibility profile in a surgical intensive care unit. J Trauma, 63(2), 307–311. https://doi.org/10.1097/TA.0b013e318120595e
Bennett, Kyla M., John E. Scarborough, Michelle Sharpe, Elizabeth Dodds-Ashley, Keith S. Kaye, Thomas Z. Hayward, and Steven N. Vaslef. “Implementation of antibiotic rotation protocol improves antibiotic susceptibility profile in a surgical intensive care unit.J Trauma 63, no. 2 (August 2007): 307–11. https://doi.org/10.1097/TA.0b013e318120595e.
Bennett KM, Scarborough JE, Sharpe M, Dodds-Ashley E, Kaye KS, Hayward TZ, et al. Implementation of antibiotic rotation protocol improves antibiotic susceptibility profile in a surgical intensive care unit. J Trauma. 2007 Aug;63(2):307–11.
Bennett, Kyla M., et al. “Implementation of antibiotic rotation protocol improves antibiotic susceptibility profile in a surgical intensive care unit.J Trauma, vol. 63, no. 2, Aug. 2007, pp. 307–11. Pubmed, doi:10.1097/TA.0b013e318120595e.
Bennett KM, Scarborough JE, Sharpe M, Dodds-Ashley E, Kaye KS, Hayward TZ, Vaslef SN. Implementation of antibiotic rotation protocol improves antibiotic susceptibility profile in a surgical intensive care unit. J Trauma. 2007 Aug;63(2):307–311.

Published In

J Trauma

DOI

EISSN

1529-8809

Publication Date

August 2007

Volume

63

Issue

2

Start / End Page

307 / 311

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Tazobactam
  • Sensitivity and Specificity
  • Retrospective Studies
  • Probability
  • Piperacillin
  • Penicillanic Acid
  • Microbial Sensitivity Tests
  • Male
  • Intensive Care Units