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A 9-Year retrospective review of antibiotic cycling in a surgical intensive care unit.

Publication ,  Journal Article
Sarraf-Yazdi, S; Sharpe, M; Bennett, KM; Dotson, TL; Anderson, DJ; Vaslef, SN
Published in: J Surg Res
August 2012

BACKGROUND: Six years after initiating a monthly antibiotic cycling protocol in the surgical intensive care unit (SICU), we retrospectively reviewed antibiogram-derived sensitivities of predominant gram-negative pathogens before and after antibiotic cycling. We also examined susceptibility patterns in the medical intensive care unit (MICU) where antibiotic cycling is not practiced. MATERIALS AND METHODS: Antibiotic cycling protocol was implemented in the SICU starting in 2003, with monthly rotation of piperacillin/tazobactam, imipenem/cilastin, and ceftazidime. SICU antibiogram data from positive clinical cultures for years 2000 and 2002 were included in the pre-cycling period, and those from 2004 to 2009 in the cycling period. RESULTS: Profiles of SICU pseudomonal isolates before (n = 116) and after (n = 205) implementing antibiotic cycling showed statistically significant improvements in susceptibility to ceftazidime (66% versus 81%; P = 0.003) and piperacillin/tazobactam (75% versus 85%; P = 0.021), while susceptibility to imipenem remained unaltered (70% in each case; P = 0.989). Susceptibility of E. coli isolates to piperacillin/tazobactam improved significantly (46% versus 83%; P < 0.0005), trend analysis showing this improvement to persist over the study period (P = 0.025). Similar findings were not observed in the MICU. Review of 2004-2009 antibiotic prescription practices showed monthly heterogeneity in the SICU, and a 2-fold higher prescribing of piperacillin/tazobactam in the MICU (P < 0.0001). CONCLUSIONS: Six years into antibiotic cycling, we found either steady or improved susceptibilities of clinically relevant gram-negative organisms in the SICU. How much of this effect is from cycling is unknown, but the antibiotic heterogeneity provided by this practice justifies its ongoing use.

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Published In

J Surg Res

DOI

EISSN

1095-8673

Publication Date

August 2012

Volume

176

Issue

2

Start / End Page

e73 / e78

Location

United States

Related Subject Headings

  • Surgical Wound Infection
  • Surgery
  • Retrospective Studies
  • Pseudomonas aeruginosa
  • Pseudomonas Infections
  • Piperacillin, Tazobactam Drug Combination
  • Piperacillin
  • Penicillanic Acid
  • Klebsiella pneumoniae
  • Klebsiella Infections
 

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Sarraf-Yazdi, S., Sharpe, M., Bennett, K. M., Dotson, T. L., Anderson, D. J., & Vaslef, S. N. (2012). A 9-Year retrospective review of antibiotic cycling in a surgical intensive care unit. J Surg Res, 176(2), e73–e78. https://doi.org/10.1016/j.jss.2011.12.014
Sarraf-Yazdi, Shiva, Michelle Sharpe, Kyla M. Bennett, Tim L. Dotson, Deverick J. Anderson, and Steven N. Vaslef. “A 9-Year retrospective review of antibiotic cycling in a surgical intensive care unit.J Surg Res 176, no. 2 (August 2012): e73–78. https://doi.org/10.1016/j.jss.2011.12.014.
Sarraf-Yazdi S, Sharpe M, Bennett KM, Dotson TL, Anderson DJ, Vaslef SN. A 9-Year retrospective review of antibiotic cycling in a surgical intensive care unit. J Surg Res. 2012 Aug;176(2):e73–8.
Sarraf-Yazdi, Shiva, et al. “A 9-Year retrospective review of antibiotic cycling in a surgical intensive care unit.J Surg Res, vol. 176, no. 2, Aug. 2012, pp. e73–78. Pubmed, doi:10.1016/j.jss.2011.12.014.
Sarraf-Yazdi S, Sharpe M, Bennett KM, Dotson TL, Anderson DJ, Vaslef SN. A 9-Year retrospective review of antibiotic cycling in a surgical intensive care unit. J Surg Res. 2012 Aug;176(2):e73–e78.
Journal cover image

Published In

J Surg Res

DOI

EISSN

1095-8673

Publication Date

August 2012

Volume

176

Issue

2

Start / End Page

e73 / e78

Location

United States

Related Subject Headings

  • Surgical Wound Infection
  • Surgery
  • Retrospective Studies
  • Pseudomonas aeruginosa
  • Pseudomonas Infections
  • Piperacillin, Tazobactam Drug Combination
  • Piperacillin
  • Penicillanic Acid
  • Klebsiella pneumoniae
  • Klebsiella Infections