Impact of a Stewardship-Initiated Restriction on Empirical Use of Ciprofloxacin on Nonsusceptibility of Escherichia coli Urinary Isolates to Ciprofloxacin
被引:12
作者:
O'Brien, Kristen A.
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机构:
Mercer Univ, Coll Pharm, Dept Pharm Practice, Atlanta, GA USAMercer Univ, Coll Pharm, Dept Pharm Practice, Atlanta, GA USA
O'Brien, Kristen A.
[1
]
Zhang, Jingwen
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机构:
Med Univ S Carolina, Coll Med, Dept Med, Charleston, SC 29425 USAMercer Univ, Coll Pharm, Dept Pharm Practice, Atlanta, GA USA
Zhang, Jingwen
[2
]
Mauldin, Patrick D.
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机构:
Med Univ S Carolina, Coll Med, Dept Med, Charleston, SC 29425 USAMercer Univ, Coll Pharm, Dept Pharm Practice, Atlanta, GA USA
Mauldin, Patrick D.
[2
]
Gomez, Juanmanuel
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h-index: 0
机构:
Med Univ S Carolina, Coll Med, Dept Med, Charleston, SC 29425 USAMercer Univ, Coll Pharm, Dept Pharm Practice, Atlanta, GA USA
Gomez, Juanmanuel
[2
]
Hurst, John M.
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机构:
Med Univ South Carolina Hosp, Dept Pharm Serv, Charleston, SC USAMercer Univ, Coll Pharm, Dept Pharm Practice, Atlanta, GA USA
Hurst, John M.
[3
]
Boger, M. Sean
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机构:
Med Univ S Carolina, Coll Med, Dept Med, Charleston, SC 29425 USAMercer Univ, Coll Pharm, Dept Pharm Practice, Atlanta, GA USA
Boger, M. Sean
[2
]
Bosso, John A.
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机构:
Med Univ S Carolina, Coll Med, Dept Med, Charleston, SC 29425 USA
South Carolina Coll Pharm, Dept Clin Pharm & Outcome Sci, Charleston, SC USAMercer Univ, Coll Pharm, Dept Pharm Practice, Atlanta, GA USA
Bosso, John A.
[2
,4
]
机构:
[1] Mercer Univ, Coll Pharm, Dept Pharm Practice, Atlanta, GA USA
[2] Med Univ S Carolina, Coll Med, Dept Med, Charleston, SC 29425 USA
[3] Med Univ South Carolina Hosp, Dept Pharm Serv, Charleston, SC USA
[4] South Carolina Coll Pharm, Dept Clin Pharm & Outcome Sci, Charleston, SC USA
STUDY OBJECTIVE To evaluate the impact of a stewardship-initiated restriction on empirical use of ciprofloxacin on the nonsusceptibility of Escherichia coli urinary isolates to ciprofloxacin over time while controlling for the use of other key antibiotics with gram-negative activity. DESIGN Retrospective single-center study. SETTING Large tertiary and quaternary care academic medical center. ISOLATES Of 3714 E. coli urinary isolates. MEASUREMENTS AND MAIN RESULTS The susceptibilities of the E. coli urinary isolates to ciprofloxacin, ceftriaxone, cefepime, piperacillin-tazobactam, meropenem, trimethoprim-sulfamethoxazole, and nitrofurantoin obtained over a 7-year period (January 1, 2006-December 31, 2012) from adult inpatients were evaluated for potential relationships with antibiotic use over time by using multiple variable regression analysis. After introduction of the restriction on empirical use of ciprofloxacin in the first quarter of 2011, ciprofloxacin use declined from 141.1-39.8 defined daily doses/1000 patient-days, and the percentage of E. coli isolates that were not susceptible to ciprofloxacin decreased from 41.5-32.8%. With all antibiotics evaluated included in the model, no apparent relationships were found between the percentage of E. coli isolates nonsusceptible to ciprofloxacin and antibiotic use. However, when nonsignificant variables were eliminated (p>0.20), ciprofloxacin use was found to be positively associated with the percentage of E. coli isolates nonsusceptible to ciprofloxacin (p=0.037), whereas ceftriaxone use was negatively associated (p=0.045). CONCLUSION The restriction and subsequent reduction of ciprofloxacin use was found to have a positive effect on the susceptibility of E. coli urinary isolates to ciprofloxacin.
机构:San Francisco VA Med Ctr, Pharm Informat & Pharmacokinet Program, San Francisco, CA 94121 USA
Leong, Julie V. B.
;
Boro, Maureen S.
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机构:
San Francisco VA Med Ctr, Pharm Informat & Pharmacokinet Program, San Francisco, CA 94121 USA
Univ Calif San Francisco, Sch Pharm, San Francisco, CA 94143 USASan Francisco VA Med Ctr, Pharm Informat & Pharmacokinet Program, San Francisco, CA 94121 USA
Boro, Maureen S.
;
Winter, Michael E.
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h-index: 0
机构:
Univ Calif San Francisco, Sch Pharm, San Francisco, CA 94143 USASan Francisco VA Med Ctr, Pharm Informat & Pharmacokinet Program, San Francisco, CA 94121 USA
机构:
Albany Coll Pharm, Dept Pharm Practice, Albany, NY 12208 USA
Ordway Res Inst, Albany, NY USAAlbany Coll Pharm, Dept Pharm Practice, Albany, NY 12208 USA
Lodise, Thomas P.
;
Lomaestro, Ben
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Albany Med Ctr Hosp, Albany, NY USAAlbany Coll Pharm, Dept Pharm Practice, Albany, NY 12208 USA
Lomaestro, Ben
;
Graves, Jeffrey
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机构:
Albany Coll Pharm, Dept Pharm Practice, Albany, NY 12208 USAAlbany Coll Pharm, Dept Pharm Practice, Albany, NY 12208 USA
Graves, Jeffrey
;
Drusano, G. L.
论文数: 0引用数: 0
h-index: 0
机构:
Ordway Res Inst, Albany, NY USAAlbany Coll Pharm, Dept Pharm Practice, Albany, NY 12208 USA
机构:
Aix Marseille Univ, Fac Med Timone, Lab Pharmacol Med & Clin, F-13385 Marseille, FranceAix Marseille Univ, Fac Med Timone, Lab Pharmacol Med & Clin, F-13385 Marseille, France
Marsot, Amelie
;
Boulamery, Audrey
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机构:
Aix Marseille Univ, Fac Med Timone, Lab Pharmacol Med & Clin, F-13385 Marseille, FranceAix Marseille Univ, Fac Med Timone, Lab Pharmacol Med & Clin, F-13385 Marseille, France
Boulamery, Audrey
;
Bruguerolle, Bernard
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机构:
Aix Marseille Univ, Fac Med Timone, Lab Pharmacol Med & Clin, F-13385 Marseille, FranceAix Marseille Univ, Fac Med Timone, Lab Pharmacol Med & Clin, F-13385 Marseille, France
Bruguerolle, Bernard
;
Simon, Nicolas
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h-index: 0
机构:
Aix Marseille Univ, Fac Med Timone, Lab Pharmacol Med & Clin, F-13385 Marseille, FranceAix Marseille Univ, Fac Med Timone, Lab Pharmacol Med & Clin, F-13385 Marseille, France
机构:San Francisco VA Med Ctr, Pharm Informat & Pharmacokinet Program, San Francisco, CA 94121 USA
Leong, Julie V. B.
;
Boro, Maureen S.
论文数: 0引用数: 0
h-index: 0
机构:
San Francisco VA Med Ctr, Pharm Informat & Pharmacokinet Program, San Francisco, CA 94121 USA
Univ Calif San Francisco, Sch Pharm, San Francisco, CA 94143 USASan Francisco VA Med Ctr, Pharm Informat & Pharmacokinet Program, San Francisco, CA 94121 USA
Boro, Maureen S.
;
Winter, Michael E.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Calif San Francisco, Sch Pharm, San Francisco, CA 94143 USASan Francisco VA Med Ctr, Pharm Informat & Pharmacokinet Program, San Francisco, CA 94121 USA
机构:
Albany Coll Pharm, Dept Pharm Practice, Albany, NY 12208 USA
Ordway Res Inst, Albany, NY USAAlbany Coll Pharm, Dept Pharm Practice, Albany, NY 12208 USA
Lodise, Thomas P.
;
Lomaestro, Ben
论文数: 0引用数: 0
h-index: 0
机构:
Albany Med Ctr Hosp, Albany, NY USAAlbany Coll Pharm, Dept Pharm Practice, Albany, NY 12208 USA
Lomaestro, Ben
;
Graves, Jeffrey
论文数: 0引用数: 0
h-index: 0
机构:
Albany Coll Pharm, Dept Pharm Practice, Albany, NY 12208 USAAlbany Coll Pharm, Dept Pharm Practice, Albany, NY 12208 USA
Graves, Jeffrey
;
Drusano, G. L.
论文数: 0引用数: 0
h-index: 0
机构:
Ordway Res Inst, Albany, NY USAAlbany Coll Pharm, Dept Pharm Practice, Albany, NY 12208 USA
机构:
Aix Marseille Univ, Fac Med Timone, Lab Pharmacol Med & Clin, F-13385 Marseille, FranceAix Marseille Univ, Fac Med Timone, Lab Pharmacol Med & Clin, F-13385 Marseille, France
Marsot, Amelie
;
Boulamery, Audrey
论文数: 0引用数: 0
h-index: 0
机构:
Aix Marseille Univ, Fac Med Timone, Lab Pharmacol Med & Clin, F-13385 Marseille, FranceAix Marseille Univ, Fac Med Timone, Lab Pharmacol Med & Clin, F-13385 Marseille, France
Boulamery, Audrey
;
Bruguerolle, Bernard
论文数: 0引用数: 0
h-index: 0
机构:
Aix Marseille Univ, Fac Med Timone, Lab Pharmacol Med & Clin, F-13385 Marseille, FranceAix Marseille Univ, Fac Med Timone, Lab Pharmacol Med & Clin, F-13385 Marseille, France
Bruguerolle, Bernard
;
Simon, Nicolas
论文数: 0引用数: 0
h-index: 0
机构:
Aix Marseille Univ, Fac Med Timone, Lab Pharmacol Med & Clin, F-13385 Marseille, FranceAix Marseille Univ, Fac Med Timone, Lab Pharmacol Med & Clin, F-13385 Marseille, France