Reduction of vancomycin-resistant enterococcal infections by limitation of broad-spectrum cephalosporin use in a trauma and burn intensive care unit - PubMed (original) (raw)

Comparative Study

Reduction of vancomycin-resistant enterococcal infections by limitation of broad-spectrum cephalosporin use in a trauma and burn intensive care unit

A K May et al. Shock. 2000 Sep.

Abstract

Both vancomycin and third-generation cephalosporin use are believed to contribute to a rise in vancomycin-resistant enterococci (VRE) infections. In 1998, the largest number of VRE infections in our hospital occurred in the trauma/burn intensive care unit (TBICU), accounting for nearly 20% of hospital infections. In an attempt to control the VRE infection rate, antibiotic protocols for prophylaxis, empiric, and definitive therapy were initiated during the final quarter of 1998 to minimize cephalosporin use by the introduction of piperacillin/tazobactam. Therefore, we undertook a study of the VRE infection rate for the TBICU in relation to vancomycin, piperacillin/tazobactam, piperacillin, third-generation cephalosporin, and total cephalosporin use before and after efforts to limit cephalosporins. These data were compared to those in the medical and surgical intensive care units. During 1998, seven VRE infections occurred in the TBICU. Following initiation of antibiotic protocols, one case of VRE infection occurred in the subsequent month and no cases in the 17 months since. The decrease in the VRE infection rate corresponded with a significant increase in the use of piperacillin/tazobactam and a reduction in third-generation and total cephalosporin use. In contrast, cephalosporin use in the medical and surgical intensive care units remains significantly higher than in the TBICU, and neither unit has had a reduction in their VRE infection rates.

PubMed Disclaimer

Cited by

Interventions to improve antibiotic prescribing practices for hospital inpatients.
Davey P, Marwick CA, Scott CL, Charani E, McNeil K, Brown E, Gould IM, Ramsay CR, Michie S. Davey P, et al. Cochrane Database Syst Rev. 2017 Feb 9;2(2):CD003543. doi: 10.1002/14651858.CD003543.pub4. Cochrane Database Syst Rev. 2017. PMID: 28178770 Free PMC article. Review.
Association between vancomycin-resistant Enterococci bacteremia and ceftriaxone usage.
McKinnell JA, Kunz DF, Chamot E, Patel M, Shirley RM, Moser SA, Baddley JW, Pappas PG, Miller LG. McKinnell JA, et al. Infect Control Hosp Epidemiol. 2012 Jul;33(7):718-24. doi: 10.1086/666331. Epub 2012 May 14. Infect Control Hosp Epidemiol. 2012. PMID: 22669234 Free PMC article.
Acquisition of rectal colonization by vancomycin-resistant Enterococcus among intensive care unit patients treated with piperacillin-tazobactam versus those receiving cefepime-containing antibiotic regimens.
Paterson DL, Muto CA, Ndirangu M, Linden PK, Potoski BA, Capitano B, Bonomo RA, Aron DC, Donskey CJ. Paterson DL, et al. Antimicrob Agents Chemother. 2008 Feb;52(2):465-9. doi: 10.1128/AAC.01316-06. Epub 2007 Nov 19. Antimicrob Agents Chemother. 2008. PMID: 18025111 Free PMC article.
Antimicrobial stewardship programs in health care systems.
MacDougall C, Polk RE. MacDougall C, et al. Clin Microbiol Rev. 2005 Oct;18(4):638-56. doi: 10.1128/CMR.18.4.638-656.2005. Clin Microbiol Rev. 2005. PMID: 16223951 Free PMC article. Review.

Reduction of vancomycin-resistant enterococcal infections by limitation of broad-spectrum cephalosporin use in a trauma and burn intensive care unit - PubMed (original) (raw)