Journal Article

Predicting Hospital Rates of Fluoroquinolone-Resistant <i>Pseudomonas aeruginosa</i> from Fluoroquinolone Use in US Hospitals and Their Surrounding Communities

Ronald E. Polk, Christopher K. Johnson, Donna McClish, Richard P. Wenzel and Michael B. Edmond

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 39, issue 4, pages 497-503
Published in print August 2004 | ISSN: 1058-4838
Published online August 2004 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/422647
Predicting Hospital Rates of Fluoroquinolone-Resistant Pseudomonas aeruginosa from Fluoroquinolone Use in US Hospitals and Their Surrounding Communities

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Rates of fluoroquinolone resistance among Pseudomonas aeruginosa in hospitals are increasing, but interhospital variability is great. We sought to determine whether this variability correlated to fluoroquinolone use in hospitals and in the surrounding community. Hospital quinolone use in 1999 (24 hospitals) through 2001 (35 hospitals) was determined from billing records. The number of fluoroquinolone prescriptions within a 10-mile (∼16-km) radius of each hospital was determined for 1999 and 2000. Hospital fluoroquinolone use increased from 1999 through 2001, from 137 to 163 defined daily doses (DDD)/1000 patient-days (P = .01). The rate of community fluoroquinolone use also increased, from 2.3 to 2.8 DDD/1000 inhabitant-days (P < .001). Rates of fluoroquinolone-resistant P. aeruginosa increased from 29% in 1999 to 36% in 2001 (P = .003). Both community and hospital fluoroquinolone use were predictive of rates of fluoroquinolone-resistant P. aeruginosa. Levofloxacin was associated with resistance, but ciprofloxacin was not. Most of the variability in resistance rates is explained by volume of fluoroquinolone use, both in the hospital and the surrounding community.

Journal Article.  4665 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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