Journal Article

Reduction in the Incidence of Methicillin-Resistant <i>Staphylococcus aureus</i> and Ceftazidime-Resistant <i>Klebsiella pneumoniae</i> Following Changes in a Hospital Antibiotic Formulary

David Landman, Mira Chockalingam and John M. Quale

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 28, issue 5, pages 1062-1066
Published in print May 1999 | ISSN: 1058-4838
Published online May 1999 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/514743
Reduction in the Incidence of Methicillin-Resistant Staphylococcus aureus and Ceftazidime-Resistant Klebsiella pneumoniae Following Changes in a Hospital Antibiotic Formulary

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In 1995, changes in our hospital formulary were made to limit an outbreak of vancomycinresistant enterococci and resulted in decreased usage of cephalosporins, imipenem, clindamycin, and vancomycin and increased usage of β-lactam/β-lactamase-inhibitor antibiotics. In this report, the effect of this formulary change on other resistant pathogens is described. Following the formulary change, there was a reduction in the monthly number (mean ± SD) of patients with methicillinresistant Staphylococcus aureus (from 21.9 ± 8.1 to 17.2 ± 7.2 patients/1,000 discharges; P = .03) and ceftazidime-resistant Klebsiella pneumoniae (from 8.6 ± 4.3 to 5.7 ± 4.0 patients/1,000 discharges; P = .02). However, there was an increase in the number of patients with cultures positive for cefotaxime-resistant Acinetobacter species (from 2.4 ± 2.2 to 5.4 ± 4.0 patients/1,000 discharges; P = .02). Altering an antibiotic formulary may be a possible mechanism to contain the spread of selected resistant pathogens. However, close surveillance is needed to detect the emergence of other resistant pathogens.

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

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