Restrictive reporting of selected antimicrobial susceptibilities influences clinical prescribing. Issue 3 (May 2015)

• Record Type: Journal Article
• Authors: Al-Tawfiq, Jaffar A.; Momattin, Hisham; Al-Habboubi, Fatemah; Dancer, Stephanie J.
• Is Part Of: Journal of infection and public health. Volume 8:Issue 3(2015)
• Page Start: 234
• Page End: 241
• Publication Date: 2015-05
• Subjects: Antibiotic stewardship -- Restrictive reporting -- DDD -- Defined daily doses -- Antimicrobial resistance; Communicable diseases -- Periodicals; Public health -- Periodicals; Epidemiology -- Periodicals; Nosocomial infections -- Prevention -- Periodicals; Medical microbiology -- Periodicals; 614.4
• DOI: 10.1016/j.jiph.2014.09.004
• Languages: English
• ISSNs: 1876-0341

Abstract

Summary: Background: Cascade and restrictive reporting are useful strategies to enhance antibiotic stewardship programs. Methods: We combined both strategies to improve the prescribing of antibiotics aimed at Gram-negative infections. Results: For Enterobacter aerogenes, the susceptibility rates to amikacin increased from 10% to 100%; for third generation cephalosporins, these rates increased from 55% to 89%. The susceptibility rates of E. aerogenes to cefepime and piperacillin–tazobactam changed little, and the ampicillin susceptibility decreased from 30% in 2009 to 11% in 2010. For Proteus mirabilis, the susceptibility rates increased for third-generation cephalosporins (48% vs. 92%) and piperacillin–tazobactam (10% vs. 98%), with minimal changes for cefepime (96% vs. 93%), ampicillin (69% vs. 73%) and amikacin (96% vs. 84%). For Pseudomonas aeruginosa, the susceptibility rates improved slightly for third-generation cephalosporins (81% vs. 91%) but reduced for piperacillin–tazobactam (99% vs. 59%). Hospital-acquired Clostridium difficile infections decreased from 0.11 to 0.07 per 1000 patient days. Conclusions: Selective reporting helps physicians choose the most appropriate antibiotics for their patients within a stewardship program, with reduced C. difficile infection.