Antibiotics involved in the occurrence of antibiotic-resistant bacteria: a nationwide multilevel study suggests differences within antibiotic classes

Gbaguidi‐Haore, Houssein; Dumartin, C.; L’Hériteau, F.; Péfau, Muriel; Hocquet, Didier; Rogues, Anne-Marie; Bertrand, Xavier

doi:10.1093/jac/dks406

Cited by 51 publications

(33 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Possible or confirmed MDRB infection leads to an increase in antibiotic consumption, which itself increases the selective pressure favouring the most resistant bacteria. Several recent studies have reported an effect of antibiotic use on MDRB emergence both at the national [10] and hospital levels [11,12]. However, it was not possible to control for differences in prescription habits, the infections treated, infection control measures and epidemic phenomena between participating hospital wards in these studies.…”

Section: Introduction Q2mentioning

confidence: 94%

Five-year trends for ventilator-associated pneumonia: Correlation between microbiological findings and antimicrobial drug consumption

Fihman

Messika

Hajage

et al. 2015

International Journal of Antimicrobial Agents

View full text Add to dashboard Cite

Section: Introduction Q2mentioning

confidence: 94%

Five-year trends for ventilator-associated pneumonia: Correlation between microbiological findings and antimicrobial drug consumption

Fihman

Messika

Hajage

et al. 2015

International Journal of Antimicrobial Agents

View full text Add to dashboard Cite

“…Many studies have shown a correlation between antibiotics use and subsequent resistance to antibiotics (22). Because the immunocompromised patients had more frequently received previous antibiotic treatment with b-lactam or fluoroquinolone in the present study, the risk for the development of antibiotic resistance may increase in these patients.…”

Section: Discussionmentioning

confidence: 82%

<i>Pseudomonas aeruginosa</i> Bacteremia among Immunocompetent and Immunocompromised Patients: Relation to Initial Antibiotic Therapy and Survival

et al. 2016

View full text Add to dashboard Cite

SUMMARY: Pseudomonas aeruginosa bacteremia occurs mainly in immunocompromised patients. However, P. aeruginosa bacteremia in immunocompetent patients has also been reported. The aim of this study was to evaluate the clinical characteristics of P. aeruginosa bacteremia in relation to the immune status of the patients. The medical records of 126 adult patients with P. aeruginosa bacteremia in Nagasaki University Hospital were retrospectively reviewed between January 2003 and December 2012. Of 126 patients with P. aeruginosa bacteremia, 60 patients (47.6z) were classified as immunocompetent. Mortality in immunocompetent patients tended to be lower than in immunocompromised patients (7-day mortality, 8z vs. 30z, P ＜ 0.01; 30-day mortality, 23z vs. 39z, P ＝ 0.053). Multivariate analysis showed that a higher sequential organ failure assessment score (hazard ratio [HR]: 1.27, P ＜ 0.01) and underlying malignancies (HR: 3.33, P ＜ 0.01) were independently associated with 30-day mortality. Initial antibiotic therapy (HR: 0.21, P ＜ 0.01) and patients' immune status (HR: 0.29, P ＝ 0.02) also had a significant impact on survival. However, there was a significant interaction between these 2 variables (P ＝ 0.03 for interaction). A subgroup analysis showed that in immunocompromised, but not immunocompetent patients, initial appropriate antibiotic therapy was associated with lower mortality (30-day mortality 20.5z vs. 66.7z, P ＜ 0.01 by log-rank test).

show abstract

“…Nem ismert, hogy a nem megfelelő indikáció, a magasabb dózisok, a hosszabb kezelés vagy a terápiaszűkítés hiánya áll-e a magas fluorokinolonfelhasználás hátterében. A fluorokinolonok rezisztenciaindukáló hatása különösen nagy [16][17][18], és hazánkban az invazív izolátumok fluorokinolonrezisztenciája minden vizsgált baktériumtörzs esetén magasabb, mint az euró-pai átlag [19]. Ezenkívül az ECDC legutóbbi pontprevalencia-vizsgálata alapján a Clostridium difficile-fertő-zések hazai aránya rendkívül magas [16], ami mögött részben a magas fluorokinolonhasználat valószínűsíthe-tő.…”

Section: áBraunclassified

Hazai kórházi antibiotikum-alkalmazás az elmúlt két évtizedben (1996–2015)

et al. 2016

View full text Add to dashboard Cite

Bevezetés: A bakteriális rezisztencia közegészségügyet fenyegető probléma, amely mérsékelhető, lassítható megfelelő antibiotikum-alkalmazással. Célkitűzés: A hazai fekvőbeteg-ellátás szisztémás antibiotikum-felhasználásának bemutatása. Módszer: A kórházi antibiotikum-felhasználási adatokat az Egészségügyi Világszervezet anatómiai-terápiás-ké-miai rendszere szerint osztályozták és a Defined Daily Dose metodika szerint kvantifikálták. A standardizálás kórházi betegforgalmi mutatókra, valamint -a nemzetközi összehasonlítás végett -populációra történt. Eredmények: A fekvőbetegszektor antibiotikum-felhasználása az elmúlt 20 évben mennyiségileg kiegyenlített volt (22,4 ± 1,5 DDD/100 ápolási nap), mintázata folyamatos változáson ment keresztül. Megfigyelhettük a parenteralis készítmények alkalmazásának emelkedését (1996-ban 26,4%, 2015-ben 41,6%). Kiemelendő a felhasználás összetételének homogenizáló-dása az amoxicillin-klavulánsav térnyerése miatt, a fluorokinolon (2,3 vs. 4,2 DDD/100 ápolási nap) és a harmadik generációs cefalosporinfelhasználás (1,0 vs. 2,9 DDD/100 ápolási nap) jelentős emelkedése, valamint a szűk spektrumú penicillinek kiszorulása. Következtetés: A hazai kórházi antibiotikum-felhasználás mennyiségileg alacsony. Ez, illetve a felhasználás mintázatában tapasztalt, nemzetközi mércével is alátámasztott alul-vagy felülreprezentált felhasználás okának és indokoltságának megítélése további vizsgálatot igényel. Orv. Hetil., 2016, 157(46), 1839-l846. Kulcsszavak: antibiotikum-felhasználás, kórházi ellátás, trend, mintázat, antibiotikum-surveillance Antibiotic use in the Hungarian hospitals in the last two decades (1996-2015)Introduction: Growing bacterial resistance threatens public health, which can be tempered by prudent antibiotic use. Aim: To quantify systemic antibacterial use in Hungarian hospitals. Method: Consumption data were analysed using the Anatomical-Therapeutic-Chemical -Defined Daily Dose (ATC/DDD) methodology. Data were standardized for patient turnover and also for population to enable international benchmarking. Results: Hospital antibiotic use was quite constant (22.4 ± 1.5 DDD/100 patient-days), but its composition changed substantially. The use of parenteral products rose gradually (in 1996 26.4% and in 2015 41.6%). The pattern of use was homogenised due to the headway of co-amoxiclav use. A substantial increase of fluoroquinolone (2.3 vs. 4.2 DDD/100 patient-days) and third generation cephalosporin (1.0 vs. 2.9 DDD/100 patient-days) use was detected. In parallel the use of narrow spectra penicillins diminished. Conclusion: Hungarian hospital antibiotic use is low. The causes and the justification of this low use together with the internationally outstanding use of certain antibacterials should be addressed in future studies.

show abstract

Antibiotics involved in the occurrence of antibiotic-resistant bacteria: a nationwide multilevel study suggests differences within antibiotic classes

Abstract: Our study suggests differences within antibiotic classes in promoting antibiotic resistance. We identified ceftriaxone, ciprofloxacin and ofloxacin as priority targets in public health strategies designed to reduce antibiotic use and antibiotic-resistant bacteria in French HCFs.

Cited by 51 publications

References 37 publications

Five-year trends for ventilator-associated pneumonia: Correlation between microbiological findings and antimicrobial drug consumption

Five-year trends for ventilator-associated pneumonia: Correlation between microbiological findings and antimicrobial drug consumption

<i>Pseudomonas aeruginosa</i> Bacteremia among Immunocompetent and Immunocompromised Patients: Relation to Initial Antibiotic Therapy and Survival

Hazai kórházi antibiotikum-alkalmazás az elmúlt két évtizedben (1996–2015)

Contact Info

Product

Resources

About