title: The effect of an antibiotic policy on bacterial resistance in patients in geriatric medical wards.
abstract: In an effort to reduce levels of trimethoprim resistance amongst urinary isolates and faecal organisms two antibiotic policies (policy 1, erythromycin, nitrofurantoin substituted for trimethoprim and ampicillin; policy 2, Augmentin (ampicillin + clavulinic acid) substituted for trimethoprim and ampicillin) were used for 50 weeks on two geriatric acute/rehabilitation wards. The policies were evaluated by comparison with the pre-policy period and between policies. The policies were applied successfully and both were associated with a fall in the proportion of trimethoprim-resistant faecal coliforms and urinary isolates. Policy 1 appeared to affect plasmid-mediated resistance to a greater extent than policy 2. There were no differences in outcome for patients during policy periods. Control of antibiotic usage by formal policies is a viable means of controlling bacterial resistance in geriatric wards. The mode of action of such policies requires further elucidation.
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001424:Bacterial Infections / Q000188:drug therapy*; D004352:Drug Resistance, Microbial; D004363:Drug Utilization; D004755:Enterobacteriaceae / Q000302:isolation & purification; D006801:Humans; D011379:Prognosis; D012007:Rectum / Q000382:microbiology; D014295:Trimethoprim / Q000627:therapeutic use; D014556:Urine / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D014295:Trimethoprim