title: Pseudomonas aeruginosa, Staphylococcus aureus, and fluoroquinolone use.
abstract: Few long-term multicenter investigations have evaluated the relationships between aggregate antimicrobial drug use in hospitals and bacterial resistance. We measured fluoroquinolone use from 1999 through 2003 in a network of US hospitals. The percentages of fluoroquinolone-resistant Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus (MRSA) were obtained from yearly antibiograms at each hospital. Univariate linear regression showed significant associations between a hospital's volume of fluoroquinolone use and percent resistance in most individual study years (1999-2001 for P. aeruginosa, 1999-2002 for S. aureus). When the method of generalized estimating equations was used, a population-averaged longitudinal model incorporating total fluoroquinolone use and the previous year's resistance (to account for autocorrelation) did not show a significant effect of fluoroquinolone use on percent resistance for most drug-organism combinations, except for the relationship between levofloxacin use and percent MRSA. The ecologic relationship between fluoroquinolone use and resistance is complex and requires further study.
authors.affiliation: Virginia Commonwealth University School of Pharmacy, Richmond, Virginia 23298-0533, USA.
authors.forename: Conan
authors.initials: C
authors.lastname: MacDougall
authors.forename: Spencer E
authors.initials: SE
authors.lastname: Harpe
authors.forename: J Patrick
authors.initials: JP
authors.lastname: Powell
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Johnson
authors.forename: Michael B
authors.initials: MB
authors.lastname: Edmond
authors.forename: Ron E
authors.initials: RE
authors.lastname: Polk
mesh_terms: D003428:Cross Infection / Q000188:drug therapy* / Q000382:microbiology; D024901:Drug Resistance, Multiple, Bacterial; D024841:Fluoroquinolones / Q000627:therapeutic use*; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D011552:Pseudomonas Infections / Q000188:drug therapy* / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000187:drug effects* / Q000254:growth & development / Q000302:isolation & purification; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000254:growth & development / Q000302:isolation & purification; D014481:United States
chemical_list: D024841:Fluoroquinolones