The effect of antibiotic therapy on the incidence of Staphylococcus aureus infections in orthopaedic patients.
BACKGROUND
This paper reports on aetiological factors, including mostly S. aureus infections, and antibiotic use in the pretreatment and treatment of complicating infections in patients hospitalised at the Department of Orthopaedics and Musculoskeletal Traumatology, Gdańsk Medical University, between 1995 and 2004. The analysis sought to establish a correlation, via statistical analysis, between the usage of specific antibiotic classes, with special regard to lincosamides, and S. aureus infection rates.


METHODS
The study population included 22,686 patients admitted for elective surgery (accounting for 86.9% to 75.1% of the sample in different years) or with acute injuries.


RESULTS
The rate of infections ranged from 2.79% to 1%, decreasing in a statistically significant manner over time. S. aureus was the dominant pathogen, accounting for 67.3% to 27.6% of the total number of bacterial strains. During the time frame of the study, the incidence of osteitis fell considerably, from 0.8% to 0.05% of the total number of patients. This was paralleled by a major increase in the use of lincosamides, mostly clindamycin. The increase in lincosamide use correlated with the decreasing incidence of S. aureus infections.


CONCLUSIONS
The statistical outcome of this 10-year study has been used to develop schemes of antibiotic therapy in the Department, a necessary component of the Hospital's economic policy at the moment.A major fall in the incidence of nosocomial infections can be achieved by focussing on adequate antibiotic prophylaxis, pretreatment and appropriate treatment of acute infections.
Dzwonkowska
Joanna
J
Hand Surgery Department, Department of Orthopaedics and Musculoskeletal Traumatology, Medical University, Gdañsk. j.dzwonkowska@amg.gda.pl
Kurlenda
Julianna
J
Baczkowski
Bogusław
B
Mazurkiewicz
Stanisław
S
Uzunov
Ivelin
I
Ziółkowski
Włodzimierz
W
Markowicz
Agnieszka
A
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D005260:Female; D005592:Fracture Fixation / Q000009:adverse effects; D006801:Humans; D008297:Male; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000706:statistics & numerical data; D009985:Orthopedics / Q000706:statistics & numerical data; D019990:Perioperative Care / Q000706:statistics & numerical data; D011044:Poland / Q000453:epidemiology; D016459:Prosthesis-Related Infections / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013530:Surgical Wound Infection / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local