title: Comparison of the effect of ciprofloxacin and Tazocin on the incidence of meticillin-resistant Staphylococcus aureus (MRSA) in an Intensive Care Unit.
abstract: Meticillin-resistant Staphylococcus aureus (MRSA) is a very significant agent of recalcitrant healthcare-associated infections. A major risk of acquiring such infections is thought to be modulated by the use of particular antimicrobial therapies. The aim of this research was to evaluate prospectively the impact of using either ciprofloxacin or Tazocin (piperacillin+tazobactam) on the incidence of MRSA in an Intensive Care Unit (ICU). The 1-year (2 x 6 months) cross-over study was carried out in a medium-sized (426 beds) teaching hospital. During the first 6-month period, ciprofloxacin was used as the first-line broad-spectrum antibiotic therapy of choice. During the second 6-month period, Tazocin was used as first-line therapy. The incidence of hospital-acquired MRSA (i.e. colonised and/or infected) and rates of compliance of the ICU healthcare workers to optimal hand hygiene practices were recorded throughout the study. The study observed no statistically significant differences (P = 0.1) between MRSA incidence rates in the ICU during the ciprofloxacin (4.4/1000 bed-days) or Tazocin (11.4/1000 bed-days) arms of the study. Interestingly, observing healthcare workers' hand hygiene practices throughout the entire study showed that healthcare workers adhered to these practices 59.2% of the time during the ciprofloxacin arm and 66.0% during the Tazocin arm. The low incidence rates within the unit demonstrated the importance of infection control in limiting the spread of MRSA despite the extensive use of antibiotics in a high-risk setting.
authors.affiliation: Clinical and Practice Research Group, School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK.
authors.forename: Mamoon A
authors.initials: MA
authors.lastname: Aldeyab
authors.forename: Carmel M
authors.initials: CM
authors.lastname: Hughes
authors.forename: Mary P
authors.initials: MP
authors.lastname: Kearney
authors.forename: Michael G
authors.initials: MG
authors.lastname: Scott
authors.forename: David A
authors.initials: DA
authors.lastname: McDowell
authors.forename: Joanne
authors.initials: J
authors.lastname: Hanley
authors.forename: M Ann S
authors.initials: MA
authors.lastname: McMahon
authors.forename: Salah M
authors.initials: SM
authors.lastname: Elshibly
authors.forename: Ronald
authors.initials: R
authors.lastname: Bailie
authors.forename: James C
authors.initials: JC
authors.lastname: McElnay
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002939:Ciprofloxacin / Q000627:therapeutic use*; D003428:Cross Infection / Q000453:epidemiology* / Q000517:prevention & control*; D003627:Data Interpretation, Statistical; D004338:Drug Combinations; D016521:Electrophoresis, Gel, Pulsed-Field; D006235:Hand Disinfection; D006920:Hygiene; D007362:Intensive Care Units; D055624:Methicillin-Resistant Staphylococcus aureus; D010397:Penicillanic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010564:Personnel, Hospital; D010878:Piperacillin / Q000627:therapeutic use*; D000077725:Piperacillin, Tazobactam Drug Combination; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*; D000078142:Tazobactam; D065093:beta-Lactamase Inhibitors
chemical_list: D000900:Anti-Bacterial Agents; D004338:Drug Combinations; D065093:beta-Lactamase Inhibitors; D000077725:Piperacillin, Tazobactam Drug Combination; D002939:Ciprofloxacin; D010397:Penicillanic Acid; D000078142:Tazobactam; D010878:Piperacillin