Impact of a hospital-wide antimicrobial formulary intervention on the incidence of multidrug-resistant gram-negative bacteria.
We examined the impact of an antimicrobial formulary change, based on reduction in third-generation cephalosporin use, on resistant gram-negative pathogens in a tertiary hospital. No significant changes were demonstrated in their incidence per 1000 patient-days. Otherwise, there was a significant decrease in rate of extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae (63.1% to 52.5%, P = .04) and third-generation cephalosporin-resistant Enterobacter species (31.4% to 25%, P = .04) between the 2 study periods. On the other hand, there was also a significant increase in rate of ampicillin-sulbactam-resistant Acinetobacter baumannii (8% to 47%, P = .01) after the implementation of the formulary intervention.
Infection Control Committee, Division of Infectious Diseases, Federal University of São Paulo, São Paulo, Brazil. ghfurtado@uol.com.br
Guilherme H C
GH
Furtado
Luciana B
LB
Perdiz
Iolanda Lopes
IL
Santana
Márcia M S C R
MM
Camargo
Fernanda C
FC
Parreira
Daniela B
DB
Angelieri
Eduardo A S
EA
Medeiros
D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001938:Brazil / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D024901:Drug Resistance, Multiple, Bacterial; D006090:Gram-Negative Bacteria / Q000187:drug effects / Q000302:isolation & purification*; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology; D006761:Hospitals; D006801:Humans; D015994:Incidence
D000900:Anti-Bacterial Agents