title: Increasing consumption of MRSA-active drugs without increasing MRSA in German ICUs.
abstract: OBJECTIVE
  The aim of our study was to analyze changes in the consumption of MRSA-active antibiotics and in the burden of methicillin-resistant S. aureus (MRSA) over a period of 9 years in a network of German intensive care units (ICU).
  
  
  METHODS
  Data from 55 ICUs in Germany were analyzed from 2001 through 2009. The term "old MRSA-active antibiotics" included vancomycin, teicoplanin and fosfomycin, whereas the term "new MRSA-active antibiotics" included quinupristin/dalfopristin, linezolid and daptomycin. The burden of MRSA was defined as MRSA per 1,000 patient-days.
  
  
  RESULTS
  A total of 1,584,995 patient-days and 32,450 S. aureus isolates were analyzed. The burden of MRSA was 4.4, and the pooled mean MRSA resistance proportion was 21.8%. Both parameters did not change significantly over time. In contrast, MRSA-active antibiotics more than doubled from 44 defined daily doses per 1,000 patient-days in 2001 to 92 in 2009. This was due to the significant increase of new MRSA-active antibiotics (from 1 to 40), whereas old MRSA antibiotics stayed stable (43 in 2001 and 52 in 2009).
  
  
  CONCLUSIONS
  New MRSA-active antibiotics did not replace old ones, but were added on top. The use of new MRSA-active antibiotics-mainly linezolid-steadily increased over a period of 9 years, although the burden of MRSA stayed stable, as did the proportion of MRSA (%).
authors.affiliation: Institute of Hygiene and Environmental Medicine, Charité University Medicine, Hindenburgdamm 27, 12203 Berlin, Germany. elisabeth.meyer@charite.de
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Meyer
authors.forename: Frank
authors.initials: F
authors.lastname: Schwab
authors.forename: Barbara
authors.initials: B
authors.lastname: Schroeren-Boersch
authors.forename: Petra
authors.initials: P
authors.lastname: Gastmeier
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004363:Drug Utilization / Q000706:statistics & numerical data; D005858:Germany; D006801:Humans; D007362:Intensive Care Units; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects*; D013203:Staphylococcal Infections / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents