ArticleIntensive care medicine2009
Impact of restriction of third generation cephalosporins on the burden of third generation cephalosporin resistant K. pneumoniae and E. coli in an ICU.
Article in Intensive care medicine, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 34 citations in OpenAlex.
- Linking antimicrobial resistance surveillance to antibiotic policy in healthcare settings: the COMBACTE-Magnet EPI-Net COACH project.The Journal of antimicrobial chemotherapy · 2020Pooled it
- Interventions to improve antibiotic prescribing practices for hospital inpatients.The Cochrane database of systematic reviews · 2017Pooled it
- Studying Factors Affecting Success of Antimicrobial Resistance Interventions through the Lens of Experience: A Thematic Analysis.Antibiotics (Basel, Switzerland) · 2022Article
- Unraveling the Nature of Antibiotics: Is It a Cure or a New Hurdle to the Patient Treatment?Cureus · 2022Review
- Public health evolutionary biology of antimicrobial resistance: priorities for intervention.Evolutionary applications · 2015Article
- Antibiotic consumption and its influence on the resistance in Enterobacteriaceae.BMC research notes · 2014Article
- Impact of restriction of cefepime use on the antimicrobial susceptibility of Gram-negative bacilli related to healthcare-associated infections in an orthopedic hospital.Infection and drug resistance · 2011Article
- Year in review in Intensive Care Medicine 2009: I. Pneumonia and infections, sepsis, outcome, acute renal failure and acid base, nutrition and glycaemic control.Intensive care medicine · 2010Review
- Dramatic increase of third-generation cephalosporin-resistant E. coli in German intensive care units: secular trends in antibiotic drug use and bacterial resistance, 2001 to 2008.Critical care (London, England) · 2010Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo test whether a reduction of third generation cephalosporin (3GC) use has a sustainable positive impact on the high endemic prevalence of 3GC resistant K. pneumoniae and E. coli.
designSegmented regression analysis of interrupted time series was used to analyse antibiotic consumption and resistance data 30 months before and 30 after the intervention.
settingSurgical intensive care unit (ICU) with 16-bed unit in a teaching hospital.
interventionIn July 2004, 3GCs were switched to piperacillin in combination with a beta-lactamase-inhibitor as standard therapy for peritonitis and other intraabdominal infections.
resultsSegmented regression analysis showed that the intervention achieved a significant and sustainable decrease in the use of 3GCs of -110.2 daily defined doses (DDD)/1,000 pd. 3GC use decreased from a level of 178.9 DDD/1,000 pd before to 68.7 DDD/1,000 pd after the intervention. The intervention resulted in a mean estimated reduction in total antibiotic use of 27%. Piperacillin/tazobactam showed a significant increase in level of 64.4 DDD/1,000 pd, and continued to increase by 2.3 DDD/1,000 pd per month after the intervention. The intervention was not associated with a significant change in the resistance densities of 3GC resistant K. pneumoniae and E. coli.
conclusionReducing 3GCs does not necessarily impact positively on the resistance situation in the ICU setting. Likewise, replacing piperacillin with beta-lactamase inhibitor might provide a selection pressure on 3GC resistant E. coli and K. pneumoniae. To improve resistance, it might not be sufficient to restrict interventions to a risk area.
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