ArticleSpinal cord2020
Use of oral third generation cephalosporins and quinolones and occurrence of antibiotic-resistant strains in the neurogenic bladder (NB) outpatient setting: a retrospective chart audit.
Article in Spinal cord, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Article
- Impact of a sustained, collaborative antimicrobial stewardship programme in spinal cord injury patients.JAC-antimicrobial resistance · 2023Article
- Reduction strategies for inpatient oral third-generation cephalosporins at a cancer center: An interrupted time-series analysis.PloS one · 2023Article
- Effect of Antimicrobial Stewardship on Oral Quinolone Use and Resistance Patterns over 8 Years (2013-2020).Antibiotics (Basel, Switzerland) · 2021Article
- Should We Delay Urodynamic Study When Patients With Spinal Cord Injury Have Asymptomatic Pyuria?Annals of rehabilitation medicine · 2021Article
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Authors and funding
6 authors.
Funding
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Abstract
STUDY
designA retrospective chart audit.
objectivesNeurogenic bladder (NB), a risk factor for urinary tract infection, has not been comprehensively studied in terms of antimicrobial stewardship. In this study, we studied the relationship between the use of oral third generation cephalosporins and quinolones, and the occurrence of antibiotic-resistant strains.
settingHyogo Prefectural Central Rehabilitation Hospital, Hyogo, Japan.
methodsWe retrospectively investigated antibiotic-resistant bacteria and the amount of antibiotics prescribed in outpatients with NB caused by spinal cord injury between 2012 and 2017. We intervened in urological departments whose physicians often prescribed third generation cephalosporins and fluoroquinolone, and analyzed the number of prescriptions and the amount of Cefdinir (CFDN) and Levofloxacin (LVFX), and studied changes of ratios in antibiotic-resistant strains such as extended-spectrum β-lactamases (ESBLs) and quinolone-resistant Escherichia coli and Klebsiella pneumoniae.
resultsThe number of CFDN prescriptions per year significantly decreased from 463 cases to 130 cases over 6 years (p = 0.012). The number of LVFX prescriptions per year decreased from 640 cases to 171 cases (p = 0.025). The incidence rate of ESBL-producing K. pneumoniae decreased from 25% to 7% of total K. pneumoniae (p < 0.001). The incidence of LVFX-resistant E. coli and K. pneumoniae significantly decreased in 2017 compared with 2012 (p = 0.03 and p = 0.016, respectively).
conclusionsAntimicrobial stewardship interventions decreased the use of CFDN and LVFX for outpatients with NB. Our findings suggested that the reduction in the use of third generation cephalosporins and quinolones correlates with observed decrease in the occurrence of antibiotic-resistant, ESBL-producing, and quinolone-resistant bacteria.
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