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Antibiotic Resistance in Pseudomonas aeruginosa Related to Quinolone Formulary Changes: An Interrupted Time Series Analysis

Published online by Cambridge University Press:  02 January 2015

E. Chandler Church
Affiliation:
Department of Pharmacy and Clinical Sciences, South Carolina College of Pharmacy
Patrick D. Mauldin
Affiliation:
Department of Pharmacy and Clinical Sciences, South Carolina College of Pharmacy Center for Medication Safety, South Carolina College of Pharmacy Ralph H. Johnson VA Medical Center, Charleston, South Carolina
John A. Bosso*
Affiliation:
Department of Pharmacy and Clinical Sciences, South Carolina College of Pharmacy Department of Medicine, College of Medicine, Medical University of South Carolina
*
Department of Clinical Pharmacy and Outcome Sciences, South Carolina College of Pharmacy, Medical University of South Carolina Campus, Charleston, South Carolina 29425 (bossoja@musc.edu)

Extract

Pseudomonas aeruginosa is a nosocomial pathogen capable of exhibiting a variety of resistance mechanisms against multiple classes of antibiotics. Fluoroquinolones, commonly used to treat a variety of infections in both ambulatory and hospitalized patients, have been increasingly linked to the development of resistance, both to fluoroquinolones and to other classes of antibiotics including β-lactams, cephalosporins, and carbapenems. In turn, as many as 95% of multidrug-resistant pseudomonal isolates may be resistant to fluoroquinolones. Although research has examined the effect of fluoroquinolone use on P. aeruginosa resistance, to our knowledge, no work has been published describing possible differences among individual fluoroquinolones related to resistance to other antibiotic classes. The purpose of this analysis was to assess the possible effects of varying usage of levofloxacin, gatifloxacin, and moxifloxacin on P. aeruginosa susceptibility to piperacillin-tazobactam, cefepime, and tobramycin. Data from January 2000 through December 2008 were obtained from clinical microbiology and pharmacy databases of the Medical University of South Carolina Medical Center, which is a 689-bed academic medical center and level 1 trauma center with adult and pediatric beds. This study was approved by the institution's institutional review board.

Type
Research Briefs
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2011

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References

1. Strateva, T, Yordanov, D. Pseudomonas aeruginosa: a phenomenon of bacterial resistance. J Med Miaobiol 2009;58:11331148.Google Scholar
2. Defez, C, Fabbro-Peray, P, Bouziges, N, et al. Risk factors for multidrug-resistant Pseudomonas aeruginosa nosocomial infection. J Hosp Infect 2004;57:209216.Google Scholar
3. Nguyen, LH, Hsu, DI, Ganapathy, V, Shriner, K, Wong-Beringer, A. Reducing empirical use of fluoroquinolones for Pseudomonas aeruginosa infections improves outcome. J Antimicrob Chemother 2008;61:714720.Google Scholar
4. Tohidpour, A, Peerayeh, SN, Mehrabadi, JF, Rezaei, YH. Determination of the efflux pump mediated resistance prevalence in Pseudomonas aeruginosa, using an efflux pump inhibitor. Curr Microbiol 2009;59:352355.Google Scholar
5. Peña, C, Suarez, C, Tubau, F, et al. Carbapenem-resistant Pseudomonas aeruginosa: factors influencing multidrug-resistant acquisition in non-critically ill patients. Eur J Clin Microbiol Infect Dis 2009;28:519522.Google Scholar
6. Rogues, AM, Dumartin, C, Amadeo, B, et al. Relationship between rates of antimicrobial consumption and the incidence of antimicrobial resistance in Staphylococcus aureus and Pseudomonas aeruginosa isolates from 47 French hospitals. Infect Control Hosp Epidemiol 2007;28:13891395.Google Scholar
7. Bosso, JA, Mauldin, PD. Assessment of effects of fluoroquinolone formulary changes on gram-negative susceptibility and MRSA isolation rates using interrupted time series analysis. Antimicrob Agents Chemother 2006;50:21062112.Google Scholar
8. Karlowsky, JA, Jones, ME, Thornsberry, C, Evangelista, AT, Cheung Yee, Y, Sahm, DF. Stable antimicrobial susceptibility rates for clinical isolates of Pseudomonas aeruginosa from the 2001-2003 Tracking Resistance in the United States Today surveillance studies. Clin Infect Dis 2005;40:S89S98.Google Scholar
9. World Health Organization (WHO). WHO Collaborating Centre for Drug Statistics Methodology. ATC/DDD index 2011. http://www.whocc.no/atcddd/. Accessed July 17, 2009.Google Scholar
10. Durbin, J, Watson, GS. Testing for serial correlation in least-squares regression. Biometrica 1951;38:159177.Google Scholar