Data/hora: 11/06/2024 05:36:30

Provedor de dados: | 55
País: | Brazil
Título: | Carbapenem stewardship: positive impact on hospital ecology
Autores: | Lima,Ana Lucia Lei Munhoz; Oliveira,Priscila Rosalba Domingos de; Paula,Adriana Pereira de; Dal-Paz,Karine; Almeida Jr,João Nóbrega de; Félix,Cássia da Silva; Rossi,Flávia.
Data: | 2011-02-01
Ano: | 2011
Palavras-chave: | Carbapenems; Drug resistance; Bacterial ecology.
Resumo: | INTRODUCTION: Excessive group 2 carbapenem use may result in decreased bacterial susceptibility. OBJECTIVE: We evaluated the impact of a carbapenem stewardship program, restricting imipenem and meropenem use. METHODS: Ertapenem was mandated for ESBL-producing Enterobacteriaceae infections in the absence of non-fermenting Gram-negative bacilli (GNB) from April 2006 to March 2008. Group 2 carbapenems were restricted for use against GNB infections susceptible only to carbapenems and suspected GNB infections in unstable patients. Cumulative susceptibility tests were done for nosocomial pathogens before and after restriction using Clinical and Laboratory Standards Institute (CLSI) guide-lines.Vitek System or conventional identification methods were performed and susceptibility testing done by disk diffusion according to CLSI.Antibiotic consumption (t-test) and susceptibilities (McNemar's test) were determined. RESULTS: The defined daily doses (DDD) of group 2 carbapenems declined from 61.1 to 48.7 DDD/1,000 patient-days two years after ertapenem introduction (p = 0.027). Mean ertapenem consumption after restriction was 31.5 DDD/1,000 patient-days. Following ertapenem introduction no significant susceptibility changes were noticed among Gram-positive cocci. The most prevalent GNB were P. aeruginosa, Klebsiella pneumoniae, and Acinetobacter spp. There was no change in P. aeruginosa susceptibility to carbapenems. Significantly improved P. aeruginosa and K. pneumoniae ciprofloxacin susceptibilities were observed, perhaps due to decreased group 2 carbapenem use. K. pneumoniae susceptibility to trimethoprim-sulfamethoxazole improved. CONCLUSION: Preferential use of ertapenem resulted in reduced group 2 carbapenem use, with a positive impact on P. aeruginosa and K. pneumoniae susceptibility.
Tipo: | Info:eu-repo/semantics/article
Idioma: | Inglês
Identificador: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702011000100001
Editor: | Brazilian Society of Infectious Diseases
Relação: | 10.1590/S1413-86702011000100001
Formato: | text/html
Fonte: | Brazilian Journal of Infectious Diseases  v.15 n.1 2011
Fonte: | info:eu-repo/semantics/openAccess