engleski

Impact of Ceftriaxone de-restriction on the occurrence of ESBL-positive bacterial strains and antibiotic consumption

As a cost-saving measure, the Drug and Therapeutics Committee (DTC) removed ceftriaxone from the list of restricted antibiotics in May, 2008, which permitted its use as a first-line antibiotic. To evaluate the impact of this change, the occurrence of extended-spectrum beta-Iactamase (ESBL)- positive bacterial strains and antibiotic consumption were monitored for 2 years before and after the intervention. In the post- intervention period, ceftriaxone utilization increased, while total antibiotic utilization did not change significantly. The utilization of all restricted antibiotics decreased (p <0.05) in the post- intervention period. Utilization of carbapenems increased (p <0.05), while utilization of quinolones increased nonsignificantly. The density of resistant ESBLs increased (p = 0.001) from 0.99 to 1.34 per 1000 bed-days fromthe pre- to the post- intervention period. Ceftriaxone use was significantly correlated with ESBL occurrence (p <0.005). It can be concluded that ceftriaxone de- restriction increased the occurrence of ESBLs and the utilization of carbapemens.

antibiotic policy ; antibiotic use ; cephalosporins ; ceftriaxone ; ESBLs ; resistance

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