Reference : Selection of resistance during sequential use of preferential antibiotic classes
Scientific journals : Article
Human health sciences : Anesthesia & intensive care
Selection of resistance during sequential use of preferential antibiotic classes
[fr] Sélection de résistance durant l'utilisation séquentielle de classes d'antibiotiques préférentielles
Damas, Pierre mailto [Centre Hospitalier Universitaire de Liège - CHU > > Soins intensifs >]
Canivet, Jean-Luc mailto [Université de Liège - ULiège > > Soins intensifs >]
Ledoux, Didier mailto [Université de Liège - ULiège > > Soins intensifs >]
Monchi, M. [ > > ]
Melin, Pierrette mailto [Université de Liège - ULiège > > Microbiologie médicale >]
Intensive Care Medicine
Springer Verlag
Yes (verified by ORBi)
New York
[en] OBJECTIVE: To determine the effect of antibiotic class pressure on the susceptibility of bacteria during sequential periods of antibiotic homogeneity. DESIGN AND SETTING: Prospective study in a mixed ICU with three separated subunits of eight, eight, and ten beds. PATIENTS AND PARTICIPANTS: The study examined the 1,721 patients with a length of stay longer than 2 days. INTERVENTIONS: Three different antibiotic regimens were used sequentially over 2 years as first-choice empirical treatment: cephalosporins, fluoroquinolone, or a penicillin-beta-lactamase inhibitor combination. Each regimen was applied for 8 months in each subunits of the ICU, using "latin square" design. RESULTS: We treated 731 infections in 546 patients (32% of patients staying more than 48 h). There were 25.5 ICU-acquired infections per 1,000 patient-days. Infecting pathogens and colonizing bacteria were found in 2,739 samples from 1,666 patients (96.8%). No significant change in global antibiotic susceptibility was observed over time. However, a decrease in the susceptibility of several species was observed for antibiotics used as the first-line therapy in the unit. Selection pressure of antibiotics and occurrence of resistance during treatment was documented within an 8-month rotation period. CONCLUSIONS: Antibiotic use for periods of several months induces bacterial resistance in common pathogens
Researchers ; Professionals

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