Parallel analysis of individual and aggregated data on antibiotic exposure and resistance in gram-negative bacilli
- PMID: 11588690
- DOI: 10.1086/322677
Parallel analysis of individual and aggregated data on antibiotic exposure and resistance in gram-negative bacilli
Abstract
To evaluate the potential bias of analyzing aggregated data, we separately examined antibiotic exposure and resistance data for 35,423 patients admitted to a university hospital in Utah, from both an individual-patient perspective and group-level perspective. From 1994 through 1998, use of defined daily doses (per 1000 patient-days) of fluoroquinolones, third-generation cephalosporins, ampicillin-sulbactam, and imipenem increased by 82%, 38%, and 99%, and decreased by 38%, respectively, whereas group-level resistance rates of Enterobacteriaceae or Pseudomonas species changed only minimally. However, in individual-patient-level analyses performed by multivariable proportional hazards regression, exposure to a fluoroquinolone, third-generation cephalosporin, ampicillin-sulbactam, or imipenem was a strong risk factor for resistance to fluoroquinolones (adjusted hazard ratio [AHR], 4.0; P<.001), third-generation cephalosporins (AHR, 3.5; P<.001), ampicillin-sulbactam (AHR, 2.3; P=.008), or imipenem (AHR, 5.7; P<.001), respectively. Thus, group-level and individual-patient-level analyses of antibiotic-use-versus-susceptibility relations yielded divergent results. Multicenter studies should include individual-patient-level data to elucidate more fully the relation between antibiotic exposure and resistance.
Similar articles
-
[Continuous surveillance of antimicrobial resistance among nosocomial gram-negative bacilli from intensive care units in China].Zhonghua Yi Xue Za Zhi. 2003 Mar 10;83(5):375-81. Zhonghua Yi Xue Za Zhi. 2003. PMID: 12820912 Chinese.
-
Comparison of beta-lactam regimens for the treatment of gram-negative pulmonary infections in the intensive care unit based on pharmacokinetics/pharmacodynamics.J Antimicrob Chemother. 2005 Nov;56(5):893-8. doi: 10.1093/jac/dki335. Epub 2005 Sep 14. J Antimicrob Chemother. 2005. PMID: 16162664
-
In vitro activity of cefoperazone-sulbactam: Singapore experience.Southeast Asian J Trop Med Public Health. 1996 Dec;27(4):734-7. Southeast Asian J Trop Med Public Health. 1996. PMID: 9253876
-
Colonization with antibiotic-resistant Gram-negative bacilli in the neonatal intensive care unit.Minerva Pediatr. 2003 Oct;55(5):385-93. Minerva Pediatr. 2003. PMID: 14608262 Review.
-
Sulbactam-containing beta-lactamase inhibitor combinations.Clin Microbiol Infect. 2008 Jan;14 Suppl 1:185-8. doi: 10.1111/j.1469-0691.2007.01847.x. Clin Microbiol Infect. 2008. PMID: 18154545 Review.
Cited by
-
The influence of gastric atrophy on Helicobacter pylori antibiotics resistance in therapy-naïve patients.Front Microbiol. 2022 Sep 23;13:938676. doi: 10.3389/fmicb.2022.938676. eCollection 2022. Front Microbiol. 2022. PMID: 36212809 Free PMC article.
-
Antibacterial Resistance in Patients with Hematopoietic Stem Cell Transplantation.Mediterr J Hematol Infect Dis. 2017 Jan 1;9(1):e2017002. doi: 10.4084/MJHID.2017.002. eCollection 2017. Mediterr J Hematol Infect Dis. 2017. PMID: 28101308 Free PMC article. Review.
-
The effect of antibiotic use on prevalence of nosocomial vancomycin-resistant enterococci- an ecologic study.Antimicrob Resist Infect Control. 2017 Sep 13;6:95. doi: 10.1186/s13756-017-0253-5. eCollection 2017. Antimicrob Resist Infect Control. 2017. PMID: 28924472 Free PMC article.
-
Selection of resistance during sequential use of preferential antibiotic classes.Intensive Care Med. 2006 Jan;32(1):67-74. doi: 10.1007/s00134-005-2805-z. Epub 2005 Nov 25. Intensive Care Med. 2006. PMID: 16308683 Clinical Trial.
-
ICU Patients' Antibiotic Exposure and Triazole-Resistance in Invasive Candidiasis: Parallel Analysis of Aggregated and Individual Data.Front Pharmacol. 2021 Mar 22;12:586893. doi: 10.3389/fphar.2021.586893. eCollection 2021. Front Pharmacol. 2021. PMID: 33828482 Free PMC article.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical