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Multicenter Study
. 2005 Aug;11(8):1197-204.
doi: 10.3201/eid1108.050116.

Pseudomonas aeruginosa, Staphylococcus aureus, and fluoroquinolone use

Conan MacDougall  1 , Spencer E Harpe, J Patrick Powell, Christopher K Johnson, Michael B Edmond, Ron E Polk
Affiliations
Multicenter Study

Pseudomonas aeruginosa, Staphylococcus aureus, and fluoroquinolone use

Conan MacDougall et al. Emerg Infect Dis. 2005 Aug.

Abstract

Few long-term multicenter investigations have evaluated the relationships between aggregate antimicrobial drug use in hospitals and bacterial resistance. We measured fluoroquinolone use from 1999 through 2003 in a network of US hospitals. The percentages of fluoroquinolone-resistant Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus (MRSA) were obtained from yearly antibiograms at each hospital. Univariate linear regression showed significant associations between a hospital's volume of fluoroquinolone use and percent resistance in most individual study years (1999-2001 for P. aeruginosa, 1999-2002 for S. aureus). When the method of generalized estimating equations was used, a population-averaged longitudinal model incorporating total fluoroquinolone use and the previous year's resistance (to account for autocorrelation) did not show a significant effect of fluoroquinolone use on percent resistance for most drug-organism combinations, except for the relationship between levofloxacin use and percent MRSA. The ecologic relationship between fluoroquinolone use and resistance is complex and requires further study.

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Figures

Figure 1
Figure 1
Fluoroquinolone use and resistance over study period. FQ, fluoroquinolone; Levo, levofloxacin; Cipro, ciprofloxacin; Moxi, moxifloxacin; Gati, gatifloxacin; DDD/1,000PD, defined daily doses/1,000 patient-days; FQ-R PSA, fluoroquinolone-resistant Pseudomonas aeruginosa; MRSA, methicillin-resistant Staphylococcus aureus.
Figure 2
Figure 2
A) Changes in fluoroquinolone use (x axis) and resistance in Pseudomonas aeruginosa (y axis) for 9 hospitals with complete data, 1999–2003. Origin is median values of fluoroquinolone use and resistance in 1999. DDD/1,000 PD, defined daily doses/1,000 patient-days. FQ-R PSA, fluoroquinolone-resistant P. aeruginosa; MRSA, methicillin-resistant Staphylococcus aureus. B) Changes in fluoroquinolone use (x axis) and resistance (y axis) in S. aureus for 9 hospitals with complete data, 1999–2003.
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References

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