Modification in prescribing practices for third-generation cephalosporins and ciprofloxacin is associated with a reduction in meticillin-resistant Staphylococcus aureus bacteraemia rate

Abstract

To decrease the incidence of hospital infections caused by meticillin-resistant Staphylococcus aureus (MRSA), an educational intervention study was performed in which the use of intravenous ciprofloxacin and third-generation cephalosporins was discouraged. The effect was assessed by observing the MRSA bacteraemia rate both within the hospital and the intensive care unit for 18 months before, and 16 months after, the two-month intervention programme. MRSA bacteraemia rate throughout the hospital was reduced by 62.9% (P<0.001) by the end of the study and MRSA colonisation rate was reduced by 38.4% (not significant). There was no concomitant decrease in episodes of bacteraemia caused by meticillin-susceptible Staphylococcus aureus (MSSA) during the study period. There was a fall in hospital dispensing of both ciprofloxacin (80.4%) and third-generation cephalosporins (75.2%). The overall incidence of MRSA bloodstream infections within critical care was reduced (4.200 vs 0.272 per 1000 occupied bed-days) but this was not significant.