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JAMA. 2003 Feb 19;289(7):885-8.

Antibiotic resistance among gram-negative bacilli in US intensive care units: implications for fluoroquinolone use.

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  • 1Department of Clinical Sciences and Administration, University of Houston College of Pharmacy, Houston, Tex, USA.

Abstract

CONTEXT:

Previous surveillance studies have documented increasing rates of antimicrobial resistance in US intensive care units (ICUs) in the early 1990s.

OBJECTIVES:

To assess national rates of antimicrobial resistance among gram-negative aerobic isolates recovered from ICU patients and to compare these rates to antimicrobial use.

DESIGN AND SETTING:

Participating institutions, representing a total of 43 US states plus the District of Columbia, provided antibiotic susceptibility results for 35 790 nonduplicate gram-negative aerobic isolates recovered from ICU patients between 1994 and 2000.

MAIN OUTCOME MEASURES:

Each institution tested approximately 100 consecutive gram-negative aerobic isolates recovered from ICU patients. Organisms were identified to the species level. Susceptibility tests were performed, and national fluoroquinolone consumption data were obtained.

RESULTS:

The activity of most antimicrobial agents against gram-negative aerobic isolates showed an absolute decrease of 6% or less over the study period. The overall susceptibility to ciprofloxacin decreased steadily from 86% in 1994 to 76% in 2000 and was significantly associated with increased national use of fluoroquinolones.

CONCLUSIONS:

This study documents the increasing incidence of ciprofloxacin resistance among gram-negative bacilli that has occurred coincident with increased use of fluoroquinolones. More judicious use of fluoroquinolones will be necessary to limit this downward trend.

PMID:
12588273
[PubMed - indexed for MEDLINE]
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