Abstract
The aim of the present study was to investigate whether replacement of broad-spectrum cephalosporins (CEPs) by piperacillin/tazobactam (TZP) as first-line empirical therapy may have an effect on beta-lactam resistance among Klebsiella pneumoniae and Escherichia coli in a tertiary care hospital. Data regarding CEP and TZP consumption and resistance were collected on a bimonthly basis during an open-label 2-year (1 year observational and 1 year interventional) study. Consumption of ceftazidime was reduced by 64.5%. In contrast, consumption of the other third-generation CEPs (cefotaxime and ceftriaxone) remained almost stable, whereas an increase in consumption of TZP by 2.8-fold was observed. A significant decrease in resistance to third-generation cephalosporins among K. pneumoniae isolates was observed, and the incidence of extended-spectrum beta-lactamase-producing isolates was notably reduced. These findings were less evident among E. coli isolates. Despite the significant increase in TZP consumption, the respective resistance rates of both bacterial species examined have remained almost unchanged.
MeSH terms
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Anti-Bacterial Agents / administration & dosage
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Anti-Bacterial Agents / pharmacology
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Anti-Bacterial Agents / therapeutic use
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Cephalosporin Resistance
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Cephalosporins / administration & dosage
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Cephalosporins / pharmacology*
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Cephalosporins / therapeutic use
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Cross Infection / drug therapy
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Cross Infection / epidemiology
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Cross Infection / microbiology
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Drug Resistance, Bacterial*
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Drug Utilization / statistics & numerical data
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Enterobacteriaceae Infections / drug therapy
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Enterobacteriaceae Infections / epidemiology
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Enterobacteriaceae Infections / microbiology
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Enzyme Inhibitors / administration & dosage
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Enzyme Inhibitors / pharmacology
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Enzyme Inhibitors / therapeutic use
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Escherichia coli / drug effects*
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Escherichia coli / isolation & purification
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Escherichia coli / metabolism
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Greece / epidemiology
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Humans
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Klebsiella pneumoniae / drug effects*
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Klebsiella pneumoniae / isolation & purification
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Klebsiella pneumoniae / metabolism
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Microbial Sensitivity Tests
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Penicillanic Acid / administration & dosage
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Penicillanic Acid / analogs & derivatives*
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Penicillanic Acid / pharmacology
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Penicillanic Acid / therapeutic use
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Penicillin Resistance
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Piperacillin / administration & dosage
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Piperacillin / pharmacology*
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Piperacillin / therapeutic use
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Prospective Studies
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Tazobactam
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Time Factors
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beta-Lactamase Inhibitors
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beta-Lactamases / metabolism
Substances
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Anti-Bacterial Agents
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Cephalosporins
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Enzyme Inhibitors
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beta-Lactamase Inhibitors
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Penicillanic Acid
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beta-Lactamases
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Tazobactam
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Piperacillin