Antimicrobial Drug Use and Methicillin-resistant<i>Staphylococcus aureus</i>, Aberdeen, 1996–2000

Monnet, Dominique; Mackenzie, Fiona; López-Lozano, J.M.; Beyaert, Arielle; Camacho, Máximo; Wilson, R.; Stuart, D.I.; Gould, Ian M.

doi:10.3201/eid1008.020694

Cited by 158 publications

(74 citation statements)

References 32 publications

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“…For studies exploring the association between antimicrobial usage and resistance, low resolution level data have been used to quantify the association between antimicrobial usage and level of occurrence of resistant bacteria and strains, which includes both the selection and spread of antimicrobial resistance (Van de Sande‐Bruinsma et al., ; Chantziaras et al., ; Garcia‐Migura et al., ; ECDC, EFSA and EMA, ). On the other hand, studies conducted at high‐resolution level, in particular those relying on time series analysis (Monnet et al., ; Aldeyab et al., ), can be used to focus on the quantification of the selection of antimicrobial resistance following antimicrobial usage. However, in this type of epidemiological studies, other factors besides antimicrobial usage (e.g.…”

Section: For Each Study Objective What Are the Requirements Regardinmentioning

confidence: 99%

“…Many studies rely on annual antimicrobial usage data, whatever their objectives. However, a limited number of studies collected monthly data to monitor usage trends in outpatient clinics; this made it possible to describe the seasonal variability of usage (Achermann et al., ; Suda et al., ), or the association between antimicrobial usage and resistance using time series analysis (Monnet et al., ). Monthly collection of antimicrobial usage is also routinely implemented in Denmark for human and veterinary antimicrobial products (DANMAP, ) and has been used to highlight specific events, such as the effect on antimicrobial usage of the introduction of generic versions of drugs (Chauvin, ; Jensen et al., ).…”

Section: For Each Study Objective What Are the Requirements Regardinmentioning

confidence: 99%

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Guidance on the Selection of Appropriate Indicators for Quantification of Antimicrobial Usage in Humans and Animals

Collineau

Belloc

Stärk

et al. 2016

Zoonoses and Public Health

159

205

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An increasing variety of indicators of antimicrobial usage has become available in human and veterinary medicine, with no consensus on the most appropriate indicators to be used. The objective of this review is therefore to provide guidance on the selection of indicators, intended for those aiming to quantify antimicrobial usage based on sales, deliveries or reimbursement data. Depending on the study objective, different requirements apply to antimicrobial usage quantification in terms of resolution, comprehensiveness, stability over time, ability to assess exposure and comparability. If the aim is to monitor antimicrobial usage trends, it is crucial to use a robust quantification system that allows stability over time in terms of required data and provided output; to compare usage between different species or countries, comparability must be ensured between the different populations. If data are used for benchmarking, the system comprehensiveness is particularly crucial, while data collected to study the association between usage and resistance should express the exposure level and duration as a measurement of the exerted selection pressure. Antimicrobial usage is generally described as the number of technical units consumed normalized by the population at risk of being treated in a defined period. The technical units vary from number of packages to number of individuals treated daily by adding different levels of complexity such as daily dose or weight at treatment. These technical units are then related to a description of the population at risk, based either on biomass or number of individuals. Conventions and assumptions are needed for all of these calculation steps. However, there is a clear lack of standardization, resulting in poor transparency and comparability. By combining study requirements with available approaches to quantify antimicrobial usage, we provide suggestions on the most appropriate indicators and data sources to be used for a given study objective.

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Section: For Each Study Objective What Are the Requirements Regardinmentioning

confidence: 99%

Section: For Each Study Objective What Are the Requirements Regardinmentioning

confidence: 99%

Guidance on the Selection of Appropriate Indicators for Quantification of Antimicrobial Usage in Humans and Animals

Collineau

Belloc

Stärk

et al. 2016

Zoonoses and Public Health

159

205

View full text Add to dashboard Cite

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“…The rationale for this apparent discrepancy is not known. Additional risk factors for healthcare‐associated MRSA include a history of hospitalization within the past 12–24 months (Warshawsky et al, 2000), previous antimicrobial utilization (Graffunder & Venezia, 2002; Monnet et al, 2004), and intravenous drug use (Charlebois et al, 2002). According to a recent abstract presented at the 16th International AIDS Conference, HIV‐positive individuals are 18 times more likely to become infected with CA‐MRSA than the general population (Crum‐Cianfione, 7 A.D.).…”

Section: Risk Factors For Hospital‐acquired and Ca‐mrsamentioning

confidence: 99%

Epidemiology, clinical manifestations, and treatment options for skin and soft tissue infection caused by community‐acquired methicillin‐resistant Staphylococcus aureus

Farley

2008

Journal of the American Academy of Nurse Practitioners

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Purpose: This article reviews the evolving epidemiology of community-acquired methicillinresistant Staphylococcus aureus (CA-MRSA) and the appropriate outpatient management of CA-MRSA skin and soft tissue infection. Further, the paper will provide the basis upon which an individualized patient educational plan may be developed. Data Sources:To complete this review, a search of English language publications was conducted through Medline and CINAHL databases . Conclusions:The epidemiology of CA-MRSA is becoming increasingly complex. Research that addresses the impact of this organism in high-risk populations and within families is urgently needed. Implications for Practice:Nurse practitioners must remain informed of the epidemiology of common and emerging drug-resistant organisms in their patient populations.

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“…Antimicrobial resistance continues to increase among bacteria that cause disease in both community and hospital settings 2–5. The relationship between antimicrobial use and antimicrobial resistance is complex, but a growing body of data strongly suggests that higher levels of antimicrobial usage are associated with increased levels of antimicrobial resistance 6–9. The persistent increase in antimicrobial resistance has created concern that we are entering a “post-antibiotic era” in which some bacterial infections will no longer be treatable 10,11.…”

Section: Introductionmentioning

confidence: 99%

Impact of an Antimicrobial Utilization Program on Antimicrobial Use at a Large Teaching Hospital A Randomized Controlled Trial

Camins

King

Wells

et al. 2009

Infect. Control Hosp. Epidemiol.

118

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Background Multidisciplinary antimicrobial utilization teams (AUT) have been proposed as a mechanism for improving antimicrobial use, but data on their efficacy remain limited. Objective To determine the impact of an AUT on antimicrobial use at a teaching hospital. Design Randomized controlled intervention trial. Setting A 953-bed public university-affiliated urban teaching hospital. Patients Patients who were prescribed selected antimicrobial agents (piperacillin-tazobactam, levofloxacin, or vancomycin) by internal medicine ward teams. Intervention Twelve internal medicine teams were randomized monthly: 6 teams to intervention group (academic detailing by the AUT), and 6 teams to a control group given indication-based guidelines for prescription of broad spectrum antimicrobials (standard of care) during a 10-month study period. Measurements Proportion of appropriate empiric, definitive (therapeutic), and end antimicrobial (overall) usage. Results A total of 784 new prescriptions of piperacillin-tazobactam, levofloxacin, and vancomycin were reviewed. The proportion of appropriate antimicrobial prescriptions written by the intervention teams was significantly higher than prescribed by the control teams: 82% vs. 73% for empiric (RR=1.14, 95% CI 1.04–1.24), 82% vs. 43% for definitive (RR=1.89, 95% CI 1.53–2.33), and 94% vs. 70% for end antimicrobial usage (RR=1.34, 95% CI 1.25–1.43). In a multivariate analysis, teams that received feedback from the AUT alone (aRR=1.37, 95% CI 1.27–1.48) or from both the AUT and the ID consult service (aRR=2.28, 95% CI 1.64–3.19) were significantly more likely to prescribe end antimicrobial usage appropriately compared to control teams. Conclusions A multidisciplinary AUT which provides feedback to prescribing physicians was an effective method in improving antimicrobial use.

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Antimicrobial Drug Use and Methicillin-resistantStaphylococcus aureus, Aberdeen, 1996–2000

Abstract: Relationships between antimicrobial use and MRSA prevalence are analyzed in Aberdeen, Scotland.

Cited by 158 publications

References 32 publications

Guidance on the Selection of Appropriate Indicators for Quantification of Antimicrobial Usage in Humans and Animals

Guidance on the Selection of Appropriate Indicators for Quantification of Antimicrobial Usage in Humans and Animals

Epidemiology, clinical manifestations, and treatment options for skin and soft tissue infection caused by community‐acquired methicillin‐resistant Staphylococcus aureus

Impact of an Antimicrobial Utilization Program on Antimicrobial Use at a Large Teaching Hospital A Randomized Controlled Trial

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