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Do Intensive Hospital Antibiotic Control Programs Prevent the Spread of Antibiotic Resistance?

Published online by Cambridge University Press:  02 January 2015

John E. McGowan Jr
John E. McGowan Jr*
Affiliation:
Department of Pathology and Laboratory Medicine, Emory University School of Medicine, and the Clinical Microbiology Laboratory, Grady Memorial Hospital, Atlanta, Georgia
*
Clinical Laboratories, Box 26.248, Grady Memorial Hospital, 80 Butler St., Atlanta, GA 30335
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Abstract

The relation between antibiotic control and resistance was assessed by review of selected journal articles from 1988 through 1994. Most studies of control or monitoring do not report susceptibility pattern as an outcome measure. Several aspects of bias and confounding prevent more than analysis of temporal association between antibiotic use restriction and resistance pattern. However, in a few institutions there has been an increase in susceptibility to antimicrobials following intensive control or monitoring. Moreover, in a few hospitals, intensive antibiotic control for selected drug-organism pairs was associated with a high prevalence of susceptibility, and the proportion susceptible fell abruptly when control or monitoring was relaxed or removed. These examples, coupled with the recent emergence of new resistant organisms, justify attempts to determine the value of intensive antibiotic control as a preventive practice. Because these studies were performed in single institutions, their power to distinguish associations was poor. Cooperative multicenter studies are needed in which selection and classification biases are addressed prospectively, and in which confounding factors are controlled.

Type
From the Third International Conference on the Prevention of Infection
Information
Infection Control & Hospital Epidemiology , Volume 15 , Issue 7 , July 1994 , pp. 478 - 483
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1994

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