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Strategies for Study of the Role of Cycling on Antimicrobial Use and Resistance

Published online by Cambridge University Press:  02 January 2015

John E. McGowan Jr.*
Affiliation:
Rollins School of Public Health of Emory University and the Emory University School of Medicine, Atlanta, Georgia
*
Epidemiology Department (Room 442 GCR), Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA 30322

Abstract

Resistant bacteria usually are seen first in the intensive care unit and other acute-care areas. Thus, strategies to control these organisms often are first tested in these healthcare settings. Frequent among these strategies are attempts to improve antimicrobial use. One proposed method to decrease resistance in special settings like the intensive care unit is the cycling or rotation of antimicrobials. This intervention must be evaluated in the context of other concomitant attempts to improve antimicrobial usage and must take into account other factors influencing resistance.

Until such studies are done, the value of cycling and other efforts to limit prescribers' choices of drugs in endemic settings will be unclear. Studies to evaluate cycling will have to be of large scale to produce useful data. It is unlikely that many hospitals or healthcare systems will have sufficient resources on their own to develop studies of sufficient power to be applied widely. Thus, cooperative studies to provide data on this important issue should be an international priority.

Type
Review
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2000

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