Impact of Piperacillin/Tazobactam Use to Intestinal Colonization of Extended- spectrum-lactamase Producing Escherichia coli and Klebsiella pneumoniae / 감염과화학요법
Infection and Chemotherapy
;
: 65-70, 2007.
Article
in Korean
| WPRIM
| ID: wpr-721581
ABSTRACT
BACKGROUND:
Being able to hydrolyze the majority of b-lactam antibiotics that are currently in use, extended-spectrum b-lactamases (ESBLs) pose a serious clinical problem. In order to solve this problem, it is recommended to use beta-lactam/beta-lactamase inhibitor instead of extended-spectrum cephalosporins. This study investigated the relationship between piperacillin/tazobactam use and ESBL-producing Klebsiella pneumoniae and Escherichia coli in stool colony. MATERIALS ANDMETHODS:
A prospective study was performed in hemato-oncology department patients of Hanyang University Hospital. During the pre-intervention period of 3 months (Feb. 2005 to Apr. 2005), antibiotics were prescribed liberally. During the intervention period of 6 months (May. 2005 to Oct. 2005), use of the 3rd (4th) generation cephalosporins and carbapenems were restricted and piperacillin/tazobactam was recommended. All enrolled patients performed stool culture or rectal swab culture. ESBL confirmed by Double disk synergy test and commercial identification kit. Between the pre-intervention and intervention groups, acquisition rates of ESBL producing organisms were compared.RESULTS:
50 cases were enrolled in pre-intervention period and 112 cases were enrolled in intervention period. In intervention period, use of 3rd (4th) generation cephalosporins and carbapenems decreased from 27 daily define dose/1,000patient/days to 6.82 DDD/1,000patient/days, but use of piperacillin/tazobactam increased from 1.98 DDD/1,000patient/days to 5.66 DDD/1,000patient/days. The intestinal acquisition rate of ESBL producing organism decreased from 30% to 12%. There was no difference in overall mortality of infectious disease between two phase.CONCLUSION:
Use of piperacillin/tazobactam instead of extended-spectrum cephalosporins reduces intestinal acquisition rate of ESBL producing K. pneumoniae and E. coli. Therefore, in order to decrease the number of ESBL producing organism, we recommend using piperacillin/tazobactam instead of using extended-spectrum cephalosporins.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Pneumonia
/
Drug Resistance, Microbial
/
Carbapenems
/
Cephalosporins
/
Communicable Diseases
/
Prospective Studies
/
Mortality
/
Colon
/
Escherichia
/
Escherichia coli
Type of study:
Observational study
/
Prognostic study
Limits:
Humans
Language:
Korean
Journal:
Infection and Chemotherapy
Year:
2007
Type:
Article
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