The effect of restricting the use of cephalosporins on the frequency of infections caused by strains resistant to methicillin S. aureus , in intensive care
Many previous studies have shown that limiting the use of antibacterial drugs helps reduce the resistance level of microorganisms. Currently, there is a clear tendency to increase the etiological significance of strains resistant to methicillin S. aureus (MRSA) in the development of nosocomial infections, which are particularly dangerous in ICU patients. Therefore, the relevance of a prospective, non-randomized, "before and after" study in Italy to establish whether restricting the use of cephalosporins in ICU patients affects the resistance of Gram-negative microorganisms that play an important role in the development of nosocomial infections, is quite understandable, and if this limitation help reduce the incidence of MRSA infections.
In the intensive care unit, designed for 18 beds, the researchers introduced a new strategy to control the use of antibacterial drugs, the essence of which was to limit the use of cephalosporins in all intensive care patients. In accordance with the study protocol, the incidence of nosocomial infections and the antibacterial drugs used were regularly monitored. Separately, the prevalence of infections caused by MRSA has been determined.
After the introduction of the program, the use of cephalosporins decreased considerably (by 70.3%), while the use of fluoroquinolones, in particular ciprolofloxacin, increased by 46.5%. Researchers note a significant decrease in the proportion of infections caused by MRSA (by 30%), as well as heterogeneous data on the sensitivity of the strains Klebsiella pneumoniae and Pseudomonas aeruginosa .
Limiting the use of cephalosporins in intensive care units has led to a decrease in the incidence of nosocomial infections caused by MRSA.