Reduction in Antibiotic use Linked with Fewer Hospital Acquired Infections

A primary goal for hospital antimicrobial stewardship programs should be to reduce broad spectrum antibiotic use. Research published in the Medical Journal of Australia provides more evidence about why.

An international shortage in 2017, of piperacillin/tazobactam (PT) – an antibiotic used to treat pelvic inflammatory disease, intra-abdominal infection, pneumonia, cellulitis, and sepsis – caused its replacement with intravenous amoxicillin/clavulanate (IVAC).

Studies showed that reducing the use of broad spectrum antibiotics was associated with a lower incidence of vancomycin-resistant Enterococcus (VRE) in hospitals.

A research team from John Hunter Hospital and the University of Newcastle, led by Associate Professor John Ferguson, set out to measure the impact of the PT shortage on VRE and methicillin-resistant Staphylococcus aureus (MRSA) acquisitions at the hospital, where there has been a continued outbreak of VRE since 2014. They compared the incidence of hospital-onset acquisitions (hospital-wide) in the 12 months before (October 2016 – September 2017) and 12 months after (November 2017 – October 2018) the start of the PT shortage.

Researchers found that reducing broad spectrum antibiotic use was linked with reduced VRE transmission and infection. Restricted use of PT has been reintroduced and usage remains at a much reduced level than prior to the shortage. Trends will continue to be observed.

To read the full article NSW Health staff can go to CIAP Journals section or contact their Library.