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http://hdl.handle.net/2445/98675
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DC Field | Value | Language |
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dc.contributor.author | Cobos-Trigueros, Nazaret | - |
dc.contributor.author | Solé, Mar | - |
dc.contributor.author | Castro, Pedro | - |
dc.contributor.author | Torres, Jorge Luis | - |
dc.contributor.author | Rinaudo, Mariano | - |
dc.contributor.author | Lazzari, Elisa de | - |
dc.contributor.author | Morata, Laura | - |
dc.contributor.author | Hernández-Munain, Cristina | - |
dc.contributor.author | Fernández, Sara (Fernández García) | - |
dc.contributor.author | Soriano Viladomiu, Alex | - |
dc.contributor.author | Nicolás Arfelis, Josep Maria | - |
dc.contributor.author | Mensa Pueyo, Josep | - |
dc.contributor.author | Vila Estapé, Jordi | - |
dc.contributor.author | Martínez, José Antonio (Martínez Martínez) | - |
dc.date.accessioned | 2016-05-19T09:52:47Z | - |
dc.date.available | 2016-05-19T09:52:47Z | - |
dc.date.issued | 2016-03-16 | - |
dc.identifier.issn | 1932-6203 | - |
dc.identifier.uri | http://hdl.handle.net/2445/98675 | - |
dc.description.abstract | OBJECTIVE: To compare the effect of two strategies of antibiotic use (mixing vs. cycling) on the acquisition of resistant microorganisms, infections and other clinical outcomes. METHODS: Prospective cohort study in an 8-bed intensive care unit during 35- months in which a mixing-cycling policy of antipseudomonal beta-lactams (meropenem, ceftazidime/piperacillin-tazobactam) and fluoroquinolones was operative. Nasopharyngeal and rectal swabs and respiratory secretions were obtained within 48h of admission and thrice weekly thereafter. Target microorganisms included methicillin-resistant S. aureus, vancomycin-resistant enterococci, third-generation cephalosporin-resistant Enterobacteriaceae and non-fermenters. RESULTS: A total of 409 (42%) patients were included in mixing and 560 (58%) in cycling. Exposure to ceftazidime/piperacillin-tazobactam and fluoroquinolones was significantly higher in mixing while exposure to meropenem was higher in cycling, although overall use of antipseudomonals was not significantly different (37.5/100 patient-days vs. 38.1/100 patient-days). There was a barely higher acquisition rate of microorganisms during mixing, but this difference lost its significance when the cases due to an exogenous Burkholderia cepacia outbreak were excluded (19.3% vs. 15.4%, OR 0.8, CI 0.5-1.1). Acquisition of Pseudomonas aeruginosa resistant to the intervention antibiotics or with multiple-drug resistance was similar. There were no significant differences between mixing and cycling in the proportion of patients acquiring any infection (16.6% vs. 14.5%, OR 0.9, CI 0.6-1.2), any infection due to target microorganisms (5.9% vs. 5.2%, OR 0.9, CI 0.5-1.5), length of stay (median 5 d for both groups) or mortality (13.9 vs. 14.3%, OR 1.03, CI 0.7-1.3). CONCLUSIONS: A cycling strategy of antibiotic use with a 6-week cycle duration is similar to mixing in terms of acquisition of resistant microorganisms, infections, length of stay and mortality. | - |
dc.format.extent | 14 p. | - |
dc.format.mimetype | application/pdf | - |
dc.language.iso | eng | - |
dc.publisher | Public Library of Science (PLoS) | - |
dc.relation.isformatof | Reproducció del document publicat a: http://dx.doi.org/10.1371/journal.pone.0150274 | - |
dc.relation.ispartof | PLoS One, 2016, vol. 11, num. 3, p. e0150274 | - |
dc.relation.uri | http://dx.doi.org/10.1371/journal.pone.0150274 | - |
dc.rights | cc by (c) Cobos-Trigueros et al., 2016 | - |
dc.rights.uri | http://creativecommons.org/licenses/by/3.0/es/ | - |
dc.source | Articles publicats en revistes (ISGlobal) | - |
dc.subject.classification | Antibiòtics | - |
dc.subject.classification | Infeccions del tracte urinari | - |
dc.subject.other | Antibiotics | - |
dc.subject.other | Urinary tract infections | - |
dc.title | Evaluation of a Mixing versus a Cycling Strategy of Antibiotic Use in Critically-Ill Medical Patients: Impact on Acquisition of Resistant Microorganisms and Clinical Outcomes | - |
dc.type | info:eu-repo/semantics/article | - |
dc.type | info:eu-repo/semantics/publishedVersion | - |
dc.date.updated | 2016-05-10T15:01:27Z | - |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | - |
dc.identifier.pmid | 26982807 | - |
Appears in Collections: | Articles publicats en revistes (ISGlobal) Articles publicats en revistes (Fonaments Clínics) Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer) |
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cobos-trigueros2016_2099.pdf | 252.76 kB | Adobe PDF | View/Open |
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