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Author Notes:

Address for correspondence: Scott K. Fridkin, Division of Healthcare Quality Improvement, MS A35, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333, USA; fax: 404-639-2647; e-mail: skf0@cdc.gov

We thank the infection-control, pharmacy, and microbiology personnel from the participating the Intensive Care Antimicrobial Resistance Epidemiology hospitals of the National Nosocomial Infections Surveillance System for reporting the data for this study; Lennox Archibald, Erica R. Pryor, and Christine D. Steward for coordinating submission and processing of data from the participating hospitals; and Holly Hill for assistance in data analysis.

Subjects:

Research Funding:

This work was supported in part by grants to the Rollins School of Public Health of Emory University for Phase 2 and 3 of Project ICARE by AstraZeneca International, Pfizer Inc., and Hoffmann-La Roche Inc. as full sponsors, and Aventis Pharma (formerly Rhone-Poulenc Rorer), the National Foundation for Infectious Diseases, The American Society for Health Systems Pharmacists Research and Education Foundation, Kimberly-Clark Corporation, and Bayer Corporation, Pharmaceuticals Division as partial sponsors.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Immunology
  • Infectious Diseases
  • UNITED-STATES HOSPITALS
  • NOSOCOMIAL INFECTIONS
  • QUALITY IMPROVEMENT
  • EMERGENCE
  • MICROORGANISMS
  • SURVEILLANCE
  • GUIDELINES
  • LEADERS
  • SURGERY
  • Antibiotic resistance
  • Nosocomial infections
  • Surveillance
  • Benchmarking
  • Quality

Monitoring antimicrobial use and resistance: Comparison with a national benchmark on reducing vancomycin use and vancomycin-resistant enterococci

Tools:

Journal Title:

Emerging Infectious Disease

Volume:

Volume 8, Number 7

Publisher:

, Pages 702-707

Type of Work:

Article | Final Publisher PDF

Abstract:

To determine if local monitoring data on vancomycin use directed quality improvement and decreased vancomycin use or vancomycin-resistant enterococci (VRE), we analyzed data from 50 intensive-care units (ICUs) at 20 U.S. hospitals reporting data on antimicrobial-resistant organisms and antimicrobial agent use. We compared local data with national benchmark data (aggregated from all study hospitals). After data were adjusted for changes in prevalence of methicillin-resistant Staphylococcus aureus, changes in specific prescriber practice at ICUs were associated with significant decreases in vancomycin use (mean decrease -48 defined daily doses per 1,000 patient days, p < 0.001). These ICUs also reported significant decreases in VRE prevalence compared with those not using unit-specific changes in practice (mean decrease of 7.5% compared with mean increase of 5.7%, p < 0.001). In this study, practice changes focused towards specific ICUs were associated with decreases in ICU vancomycin use and VRE prevalence.

Copyright information:

Articles from Emerging Infectious Diseases are provided here courtesy of Centers for Disease Control and Prevention

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