This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (224)  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Topic Collections  • Critical Care/ Intensive Care Medicine  • Adult Critical Care  • Drug Therapy  • Drug Therapy, Other  • Alert me on articles by topic  Social Bookmarking   What's this?

Implications for Fluoroquinolone Use

Melinda M. Neuhauser, PharmD; Robert A. Weinstein, MD; Robert Rydman, PhD; Larry H. Danziger, PharmD; George Karam, MD; John P. Quinn, MD

JAMA. 2003;289:885-888.

Context  Previous surveillance studies have documented increasing rates of antimicrobial resistance in US intensive care units (ICUs) in the early 1990s.

Objectives  To assess national rates of antimicrobial resistance among gram-negative aerobic isolates recovered from ICU patients and to compare these rates to antimicrobial use.

Design and Setting  Participating institutions, representing a total of 43 US states plus the District of Columbia, provided antibiotic susceptibility results for 35 790 nonduplicate gram-negative aerobic isolates recovered from ICU patients between 1994 and 2000.

Main Outcome Measures  Each institution tested approximately 100 consecutive gram-negative aerobic isolates recovered from ICU patients. Organisms were identified to the species level. Susceptibility tests were performed, and national fluoroquinolone consumption data were obtained.

Results  The activity of most antimicrobial agents against gram-negative aerobic isolates showed an absolute decrease of 6% or less over the study period. The overall susceptibility to ciprofloxacin decreased steadily from 86% in 1994 to 76% in 2000 and was significantly associated with increased national use of fluoroquinolones.

Conclusions  This study documents the increasing incidence of ciprofloxacin resistance among gram-negative bacilli that has occurred coincident with increased use of fluoroquinolones. More judicious use of fluoroquinolones will be necessary to limit this downward trend.

Author Affiliations: Department of Clinical Sciences and Administration, University of Houston College of Pharmacy, Houston, Tex (Dr Neuhauser); Department of Medicine, Rush Medical College, Chicago, Ill (Drs Weinstein and Quinn); Department of Medicine (Drs Weinstein and Quinn) and Department of Emergency Medicine (Dr Rydman), Cook County Hospital, Chicago, Ill; School of Public Health (Dr Rydman) and Department of Pharmacy Practice (Dr Danziger), University of Illinois at Chicago; and Department of Medicine, Louisiana State University School of Medicine, New Orleans (Dr Karam).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Introduction of Ertapenem into a Hospital Formulary: Effect on Antimicrobial Usage and Improved In Vitro Susceptibility of Pseudomonas aeruginosa
Goldstein et al.
Antimicrob. Agents Chemother. 2009;53:5122-5126.
ABSTRACT | FULL TEXT  

Plasmid-Mediated Quinolone Resistance: a Multifaceted Threat
Strahilevitz et al.
Clin. Microbiol. Rev. 2009;22:664-689.
ABSTRACT | FULL TEXT  

Prevalence and antimicrobial susceptibility of gram-negative bacteria isolated from bovine mastitis between 2003 and 2008 in Korea
Nam et al.
J DAIRY SCI 2009;92:2020-2026.
ABSTRACT | FULL TEXT  

Antimicrobial resistance in hospitals: How concerned should we be?
Mulvey and Simor
CMAJ 2009;180:408-415.
FULL TEXT  

The Utility of Fluoroquinolones in the Critically Ill
Wargo et al.
Journal of Pharmacy Practice 2008;21:346-355.
ABSTRACT  

Emergence and Acquisition of Fluoroquinolone-Resistant Gram-Negative Bacilli in the Intestinal Tracts of Mice Treated with Fluoroquinolone Antimicrobial Agents
Pultz et al.
Antimicrob. Agents Chemother. 2008;52:3457-3460.
ABSTRACT | FULL TEXT  

Predictors of 30-Day Mortality and Hospital Costs in Patients With Ventilator-Associated Pneumonia Attributed to Potentially Antibiotic-Resistant Gram-Negative Bacteria
Kollef et al.
Chest 2008;134:281-287.
ABSTRACT | FULL TEXT  

Reducing empirical use of fluoroquinolones for Pseudomonas aeruginosa infections improves outcome
Nguyen et al.
J Antimicrob Chemother 2008;61:714-720.
ABSTRACT | FULL TEXT  

Risk factors of carbapenem-resistant Klebsiella pneumoniae infections: a matched case control study
Falagas et al.
J Antimicrob Chemother 2007;60:1124-1130.
ABSTRACT | FULL TEXT  

Antimicrobial Resistance among Gram-Negative Bacilli Causing Infections in Intensive Care Unit Patients in the United States between 1993 and 2004
Lockhart et al.
J. Clin. Microbiol. 2007;45:3352-3359.
ABSTRACT | FULL TEXT  

Optimising the duration of antibiotic therapy for ventilator-associated pneumonia
Chastre and Luyt
ERR 2007;16:40-44.
ABSTRACT | FULL TEXT  

Secondary Acylation of Klebsiella pneumoniae Lipopolysaccharide Contributes to Sensitivity to Antibacterial Peptides
Clements et al.
J. Biol. Chem. 2007;282:15569-15577.
ABSTRACT | FULL TEXT  

Time to get serious about infection prevention in the ICU.
Kollef
Chest 2006;130:1293-1296.
FULL TEXT  

Levofloxacin pharmacokinetics and pharmacodynamics in patients with severe burn injury.
Kiser et al.
Antimicrob. Agents Chemother. 2006;50:1937-1945.
ABSTRACT | FULL TEXT  

Using Interrupted Time Series Analysis To Assess Associations of Fluoroquinolone Formulary Changes with Susceptibility of Gram-Negative Pathogens and Isolation Rates of Methicillin-Resistant Staphylococcus aureus.
Bosso and Mauldin
Antimicrob. Agents Chemother. 2006;50:2106-2112.
ABSTRACT | FULL TEXT  

Differential Effects of Levofloxacin and Ciprofloxacin on the Risk for Isolation of Quinolone-Resistant Pseudomonas aeruginosa.
Kaye et al.
Antimicrob. Agents Chemother. 2006;50:2192-2196.
ABSTRACT | FULL TEXT  

Fluoroquinolone-Resistant Urinary Isolates of Escherichia coli from Outpatients Are Frequently Multidrug Resistant: Results from the North American Urinary Tract Infection Collaborative Alliance-Quinolone Resistance Study.
Karlowsky et al.
Antimicrob. Agents Chemother. 2006;50:2251-2254.
ABSTRACT | FULL TEXT  

Optimization of Meropenem Minimum Concentration/MIC Ratio To Suppress In Vitro Resistance of Pseudomonas aeruginosa
Tam et al.
Antimicrob. Agents Chemother. 2005;49:4920-4927.
ABSTRACT | FULL TEXT  

Bacterial Cell Killing Mediated by Topoisomerase I DNA Cleavage Activity
Cheng et al.
J. Biol. Chem. 2005;280:38489-38495.
ABSTRACT | FULL TEXT  

Comparison of {beta}-lactam regimens for the treatment of Gram-negative pulmonary infections in the intensive care unit based on pharmacokinetics/pharmacodynamics
Burgess and Frei
J Antimicrob Chemother 2005;56:893-898.
ABSTRACT | FULL TEXT  

Ventilator-Associated Pneumonia: Insights From Recent Clinical Trials
Shorr and Kollef
Chest 2005;128:583S-591S.
ABSTRACT | FULL TEXT  

Extended-Spectrum {beta}-Lactamases: a Clinical Update
Paterson and Bonomo
Clin. Microbiol. Rev. 2005;18:657-686.
ABSTRACT | FULL TEXT  

Antibiotic Utilization and Outcomes for Patients With Clinically Suspected Ventilator-Associated Pneumonia and Negative Quantitative BAL Culture Results
Kollef and Kollef
Chest 2005;128:2706-2713.
ABSTRACT | FULL TEXT  

Macrolides in Community-Acquired Pneumonia: Does the Bell Toll for Thee?
Granowitz and Brown
Chest 2005;128:1089-1093.
FULL TEXT  

Pharmacokinetics and Pharmacodynamics of Imipenem during Continuous Renal Replacement Therapy in Critically Ill Patients
Fish et al.
Antimicrob. Agents Chemother. 2005;49:2421-2428.
ABSTRACT | FULL TEXT  

Posttreatment Changes in Escherichia coli Antimicrobial Susceptibility Rates among Diarrheic Patients Treated with Ciprofloxacin
Putnam et al.
Antimicrob. Agents Chemother. 2005;49:2571-2572.
ABSTRACT | FULL TEXT  

Daptomycin: A novel cyclic lipopeptide antimicrobial
Schriever et al.
Am J Health Syst Pharm 2005;62:1145-1158.
ABSTRACT | FULL TEXT  

Modelling time-kill studies to discern the pharmacodynamics of meropenem
Tam et al.
J Antimicrob Chemother 2005;55:699-706.
ABSTRACT | FULL TEXT  

Metallo-{beta}-Lactamases: the Quiet before the Storm?
Walsh et al.
Clin. Microbiol. Rev. 2005;18:306-325.
ABSTRACT | FULL TEXT  

Pseudomonas aeruginosa Bloodstream Infection: Importance of Appropriate Initial Antimicrobial Treatment
Micek et al.
Antimicrob. Agents Chemother. 2005;49:1306-1311.
ABSTRACT | FULL TEXT  

Infection Control in Intensive Care Units
Mohr et al.
Journal of Pharmacy Practice 2005;18:84-90.
ABSTRACT  

Gram-Negative Resistance in the Intensive Care Unit
Patel and Crank
Journal of Pharmacy Practice 2005;18:91-99.
ABSTRACT  

Fluoroquinolone-resistant Pseudomonas aeruginosa: risk factors for acquisition and impact on outcomes
Hsu et al.
J Antimicrob Chemother 2005;55:535-541.
ABSTRACT | FULL TEXT  

Antibiotic Rotation and Development of Gram-Negative Antibiotic Resistance
van Loon et al.
Am. J. Respir. Crit. Care Med. 2005;171:480-487.
ABSTRACT | FULL TEXT  

Guidelines for the Management of Adults with Hospital-acquired, Ventilator-associated, and Healthcare-associated Pneumonia
Am. J. Respir. Crit. Care Med. 2005;171:388-416.
FULL TEXT  

Use of an Efflux Pump Inhibitor To Determine the Prevalence of Efflux Pump-Mediated Fluoroquinolone Resistance and Multidrug Resistance in Pseudomonas aeruginosa
Kriengkauykiat et al.
Antimicrob. Agents Chemother. 2005;49:565-570.
ABSTRACT | FULL TEXT  

Test Characteristics of Perirectal and Rectal Swab Compared to Stool Sample for Detection of Fluoroquinolone-Resistant Escherichia coli in the Gastrointestinal Tract
Lautenbach et al.
Antimicrob. Agents Chemother. 2005;49:798-800.
ABSTRACT | FULL TEXT  

National Surveillance of Antimicrobial Resistance in Pseudomonas aeruginosa Isolates Obtained from Intensive Care Unit Patients from 1993 to 2002
Obritsch et al.
Antimicrob. Agents Chemother. 2004;48:4606-4610.
ABSTRACT | FULL TEXT  

Comparison of Two Urinary Antigen Tests for Establishment of Pneumococcal Etiology of Adult Community-Acquired Pneumonia
Stralin et al.
J. Clin. Microbiol. 2004;42:3620-3625.
ABSTRACT | FULL TEXT  

The Magnitude of the Association between Fluoroquinolone Use and Quinolone-Resistant Escherichia coli and Klebsiella pneumoniae May Be Lower than Previously Reported
Bolon et al.
Antimicrob. Agents Chemother. 2004;48:1934-1940.
ABSTRACT | FULL TEXT  

A Randomized Controlled Trial of an Antibiotic Discontinuation Policy for Clinically Suspected Ventilator-Associated Pneumonia
Micek et al.
Chest 2004;125:1791-1799.
ABSTRACT | FULL TEXT  

The Klebsiella pneumoniae O Antigen Contributes to Bacteremia and Lethality during Murine Pneumonia
Shankar-Sinha et al.
Infect. Immun. 2004;72:1423-1430.
ABSTRACT | FULL TEXT  

Single Versus Combined Antibiotic Therapy for Gram-Negative Infections
Klibanov et al.
The Annals of Pharmacotherapy 2004;38:332-337.
ABSTRACT | FULL TEXT  

Comparison of 8 vs 15 Days of Antibiotic Therapy for Ventilator-Associated Pneumonia in Adults: A Randomized Trial
Chastre et al.
JAMA 2003;290:2588-2598.
ABSTRACT | FULL TEXT  

How good is the evidence for the recommended empirical antimicrobial treatment of patients hospitalized because of community-acquired pneumonia? A systematic review
Oosterheert et al.
J Antimicrob Chemother 2003;52:555-563.
ABSTRACT | FULL TEXT  

Inappropriate Fluoroquinolone Use Resulting From Lack of Specific Guidelines
Luh and Karnath
Arch Intern Med 2003;163:1978-1978.
FULL TEXT  

Nonspecific Guidelines Lead to Inappropriate Fluoroquinolone Use
Luh and Karnath
Arch Intern Med 2003;163:1617-1618.
FULL TEXT  

Quinolone Resistance Mounts Among Gram-Negative Pathogens
Journal Watch Dermatology 2003;2003:11-11.
FULL TEXT  

Quinolone Resistance Mounts Among Gram-Negative Pathogens
JWatch General 2003;2003:2-2.
FULL TEXT