Plüss-Suard, C; Pannatier, A; Ruffieux, C; Kronenberg, Andreas; Mühlemann, K; Zanetti, G (2012). Changes in the use of broad-spectrum antibiotics after cefepime shortage: a time series analysis. Antimicrobial agents and chemotherapy, 56(2), pp. 989-94. Washington, D.C.: American Society for Microbiology 10.1128/AAC.05560-11
Full text not available from this repository. (Request a copy)The original cefepime product was withdrawn from the Swiss market in January 2007 and replaced by a generic 10 months later. The goals of the study were to assess the impact of this cefepime shortage on the use and costs of alternative broad-spectrum antibiotics, on antibiotic policy, and on resistance of Pseudomonas aeruginosa toward carbapenems, ceftazidime, and piperacillin-tazobactam. A generalized regression-based interrupted time series model assessed how much the shortage changed the monthly use and costs of cefepime and of selected alternative broad-spectrum antibiotics (ceftazidime, imipenem-cilastatin, meropenem, piperacillin-tazobactam) in 15 Swiss acute care hospitals from January 2005 to December 2008. Resistance of P. aeruginosa was compared before and after the cefepime shortage. There was a statistically significant increase in the consumption of piperacillin-tazobactam in hospitals with definitive interruption of cefepime supply and of meropenem in hospitals with transient interruption of cefepime supply. Consumption of each alternative antibiotic tended to increase during the cefepime shortage and to decrease when the cefepime generic was released. These shifts were associated with significantly higher overall costs. There was no significant change in hospitals with uninterrupted cefepime supply. The alternative antibiotics for which an increase in consumption showed the strongest association with a progression of resistance were the carbapenems. The use of alternative antibiotics after cefepime withdrawal was associated with a significant increase in piperacillin-tazobactam and meropenem use and in overall costs and with a decrease in susceptibility of P. aeruginosa in hospitals. This warrants caution with regard to shortages and withdrawals of antibiotics.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology |
UniBE Contributor: |
Kronenberg, Andreas Oskar |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
0066-4804 |
Publisher: |
American Society for Microbiology |
Language: |
English |
Submitter: |
Factscience Import |
Date Deposited: |
04 Oct 2013 14:24 |
Last Modified: |
05 Dec 2022 14:07 |
Publisher DOI: |
10.1128/AAC.05560-11 |
PubMed ID: |
22123703 |
Web of Science ID: |
000299658900053 |
URI: |
https://boris.unibe.ch/id/eprint/8446 (FactScience: 213991) |
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