STUDY OBJECTIVES: To compare the use of @entity7660 and subsequent @entity796 sensitivity patterns before and after implementation of a clinical pharmacist-facilitated antimicrobial restriction program in August 1997. DESIGN: Retrospective consecutive data collection. SETTING: Large university-affiliated medical center. INTERVENTION: The study results are the accumulation of the daily intervention activities of the antimicrobial restriction program. Data on antimicrobial grams purchased/1,000 @entity1 -days and susceptibility patterns were collected and analyzed retrospectively. MEASURES AND MAIN RESULTS: Annual grams of @entity5505 , @entity3400 , @entity3400 - @entity7120 , and other antipseudomonal @entity7660 purchased/1,000 @entity1 -days were compared during the 2 full calendar years before the antimicrobial restriction program (1995-1996) with the 4 full calendar years after the program was implemented (1998-2001). @entity796 resistance trends for the antipseudomonal @entity7660 , @entity2177 , and @entity2890 also were compared for the 2 years before the program (1995-1996) with the last 2 years of the program (2000-2001). A 44% reduction in @entity5505 use was documented; ostensibly, minimal changes occurred in the overall use of @entity3400 and @entity3400 - @entity7120 . During the same time period, @entity5505 resistance fell from 24% to 11.8% (p<0.001), whereas @entity3400 resistance fell from 32.5% to 18.5% (p<0.001). Imipenem resistance declined from 20.5% to 12.3% (p<0.001) with an 18% reduction in use. Aztreonam resistance declined from 29.5% to 16.5% (p<0.001) despite a 57% increase in use. No changes in resistance to either @entity2177 or @entity2890 were found. CONCLUSION: Through an antimicrobial restriction program, a dramatic reduction in @entity5505 use was achieved with judicious use of other antipseudomonal antimicrobials, which resulted in reduced resistance of @entity796 to other @entity7660 .

The effect of an antimicrobial restriction program on XXXX resistance to @entity7660 in a large teaching hospital.

@entity1 :: ('9606', 'Species') :: ['patient'] @entity796 :: ('287', 'Species') :: ['Pseudomonas aeruginosa', 'P aeruginosa'] @entity2890 :: ('MESH:D014031', 'Chemical') :: ['tobramycin'] @entity2177 :: ('MESH:D002939', 'Chemical') :: ['ciprofloxacin'] @entity7660 :: ('MESH:D047090', 'Chemical') :: ['beta-lactams'] @entity7120 :: ('MESH:C043265', 'Chemical') :: ['tazobactam'] @entity3400 :: ('MESH:D010878', 'Chemical') :: ['piperacillin'] @entity5505 :: ('MESH:D002442', 'Chemical') :: ['ceftazidime']
@entity796 :: (287,Species) :: ['Pseudomonas aeruginosa']
