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Effect of restricting piperacillin/tazobactam prescription on rates of antimicrobial resistance in gram-negative bacteria and antibiotic consumption

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Abstract

The increasing resistance of gram-negative bacteria is a serious global public health concern. One way to prevent increasing antibiotic resistance is by implementing the antibiotic stewardship program. This study aimed to assess the changes in the consumption of antimicrobials and antimicrobial resistance rates after implementing piperacillin/tazobactam restriction. This study was conducted at Kandong Sacred Heart Hospital. We retrospectively collected and analysed data between October 2018 and May 2021 to evaluate antibiotic consumption and resistance patterns after restricting piperacillin/tazobactam. This study included two periods, a 16-month pre-restriction period and a 16-month post-restriction period. During the study period, there was a significant decrease in the consumption of piperacillin/tazobactam after implementing the restriction policy (127.82 ± 9.39 to 104.82 ± 15.66 defined daily doses/1000 patient days, p < 0.001). A significant decrease in the resistance rate of Acinetobacter spp. was observed for cefepime (p = 0.001), ceftazidime (p = 0.004), levofloxacin (p = 0.021), meropenem (p = 0.002) and piperacillin (p = 0.028). The introduction of piperacillin/tazobactam restriction reduced their use and positively impacted the resistance rates of Acinetobacter spp., carbapenem-resistant Pseudomonas spp. and carbapenem-resistant Enterobacteriaceae which are major threats to nosocomial infections.

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Data availability

The datasets generated and/or during analysed during the current study are available from the corresponding author on reasonable request.

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Funding

This work was supported by the Kangdong Sacred Heart Hospital Fund [grant number 2021–03].

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Authors and Affiliations

  1. Division of Infectious Disease, Kangdong Sacred Heart Hospital, Hallym University School of Medicine, 150, Seongan-Ro, Gangdong-Gu, Seoul, 05355, Republic of Korea

    Jihyu Oh, So Yeon Park, Jin Seo Lee & Seo Hu Lee

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  1. Jihyu Oh
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  2. So Yeon Park
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Contributions

Jihyu Oh: methodology, investigation, and writing. So Yeon Park: supervision, conceptualization, and statistical analysis. Jin Seo Lee: conceptualization and supervision. Seo Hu Lee: investigation.

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Correspondence to So Yeon Park.

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This study was approved by the Institutional Review Board of Kandong Sacred Heart Hospital (study number 2021–03-009).

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Oh, J., Park, S.Y., Lee, J.S. et al. Effect of restricting piperacillin/tazobactam prescription on rates of antimicrobial resistance in gram-negative bacteria and antibiotic consumption. Eur J Clin Microbiol Infect Dis 42, 53–60 (2023). https://doi.org/10.1007/s10096-022-04525-1

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