The effect of an antibiotic policy on bacterial resistance in patients in geriatric medical wards

M. J. Bendall, S. Ebrahim, R. G. Finch, R. C. Slack, K. J. Towner

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    13 Citations (Scopus)

    Abstract

    In an effort to reduce levels of trimethoprim resistance amongst urinary isolates and faecal organisms two antibiotic policies (policy 1, erythromycin, nitrofurantoin substituted for trimethoprim and ampicillin; policy 2, Augmentin (ampicillin+clavulinic acid) substituted for trimethoprim and ampicillin) were used for 50 weeks on two geriatric acute/rehabilitation wards. The policies were evaluated by comparison with the pre-policy period and between policies. The policies were applied successfully and both were associated with a fall in the proportion of trimethoprim-resistant faecal conforms and urinary isolates. Policy 1 appeared to affect plasmid-mediated resistance to a greater extent than policy 2. There were no differences in outcome for patients during policy periods. Control of antibiotic usage by formal policies is a viable means of controlling bacterial resistance in geriatric wards. The mode of action of such policies requires further elucidation.

    Original languageEnglish
    Pages (from-to)849-854
    Number of pages6
    JournalQJM
    Volume60
    Issue number3
    DOIs
    Publication statusPublished - Sept 1986

    Bibliographical note

    Funding Information:
    We thank the nursing and medical staff, and in particular DrS. Tamrazian, of wards El and D2 and staff of the microbiology and pharmacy departments for their help with this study. We also thank Mr Steve Nicklin (statistics student, Sheffield Polytechnic) for help with data coding, and the Department of Community Health for use of their data processing facilities. Beechams Research Laboratories kindly provided supplies of Augmentin and financial support for data collation. Miss Dawn Owen kindly typed the manuscript. S.E. was supported by a Wellcome Trust training fellowship.

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