Multiresistant Gram-negative bacilli, including strains of Klebsiella pneumoniae, Enterobacter spp, Acinetobacter baumannii and Pseudomonas aeruginosa, resistant to broad spectrum beta-lactams, aminoglycosides and fluoroquinolones, are recovered at increasing frequency from patients suffering from nosocomial infections, particularly from those receiving intensive care.
The emergence and spread of resistant pathogens to endemic and epidemic levels has frequently been related in time and place to the intensive use of antibiotics to which these microorganisms have developed resistance, notably third generation cephalosporins and fluoroquinolones.
Recent investigations have indicated that the prevalence of resistance can be reduced by scheduled changes of empiric treatment regimens, involving discontinuation of intensively prescribed drugs and substitution with newly introduced antibiotics of another class to which the prevalent resistant strains remain susceptible.
Among these drugs, penicillins-beta-lactamase inhibitor combinations, fourth generation'cephalosporins and, where little used previously, fluoroquinolones, have been introduced successfully in high risk units where ceftazidime-resistant strains of K. pneumoniae, Enterobacter and Citrobacter spp or glycopeptide-resistant enterococci had become highly prevalent. (...)
Mots-clés Pascal : Politique sanitaire, Utilisation, Prescription médicale, Antibiotique, Antibactérien, Recommandation, Modalité traitement, Résistance, Hôpital, Prévention, Infection nosocomiale
Mots-clés Pascal anglais : Health policy, Use, Medical prescription, Antibiotic, Antibacterial agent, Recommendation, Application method, Resistance, Hospital, Prevention, Nosocomial infection
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0225249
Code Inist : 002B30A01C. Création : 16/11/1999.