Changes in the use of broad-spectrum antibiotics after cefepime shortage: a time series analysis.

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Serval ID
serval:BIB_D1D1EFFA60DA
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Changes in the use of broad-spectrum antibiotics after cefepime shortage: a time series analysis.
Journal
Antimicrobial Agents and Chemotherapy
Author(s)
Plüss-Suard Catherine, Pannatier André, Ruffieux Christiane, Kronenberg Andreas, Mühlemann Katrin, Zanetti Giorgio
ISSN
1098-6596 (Electronic)
ISSN-L
0066-4804
Publication state
Published
Issued date
2012
Peer-reviewed
Oui
Volume
56
Number
2
Pages
989-994
Language
english
Abstract
The original cefepime product was withdrawn from the Swiss market in January 2007, and replaced by a generic 10 months later.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 towards 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.
Pubmed
Open Access
Yes
Create date
30/11/2011 16:45
Last modification date
20/08/2019 16:51
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