Impact of the PROVAUR stewardship programme on linezolid resistance in a tertiary university hospital: a before-and-after interventional study

J Antimicrob Chemother. 2016 Sep;71(9):2606-11. doi: 10.1093/jac/dkw179. Epub 2016 May 30.

Abstract

Background: There is little evidence of the impact of antimicrobial stewardship programmes on antimicrobial resistance.

Objectives: To study the efficacy and safety of a package of educational and interventional measures to optimize linezolid use and its impact on bacterial resistance.

Methods: A quasi-experimental study was designed and carried out before and after implementation of a stewardship programme in hospitalized patients with Gram-positive infections treated with linezolid.

Results: The intervention reduced linezolid consumption by 76%. The risk of linezolid-resistant CoNS isolates (OR = 0.37; 95% CI = 0.27-0.49; P < 0.001) and Enterococcus faecalis (OR = 0.44; 95% CI = 0.21-0.90; P = 0.03) during the intervention period was lower than in the pre-intervention period.

Conclusions: A programme to optimize linezolid use can contribute to reducing the resistance rate of CoNS and E. faecalis to this antibiotic.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use*
  • Attitude of Health Personnel
  • Behavior Therapy
  • Drug Resistance, Bacterial*
  • Drug Utilization / standards*
  • Education, Medical, Continuing / methods
  • Enterococcus faecalis / drug effects
  • Enterococcus faecalis / isolation & purification
  • Gram-Positive Bacterial Infections / drug therapy*
  • Health Policy*
  • Hospitals, University
  • Humans
  • Linezolid / pharmacology
  • Linezolid / therapeutic use*
  • Non-Randomized Controlled Trials as Topic
  • Retrospective Studies
  • Staphylococcus / drug effects
  • Staphylococcus / isolation & purification
  • Surveys and Questionnaires
  • Tertiary Care Centers

Substances

  • Anti-Bacterial Agents
  • Linezolid