The Effect of a 4th Generation-Cephalosporin Introduction upon the Incidence of Multidrug-Resistant Gram-Negative Bacteria in a Non-Teaching Hospital

Problem statement: Antimicrobial resistance is a worrisome situation in hospitals around the world and the misuse of certain classes of antimicrobials has contributed for this situation. Approach: We performed a prospective surveillance study on the incidence of multi-drug resistant bacteria before (phase 1) and after (phase 2) the introduction of a 4th-generation cephalosporin in a non-teaching hospital. Results: There was a significant reduction in the incidence of Enterobacter species (from 1.3 isolates per 100 patient-days to 0.39 isolates per 100 patient-days, p = 0.01) between the two periods. We also observed a reduction in the consumption of ceftazidime (from 64.3 DDD per 1000 patient-days to 29.6 DDD per 1000 patient-days, p = 0.002) and ceftriaxone (from 323.9 DDD per 1000 patient-days to 246.2 DDD per 1000 patient-days, p = 0.01). Conclusion: The introduction of a 4th-generation cephalosporin in our setting resulted in an important reduction in the incidence of Enterobacter species