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Canadian Journal of Infectious Diseases
Volume 11 (2000), Issue 2, Pages 107-111
Original Article

Microbiologic Surveillance and Parenteral Antibiotic Use in a Critical Care Unit

Sharon K Yamashita,1,2 Marie Louie,3,4 Andrew E Simor,3,4 and Anita Rachlis4

1Department of Pharmacy, University of Toronto, Toronto, Ontario, Canada
2Department of Clinical Pharmacology, University of Toronto, Toronto, Ontario, Canada
3Department of Microbiology, University of Toronto, Toronto, Ontario, Canada
4Division of Infectious Diseases, Department of Medicine, Sunnybrook and Women's College Health Sciences Centre, and University of Toronto, Toronto, Ontario, Canada

Copyright © 2000 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


OBJECTIVE: To evaluate parenteral antibiotic utilization and bacterial resistance patterns in a critical care unit (CrCU).

DESIGN: Descriptive, prospective audit of infection site, culture and antimicrobial susceptibility test results, parenteral antibiotic usage and duration, total antibiotic acquisition costs, and length of stay.

SETTING: A 17-bed medical-surgical CrCU in a tertiary care teaching hospital in Metropolitan Toronto.

PATIENTS: Two hundred and fifty-eight patients admitted to the CrCU between May 1995 and April 1996 who received antimicrobial therapy.

RESULTS: The most frequently prescribed antibiotics were cefazolin (47%, 1098 g), gentamicin (33%,141 g) and ceftriaxone (20%, 255 g). The most common indications for antimicrobial therapy included surgical prophylaxis (34%) and pneumonia (35%). The following organisms were isolated from patients treated with antibiotics: Staphylococcus aureus (26%), Pseudomonas aeruginosa (13%), enterococci (12%), Haemophilus influenzae (11%), Escherichia coli (11%), Enterobacter cloacae (8%) and other Gram-negative bacilli (19%). Only 9% of Gram-negative bacilli were resistant to aminoglycosides, 3% were resistant to ciprofloxacin and no extended-spectrum beta-lactamases or imipenem-resistance were detected. No vancomycin-resistant enterococci and only two methicillin-resistant Staphylococcus aureus isolates were identified.

CONCLUSIONS: Antibiotic use during the audit appeared appropriate for the specific clinical indications. Low levels of bacterial resistance were detected during the audit.