{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T21:57:30Z","timestamp":1775080650284,"version":"3.50.1"},"reference-count":11,"publisher":"Cambridge University Press (CUP)","issue":"5","license":[{"start":{"date-parts":[[2015,1,2]],"date-time":"2015-01-02T00:00:00Z","timestamp":1420156800000},"content-version":"unspecified","delay-in-days":3898,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2004,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0195941700085891_abs1\"><jats:title>Background:<\/jats:title><jats:p>The substitution of piperacillin\/tazobactam, ampicillin\/sulbactam, or both for third-generation cephalosporins has been associated with reduced vancomycin-resistant enterococci (VRE). However, piperacillin\/tazobactam came into widespread use during a period in which the prevalence of VRE increased. We hypothesized that the increasing use of piperacillin\/tazobactam and other agents with relatively enhanced anti-enterococcal activity (ie, piperacillin, ampicillin\/sulbactam, and ampicillin) has been associated with increased or unchanged rates of VRE in some hospitals.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700085891_abs2\"><jats:title>Design:<\/jats:title><jats:p>We retrospectively evaluated the correlation between hospital antibiotic use (defined daily doses per 10,000 patient-days of care) and incidence of stool or non-stool VRE isolation. We assessed whether a high or increasing proportion of use of beta-lactam agents with relatively enhanced versus minimal (ie, third-generation cephalosporins and ticarcillin\/clavulanate) anti-enterococcal activity would prevent increased VRE.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700085891_abs3\"><jats:title>Setting:<\/jats:title><jats:p>Four academic medical centers.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700085891_abs4\"><jats:title>Results:<\/jats:title><jats:p>With the increasing use of piperacillin\/tazobactam, the use of beta-lactam agents with enhanced activity against enterococci surpassed the combined use of third-generation cephalosporins and ticarcillin\/clavulanate in each hospital. In one hospital, the incidence of VRE was positively correlated with the use of piperacillin\/tazobactam or beta-lactam agents with enhanced anti-enterococcal activity (<jats:italic>P<\/jats:italic>&lt; .0001). The incidence of VRE rose steadily in another hospital despite relatively high use of beta-lactam agents with enhanced versus minimal anti-enterococcal activity. A negative correlation between VRE and piperacillin\/tazobactam or beta-lactam agents with enhanced anti-enterococcal activity was observed in one hospital, but this correlation was not statistically significant.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700085891_abs5\"><jats:title>Conclusion:<\/jats:title><jats:p>Increasing the hospital use of piperacillin\/tazobactam and other beta-lactams with relatively enhanced anti-enterococcal activity may not be an effective control measure for VRE.<\/jats:p><\/jats:sec>","DOI":"10.1086\/502409","type":"journal-article","created":{"date-parts":[[2006,4,14]],"date-time":"2006-04-14T17:17:46Z","timestamp":1145035066000},"page":"380-383","source":"Crossref","is-referenced-by-count":35,"title":["Effect of the Increasing Use of Piperacillin\/Tazobactam on the Incidence of Vancomycin-Resistant Enterococci in Four Academic Medical Centers"],"prefix":"10.1017","volume":"25","author":[{"given":"Usha","family":"Stiefel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David L.","family":"Paterson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole J.","family":"Pultz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven M.","family":"Gordon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David C.","family":"Aron","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Curtis J.","family":"Donskey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2015,1,2]]},"reference":[{"key":"S0195941700085891_ref008","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200012283432604"},{"key":"S0195941700085891_ref004","doi-asserted-by":"publisher","DOI":"10.1089\/109629600321326"},{"key":"S0195941700085891_ref005","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.46.6.1619-1628.2002"},{"key":"S0195941700085891_ref001","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/23.5.1020"},{"key":"S0195941700085891_ref003","doi-asserted-by":"publisher","DOI":"10.1097\/00024382-200014030-00003"},{"key":"S0195941700085891_ref009","author":"Paterson","year":"2003"},{"key":"S0195941700085891_ref006","doi-asserted-by":"publisher","DOI":"10.1086\/315428"},{"key":"S0195941700085891_ref002","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/43.2.261"},{"key":"S0195941700085891_ref007","doi-asserted-by":"publisher","DOI":"10.1086\/314874"},{"key":"S0195941700085891_ref011","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-131-4-199908170-00006"},{"key":"S0195941700085891_ref010","doi-asserted-by":"publisher","DOI":"10.1086\/322677"}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0195941700085891","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,29]],"date-time":"2024-07-29T08:36:05Z","timestamp":1722242165000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0195941700085891\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,5]]},"references-count":11,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2004,5]]}},"alternative-id":["S0195941700085891"],"URL":"https:\/\/doi.org\/10.1086\/502409","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2004,5]]}}}