{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T05:52:58Z","timestamp":1771566778704,"version":"3.50.1"},"reference-count":22,"publisher":"Cambridge University Press (CUP)","issue":"9","license":[{"start":{"date-parts":[[2015,1,2]],"date-time":"2015-01-02T00:00:00Z","timestamp":1420156800000},"content-version":"unspecified","delay-in-days":5967,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[1998,9]]},"abstract":"Abstract<\/jats:title>\n \n Objective:<\/jats:title>\n \n To reduce the use of amoxicillin-clavulanate after high-resistance rates in\n Escherichia coli<\/jats:italic>\n were detected.\n <\/jats:p>\n <\/jats:sec>\n \n Design:<\/jats:title>\n Intervention study; the interventions were introduced successively over a 4-year period while closely monitoring the resistance patterns.<\/jats:p>\n <\/jats:sec>\n \n Setting:<\/jats:title>\n A 260-bed acute-care hospital in Switzerland.<\/jats:p>\n <\/jats:sec>\n \n Interventions:<\/jats:title>\n Introduction of therapeutic guidelines for specific departments or indications, which proposed alternative antibiotics to amoxicillin-clavulanate. The perioperative prophylactic use of amoxicillin-clavulanate was eliminated completely.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n The absolute amount of amoxicillin-clavulanate consumed decreased by 23%, from 24.8 g per 100 patient days in 1992 to 18.5 g per 100 patient days in 1995. The number of courses, a parameter that takes the prophylactic use into account, decreased by 62% from 2.3 per 100 patient days in 1992 to 0.9 per 100 patient days in 1995. The percentage of sensitive strains increased from 54.9% (n=512) in 1992 and 54.0% (n=506) in 1993 to 72.1% (n=546) in 1994 and 83.1% (n=668) in 1995. No major changes were detected for other antimicrobials, such as cotrimoxazole, tetracycline, or cefuroxime, used in this 4-year period.<\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n \n A decrease in the use of amoxicillin-clavulanate was followed by an increase in susceptibility of\n E coli<\/jats:italic>\n to it. It was not possible to prove a causative relationship. Only a temporal association was discovered. The reduction of the use of amoxicillin-clavulanate was achieved through the implementation of treatment guidelines, facilitated through a close collaboration among the clinical pharmacists, the infection control practitioner, the microbiology laboratory, and the physicians in charge of the respective departments.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1086\/647893","type":"journal-article","created":{"date-parts":[[2009,9,16]],"date-time":"2009-09-16T14:17:04Z","timestamp":1253110624000},"page":"653-656","source":"Crossref","is-referenced-by-count":17,"title":["Use of Amoxicillin-Clavulanate and Resistance in\n Escherichia coli<\/i>\n Over a 4-Year Period"],"prefix":"10.1017","volume":"19","author":[{"given":"Stephanie","family":"Natsch","sequence":"first","affiliation":[{"name":"Hospital of Schaffhausen"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Conrad","sequence":"additional","affiliation":[{"name":"Hospital of 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