{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T02:56:42Z","timestamp":1791255402271,"version":"4.1.0"},"reference-count":27,"publisher":"American Society for Microbiology","issue":"9","license":[{"start":{"date-parts":[[2002,9,1]],"date-time":"2002-09-01T00:00:00Z","timestamp":1030838400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2002,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            It is generally assumed that the antibiotic prescription policy of a hospital has a significant impact on bacterial resistance rates; however, few studies are available to support this concept with valid statistical data. During a 3-year period from 1997 to 2000, we monitored the consumption of \u03b2-lactam and other antibiotics with known activity against\n            <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n            in a 600-bed community hospital. Monthly isolations of\n            <jats:italic>P. aeruginosa<\/jats:italic>\n            were assessed, and resistance rates were recorded. Partial correlation coefficients between consumption and resistance rates were determined, taking into account possible associations with other variables such as seasonal effects and transfers from other hospitals. A total of 30 \u00b1 7 novel\n            <jats:italic>P. aeruginosa<\/jats:italic>\n            strains per month were isolated without epidemic clustering. Prescriptions of imipenem varied significantly during the study period, while prescriptions of other antipseudomonal agents were stable, with the exception of an increase in piperacillin-tazobactam prescriptions. Rates of resistance of\n            <jats:italic>P. aeruginosa<\/jats:italic>\n            to the antimicrobial agents used showed a time course similar to figures for imipenem consumption. Monthly rates of resistance to imipenem (partial correlation coefficient [cc], 0.63), piperacillin-tazobactam (cc, 0.57), and ceftazidime (cc, 0.56) were significantly associated with imipenem prescription rates in the same or the preceding month, while consumption of ceftazidime or piperacillin-tazobactam had no apparent association with resistance. Among the variables investigated, imipenem consumption was identified as the major factor associated with both carbapenem and \u03b2-lactam resistance in endemic\n            <jats:italic>P. aeruginosa<\/jats:italic>\n            . Periods of extensive imipenem use were associated with significant increases in resistance. Our data support the concept that a written antibiotic policy which balances the use of various antibiotic classes may help to avoid disturbances of a hospital's microbial sensitivity patterns.\n          <\/jats:p>","DOI":"10.1128\/aac.46.9.2920-2925.2002","type":"journal-article","created":{"date-parts":[[2002,10,1]],"date-time":"2002-10-01T19:36:19Z","timestamp":1033500979000},"page":"2920-2925","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":117,"title":["Consumption of Imipenem Correlates with \u03b2-Lactam Resistance in\n            <i>Pseudomonas aeruginosa<\/i>"],"prefix":"10.1128","volume":"46","author":[{"given":"Philipp M.","family":"Lepper","sequence":"first","affiliation":[{"name":"Section of Hospital Hygiene, Department of Medical Microbiology and Hygiene, Ulm University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eberhard","family":"Grusa","sequence":"additional","affiliation":[{"name":"Clinical Pharmacy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helga","family":"Reichl","sequence":"additional","affiliation":[{"name":"Microbiological Laboratory, Klinikum Memmingen, Memmingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josef","family":"Ho\u0308gel","sequence":"additional","affiliation":[{"name":"Institute of Biometry and Medical Documentation, University of Ulm, Ulm"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Trautmann","sequence":"additional","affiliation":[{"name":"Section of Hospital Hygiene, Department of Medical Microbiology and Hygiene, Ulm University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.159.10.1127"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.43.6.1379"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.160.4.501"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.38.6.1309"},{"key":"e_1_3_2_6_2","unstructured":"Deutsches Institut f\u00fcr Normung e.V. 2000. Methods for antibiotic susceptibility testing of bacterial pathogens p. 1-11. DIN 58940-4 attachment 1. Beuth Verlag Berlin Germany."},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200009073431004"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(93)91285-T"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.162.3.9905050"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1086\/514760"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1086\/338237"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.42.11.2966"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.38.4.681"},{"key":"e_1_3_2_14_2","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1086\/501614","volume":"20","year":"1999","unstructured":"Lee, S. C., C. P. Fung, P. Y. Liu, T. C. Wang, L. C. See, N. Lee, S. C. Chen, and W. B. Shieh. 1999. Nosocomial infections with ceftazidime-resistant Pseudomonas aeruginosa: risk factors and outcome. Infect. Control Hosp. Epidemiol.20:205-207.","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.36.9.2046"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0924-8579(99)00135-1"},{"key":"e_1_3_2_17_2","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1007\/BF01591486","volume":"15","year":"1996","unstructured":"Lyytikainen, O., M. Vaara, E. Jarviluoma, K. Rosenqvist, L. Tiittanen, and V. Valtonen. 1996. Increased resistance among Staphylococcus epidermidis isolates in a large teaching hospital over a 12-year period. Eur. J. Clin. Microbiol. Infect. Dis.15:133-138.","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"e_1_3_2_18_2","doi-asserted-by":"crossref","first-page":"S36","DOI":"10.1086\/503172","volume":"21","year":"2000","unstructured":"McGowan, J. E. J. 2000. Strategies for study of the role of cycling on antimicrobial use and resistance. Infect. Control Hosp. Epidemiol.21:S36-S43.","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.2307\/30142426"},{"key":"e_1_3_2_20_2","unstructured":"National Committee for Clinical Laboratory Standards. 2000. Methods for dilution antimicrobial sensitivity tests for bacteria that grow aerobically. Approved standard M-A3. National Committee for Clinical Laboratory Standards Wayne Pa."},{"key":"e_1_3_2_21_2","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1007\/PL00002565","volume":"69","year":"1998","unstructured":"Rodloff, A. C., P. Kujath, B. Lunstedt, and W. Gaus. 1998. Comparative study of the cost-effectiveness of initial therapy with imipenem\/cilastatin in secondary peritonitis. Chirurg69:1093-1100. (In German.)","journal-title":"Chirurg"},{"key":"e_1_3_2_22_2","doi-asserted-by":"crossref","unstructured":"Rodloff A. C. H. J. Laubenthal A. Bastian K. Bestehorn G. Buchele and W. Gaus. 1996. Comparative study of the cost-effectiveness relationship of initial therapy with imipenem\/cilastatin in nosocomial pneumonia. Group study. Anasthesiol. Intensivmed. Notfallmed. Schmerzther. 31 : 172-180. (In German.)","DOI":"10.1055\/s-2007-995895"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01695658"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.28.1.41"},{"key":"e_1_3_2_25_2","first-page":"49","volume":"22","year":"2000","unstructured":"Trautmann, M., T. Michalsky, H. Wiedeck, V. Radosavljevic, and M. Ruhnke. 2000. Tap water colonization with Pseudomonas aeruginosa in a surgical intensive care unit and relationship to Pseudomonas infections of ICU patients. Infect. Control Hosp. Epidemiol.22:49-52.","journal-title":"Infect. Control Hosp. 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