{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T02:54:20Z","timestamp":1773284060327,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2012,1,16]],"date-time":"2012-01-16T00:00:00Z","timestamp":1326672000000},"content-version":"vor","delay-in-days":3182,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2003,5]]},"abstract":"<jats:p>\n                    <jats:bold>Study Objectives<\/jats:bold>\n                    . To compare the use of \u03b2\u2010lactams and subsequent\n                    <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                    sensitivity patterns before and after implementation of a clinical pharmacist\u2010facilitated antimicrobial restriction program in August 1997.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Design<\/jats:bold>\n                    . Retrospective consecutive data collection.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Setting<\/jats:bold>\n                    . Large university\u2010affiliated medical center.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Intervention<\/jats:bold>\n                    . The study results are the accumulation of the daily intervention activities of the antimicrobial restriction program. Data on antimicrobial grams purchased\/1000 patient\u2010days and susceptibility patterns were collected and analyzed retrospectively.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Measures and Main Results<\/jats:bold>\n                    . Annual grams of ceftazidime, piperacillin, piperacillin\u2010tazobactam, and other antipseudomonal \u03b2\u2010lactams purchased\/1000 patient\u2010days were compared during the 2 full calendar years before the antimicrobial restriction program (1995\u20131996) with the 4 full calendar years after the program was implemented (1998\u20132001).\n                    <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                    resistance trends for the antipseudomonal \u03b2\u2010lactams, ciprofloxacin, and tobramycin also were compared for the 2 years before the program (1995\u20131996) with the last 2 years of the program (2000\u20132001). A 44% reduction in ceftazidime use was documented; ostensibly, minimal changes occurred in the overall use of piperacillin and piperacillin\u2010tazobactam. During the same time period, ceftazidime resistance fell from 24% to 11.8% (p&lt;0.001), whereas piperacillin resistance fell from 32.5% to 18.5% (p&lt;0.001). Imipenem resistance declined from 20.5% to 12.3% (p&lt;0.001) with an 18% reduction in use. Aztreonam resistance declined from 29.5% to 16.5% (p&lt;0.001) despite a 57% increase in use. No changes in resistance to either ciprofloxacin or tobramycin were found.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion<\/jats:bold>\n                    . Through an antimicrobial restriction program, a dramatic reduction in ceftazidime use was achieved with judicious use of other antipseudomonal antimicrobials, which resulted in reduced resistance of\n                    <jats:italic>P. aeruginosa<\/jats:italic>\n                    to other \u03b2\u2010lactams.\n                  <\/jats:p>","DOI":"10.1592\/phco.23.5.618.32197","type":"journal-article","created":{"date-parts":[[2004,5,11]],"date-time":"2004-05-11T11:14:20Z","timestamp":1084274060000},"page":"618-624","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["The Effect of an Antimicrobial Restriction Program on\n                    <i>Pseudomonas aeruginosa<\/i>\n                    Resistance to \u03b2\u2010Lactams in a Large Teaching Hospital"],"prefix":"10.1002","volume":"23","author":[{"given":"Randolph E.","family":"Regal","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daryl D.","family":"DePestel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather L.","family":"VandenBussche","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,1,16]]},"reference":[{"key":"e_1_2_1_2_2","first-page":"2310","volume-title":"Principles and practice of infectious diseases","author":"Pollack 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