TY - JOUR AU - Conlon-Bingham, Geraldine Mary AU - Aldeyab, Mamoon AU - Scott, Michael AU - Kearney, Mary Patricia AU - Farren, David AU - Gilmore, Fiona AU - McElnay, James T1 - Effects of Antibiotic Cycling Policy on Incidence of Healthcare-Associated MRSA and Clostridioides difficile Infection in Secondary Healthcare Settings T2 - Emerging Infectious Disease journal PY - 2019 VL - 25 IS - 1 SP - 52 SN - 1080-6059 AB - This quasi-experimental study investigated the effect of an antibiotic cycling policy based on time-series analysis of epidemiologic data, which identified antimicrobial drugs and time periods for restriction. Cyclical restrictions of amoxicillin/clavulanic acid, piperacillin/tazobactam, and clarithromycin were undertaken over a 2-year period in the intervention hospital. We used segmented regression analysis to compare the effect on the incidence of healthcare-associated Clostridioides difficile infection (HA-CDI), healthcare-associated methicillin-resistant Staphylococcus aureus (HA-MRSA), and new extended-spectrum β-lactamase (ESBL) isolates and on changes in resistance patterns of the HA-MRSA and ESBL organisms between the intervention and control hospitals. HA-CDI incidence did not change. HA-MRSA incidence increased significantly in the intervention hospital. The resistance of new ESBL isolates to amoxicillin/clavulanic acid and piperacillin/tazobactam decreased significantly in the intervention hospital; however, resistance to piperacillin/tazobactam increased after a return to the standard policy. The results question the value of antibiotic cycling to antibiotic stewardship. KW - Clostridioides difficile KW - Clostridium difficile KW - methicillin-resistant Staphylococcus aureus KW - extended-spectrum β-lactamase KW - MRSA KW - CDI KW - ESBL KW - antibiotic cycling KW - nosocomial infections KW - healthcare-acquired infections KW - antimicrobial drug resistance KW - Ireland KW - bacteria DO - 10.3201/eid2501.180111 UR - https://wwwnc.cdc.gov/eid/article/25/1/18-0111_article ER - End of Reference