Gram negative resistance and antibiotic use in ICU
Research type
Research Study
Full title
Association between Gram negative bacteria resistance and antimicrobial use in Intensive Care Unit adult population
IRAS ID
164895
Contact name
Anika Kadchha
Contact email
Sponsor organisation
Joint Research & Enterprise Office
Clinicaltrials.gov Identifier
14/LO/1919, REC ref no
Duration of Study in the UK
0 years, 7 months, 15 days
Research summary
Although the principle that antibiotic use selects for bacterial resistance is accepted, there is much to learn about how antibiotic prescribing influences emergence of resistance in complex settings such as the ICU. Resistant bacteria may be identified at clinical sites on admission, emerge endogenously in an individual or be acquired exogenously predominantly through patient-to-patient transmission. Antibiotics may differ in their tendency to select for resistance, contributing to intricate resistance/susceptibility dynamics.
Given that much antibiotic prescribing on ICU is made empirically, before microbiological tests results are known, clinicians rely on multiple sources of information to make treatment decisions in septic patients. These include formal guidelines, recent unit level rates of resistance to particular antibiotics, risk factors for resistance in individual patients and prior culture results from individual patients.
There is therefore the potential for both recent unit-level consumption of particular antibiotics to impact on current resistance, and for recent unit-level resistance to particular antibiotics to impact on the decision making process for choice of empiric antibiotic therapy. The multiple sources of resistant bacteria are generally difficult to disentangle; in the absence of detailed information at molecular level and on consumption in the general population this may be prove a challenging task. Therefore, aggregated data analyses, i.e. making no distinction between resistance potential backgrounds are an important step in order to forward our understanding on its relationship with antibiotic consumption.Time series analysis is perhaps most relevant to the analysis of data produced by surveillance activity carried through long time periods and hospital circumstances are amongst the suitable examples. Such methods have always enjoyed an important role amongst valuable tools which may shed a preliminary light on assessment of evidence of outbreaks, trends and various relationships between one or more temporal sequence of events.
REC name
London - Fulham Research Ethics Committee
REC reference
14/LO/1919
Date of REC Opinion
22 Oct 2014
REC opinion
Favourable Opinion