Effect of individual- and group-level antibiotic exposure on MRSA isolation: a multilevel analysis

Arno Muller; Frédéric Mauny; Daniel Talon; Peter T. Donnan; Stephan Harbarth; Xavier Bertrand

doi:10.1093/jac/dkl343

Effect of individual- and group-level antibiotic exposure on MRSA isolation: a multilevel analysis

Arno Muller, Frédéric Mauny, Daniel Talon, Peter T. Donnan, Stephan Harbarth, Xavier Bertrand (Lead / Corresponding author)

Research output: Contribution to journal › Article › peer-review

64 Citations (Scopus)

Abstract

Objectives: To observe the relative role of individual and group-level antimicrobial selective pressure on subsequent methicillin-resistant Staphylococcus aureus (MRSA) isolation in a university hospital. Methods: For this purpose, 18596 patients were included in a retrospective statistical analysis, applying multilevel modelling with discrete time intervals at the lowest level. Individual-level and hospital group variables on antimicrobial exposure and MRSA colonization pressure were collected from computerized databases. Results: The simultaneous hospital group- and individual-level analysis showed individual exposure to fluoroquinolones and collective exposure to penicillins to be associated with MRSA isolation after adjustment for colonization pressure and other potential confounders. Conclusions: These results support efforts to reduce prescriptions of selected antimicrobial drug classes such as fluoroquinolones and show the added value of multilevel analysis for research on the adverse outcomes of antibiotic prescribing.

Original language	English
Pages (from-to)	878-881
Number of pages	4
Journal	Journal of Antimicrobial Chemotherapy
Volume	58
Issue number	4
DOIs	https://doi.org/10.1093/jac/dkl343
Publication status	Published - 1 Oct 2006

Keywords

Antimicrobial use
Ecological bias
Individual exposure
Methicillin-resistant Staphylococcus aureus

ASJC Scopus subject areas

Pharmacology
Microbiology

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10.1093/jac/dkl343

Cite this

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abstract = "Objectives: To observe the relative role of individual and group-level antimicrobial selective pressure on subsequent methicillin-resistant Staphylococcus aureus (MRSA) isolation in a university hospital. Methods: For this purpose, 18596 patients were included in a retrospective statistical analysis, applying multilevel modelling with discrete time intervals at the lowest level. Individual-level and hospital group variables on antimicrobial exposure and MRSA colonization pressure were collected from computerized databases. Results: The simultaneous hospital group- and individual-level analysis showed individual exposure to fluoroquinolones and collective exposure to penicillins to be associated with MRSA isolation after adjustment for colonization pressure and other potential confounders. Conclusions: These results support efforts to reduce prescriptions of selected antimicrobial drug classes such as fluoroquinolones and show the added value of multilevel analysis for research on the adverse outcomes of antibiotic prescribing.",

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T2 - a multilevel analysis

AU - Muller, Arno

AU - Mauny, Frédéric

AU - Talon, Daniel

AU - Donnan, Peter T.

AU - Harbarth, Stephan

AU - Bertrand, Xavier

PY - 2006/10/1

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KW - Ecological bias

KW - Individual exposure

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Effect of individual- and group-level antibiotic exposure on MRSA isolation: a multilevel analysis

Abstract

Keywords

ASJC Scopus subject areas

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