Clinical and Practice Research Group, School of Pharmacy, Queen's University Belfast, Belfast, Northern Ireland, UK.
Pharmacy and Medicines Management Centre, Northern Health and Social Care Trust, Ballymena, Northern Ireland, UK.
Epidemiol Infect. 2014 Mar;142(3):494-500. doi: 10.1017/S0950268813001374. Epub 2013 Jun 5.
The objective of this study was to evaluate the impact of restricting high-risk antibiotics on methicillin-resistant Staphylococcus aureus (MRSA) incidence rates in a hospital setting. A secondary objective was to assess the impact of reducing fluoroquinolone use in the primary-care setting on MRSA incidence in the community. This was an interventional, retrospective, ecological investigation in both hospital and community (January 2006 to June 2010). Segmented regression analysis of interrupted time-series was employed to evaluate the intervention. The restriction of high-risk antibiotics was associated with a significant change in hospital MRSA incidence trend (coefficient=-0·00561, P=0·0057). Analysis showed that the intervention relating to reducing fluoroquinolone use in the community was associated with a significant trend change in MRSA incidence in community (coefficient=-0·00004, P=0·0299). The reduction in high-risk antibiotic use and fluoroquinolone use contributed to both a reduction in incidence rates of MRSA in hospital and community (primary-care) settings.
本研究旨在评估在医院环境中限制使用高风险抗生素对耐甲氧西林金黄色葡萄球菌（MRSA）发病率的影响。次要目标是评估减少初级保健中氟喹诺酮类药物使用对社区中 MRSA 发病率的影响。这是一项在医院和社区（2006 年 1 月至 2010 年 6 月）进行的干预性、回顾性、生态学研究。采用分段回归分析对中断时间序列进行评估。限制使用高风险抗生素与医院 MRSA 发病率趋势的显著变化相关（系数=-0.00561，P=0.0057）。分析表明，与减少社区中氟喹诺酮类药物使用相关的干预措施与社区（初级保健）MRSA 发病率的显著趋势变化相关（系数=-0.00004，P=0.0299）。减少高风险抗生素和氟喹诺酮类药物的使用有助于降低医院和社区（初级保健）环境中 MRSA 的发病率。
