Effects of Antibiotic Cycling Policy on Incidence of Healthcare-Associated MRSA and Clostridioides difficile Infection in Secondary Healthcare Settings

    Research output: Contribution to journalArticle

    • Geraldine Mary Conlon-Bingham
    • Mamoon Aldeyab
    • Michael Scott
    • Mary Patricia Kearney
    • David Farren
    • Fiona Gilmore
    • James McElnay

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    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.



    Original languageEnglish
    Number of pages11
    Pages (from-to)52-62
    JournalEmerging Infectious Disease journal
    Journal publication date01 Jan 2019
    Issue number1
    Publication statusPublished - 01 Jan 2019

      Research areas

    • antibiotic cycling, antimicrobial drug resistance, bacteria, CDI, Clostridioides difficile, Clostridium difficile, ESBL, extended-spectrum β-lactamase, healthcare-acquired infections, Ireland, methicillin-resistant Staphylococcus aureus, MRSA, nosocomial infections

    ID: 162533317