Change in Antibiotic Usage Decreases Bacterial Resistance

Despite a lack of new antibiotics on the market, a study that will be presented at the European Association of Urology conference shows that a change in the way the drugs are used can reduce bacterial resistance.

With antibiotic resistance continuing to be an issue, new guidelines were introduced in 2010 for urological surgery where antibiotics are commonly prescribed.

Lead Researcher Tommaso Cai, MD, and an international team of clinicians began measuring the outcomes of 3,529 urological procedures. The results were taken from open, laparoscopic, endoscopic, and robotic surgeries over a 33-month period beginning in 2011. Those results were compared with records of 2,619 similar procedures between 2006 and 2008, before the new guidelines were in place.

“The changes we made were fairly significant, and required monthly audits to ensure that we were sticking to the new system,” Cai said in a news release. “For example, under the old system it was standard practice to give a patient who was having an operation for benign prostatic hyperplasia, the antibiotic ciprofloxacin both before surgery, and then for 7 days afterwards. But when we adhered to the guidelines we only gave the antibiotic prior to the surgery.”

As a result Cai explained that the infection rate remained similar between the two periods. There was, however, a significant decrease in antibiotic costs as well as bacterial resistance with the new method.

With the previous guidelines the drug-related costs for a procedure was €46.90, or $51.33, and the new version shows a 60% drop to €18.77, or $20.54.

Robert Pickard, MD, FRCS (Urol), professor of urology at Newcastle University, explained that the main bacterium, Escherichia coli (E. Coli), that causes different kinds of urinary infections is continuing to become more resistant to antibiotics, which proposes a major health threat.

“The only proven way to reduce the threat is by antibiotic stewardship to control the overuse and misuse of antibiotics in healthcare,” Pickard said.

Results from the study show that E. Coli resistance to ciprofloxacin went down by about 15% after complying with the new guidelines.

“This study shows that by following a few simple rules hospital usage of antibiotics can be dramatically reduced without affecting patient safety, and results in lower resistance and reduced costs,” Pickard said.