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The effect of an antibiotic policy on the control of vancomycin-resistant enterococci outbreak and on the resistance patterns of bacteria isolated from the blood of patients in a hematology unit.

INTRODUCTION
Antibiotic resistance has become one of the main medical problems worldwide. This is mainly due to an overuse and misuse of antibiotics.


OBJECTIVES
The aim of the study was to assess the effect of an antibiotic policy and enhanced infection control on the occurrence of epidemic strains of vancomycin-resistant enterococci (VRE) and resistance patterns of bacteria isolated from the blood of patients hospitalized in two departments of a hematology center in Poland.


PATIENTS AND METHODS
Antibiotic use was calculated in daily defined doses (DDD) per 100 patient-days during the two 5-month periods, before and after the introduction of the policy. Infection control measures included a 1-week screening for VRE rectal carriage and contact isolation.


RESULTS
Antibiotic consumption decreased from 82.1 to 57.3 DDD per 100 patient-days, mainly because of a decrease in the use of co-trimoxazole, other antimicrobials active against anaerobes, and cephalosporins. A significant change in antibiotic resistance patterns was observed and in vitro efficacy of antibiotics against bacteria isolated from the blood increased remarkably. We managed to eradicate the outbreak of VRE.


CONCLUSIONS
The introduction of antibiotic policy and enhanced infection control measures may prove efficacious in VRE control.