Specific antibiograms needed for outpatients in primary care

(HealthDay)—Antibiograms, which are designed to help physicians select appropriate antimicrobials to treat bacterial pathogens, should be specifically tailored for outpatients in primary care settings, according to research published in the May issue of Diagnostic Microbiology & Infectious Disease.

Jessina C. McGregor, Ph.D., from Oregon Health & Science University in Portland, and colleagues developed inpatient and primary care outpatient antibiograms for a regional health maintenance organization (HMO) and academic health care system (AHS). They summarized and compared antimicrobial susceptibilities from 16,428 cultures from 2010 for Enterococcus, Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa.

The researchers found that, in inpatients and primary care outpatients, methicillin susceptibility among S. aureus was similar in both the HMO and AHS. Susceptibility of E. coli to trimethoprim/sulfamethoxazole was also similar in both the HMO and AHS. However, susceptibility to ciprofloxacin was significantly lower in inpatient versus primary care outpatient settings. In the HMO, the frequency of ciprofloxacin-susceptible P. aeruginosa was significantly higher in primary care outpatients than inpatients.

"Comparison of cumulative susceptibilities across settings yielded no consistent patterns; therefore, outpatient primary care antibiograms may more accurately inform prudent empiric antibiotic prescribing," the authors write.

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