Changing Patterns of Resistance to Ampicillin/Sulbactam

Abstract

Objective: To report on methods to halt the increasing resistance of gram-negative organisms to ampicillin/sulbactam. Design: A before-after observational design was used to evaluate susceptibility of organisms to ampicillin/sulbactam. Setting: A university teaching hospital. Interventions: An educational program regarding appropriate prescribing of ampicillin/sulbactam and restriction of the use of ampicillin/sulbactam. Main Outcome Measures: Antimicrobial susceptibility to ampicillin/sulbactam. Results: The trend in increasing resistance was halted for Escherichia coli and Enterobacter. Emerging resistance of other organisms was not observed. Conclusions: The trend in increasing resistance was halted by restrictions on prescribing and by providing education regarding rational prescribing of ampicillin/sulbactam. We recommend that this combination not be used empirically to treat nosocomial infections or for bacteria against which ampicillin alone is effective.