The Effect of Antibiotic-Cycling Strategy on Antibiotic-Resistant Bacterial Infections or Colonization in Intensive Care Units: A Systematic Review and Meta-Analysis.
Xiao-Jin Li, Yong Liu, Liang Du and 1 others
PMID 32851794WHAT IT FOUND
Antibiotic cycling in ICUs did not clearly reduce overall resistant bacterial infections or colonization.
It lowered some gram-positive resistant bacteria and hospital-acquired infections, but other infection-control measures limit certainty.
Key findings
01The overall pooled effect of antibiotic cycling on resistant bacterial infection or colonization was not statistically significant.
02Gram-positive resistant bacteria decreased during cycling periods in 9 studies (RR = 0.726, 95% CI 0.534 to 0.988, p = .045).
03In studies that used antibiotic mixing as the control, cycling did not show a clear advantage over mixing.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Most included studies were before-after or crossover designs, so changes over time could affect the results. The pooled analyses showed high heterogeneity, and the authors said methodological quality, ICU type, and control period affected the results. Other infection-control measures, such as hand hygiene, isolation, environmental cleaning, chlorhexidine bathing, and ventilator-associated pneumonia prevention, may have confounded the cycling periods. The review included studies of low, moderate, and high quality.
Declared interests
Funding: Sichuan University and the National Natural Science Foundation of China. The supplied text does not state any other conflicts of interest.
The easy way to misread this
Do not conclude that antibiotic cycling prevents resistant infections in your ICU. The overall resistant-bacteria outcome was not clearly reduced, and reductions in hospital-acquired infection or ventilator-associated pneumonia may reflect other infection-control measures.