Impact of an enhanced antibiotic stewardship on reducing methicillin-resistant Staphylococcus aureus in primary and secondary healthcare settings

M.A. Aldeyab, M.G. Scott, M.P. Kearney, Y.M. Alahmadi, F.A. Magee, G. Conlon, J.C. McElnay

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16 Citations (Scopus)


The objective of this study was to evaluate the impact of restricting high-risk antibiotics on methicillin-resistant Staphylococcus aureus (MRSA) incidence rates in a hospital setting. A secondary objective was to assess the impact of reducing fluoroquinolone use in the primary-care setting on MRSA incidence in the community. This was an interventional, retrospective, ecological investigation in both hospital and community (January 2006 to June 2010). Segmented regression analysis of interrupted time-series was employed to evaluate the intervention. The restriction of high-risk antibiotics was associated with a significant change in hospital MRSA incidence trend (coefficient=-0·00561, P=0·0057). Analysis showed that the intervention relating to reducing fluoroquinolone use in the community was associated with a significant trend change in MRSA incidence in community (coefficient=-0·00004, P=0·0299). The reduction in high-risk antibiotic use and fluoroquinolone use contributed to both a reduction in incidence rates of MRSA in hospital and community (primary-care) settings. © 2013 Cambridge University Press.
Original languageEnglish
Pages (from-to)494-500
Number of pages7
JournalEpidemiology and Infection
Issue number3
Early online date5 Jun 2013
Publication statusPublished - 2014


  • Antibiotic stewardship
  • Fluoroquinolones
  • Interrupted-time series
  • Methicillin-resistant Staphylococcus aureus
  • Primary and secondary care
  • amoxicillin plus clavulanic acid
  • antibiotic agent
  • cephalosporin derivative
  • clindamycin
  • macrolide
  • quinoline derived antiinfective agent
  • quinolone derivative
  • antibiotic stewardship
  • antibiotic therapy
  • article
  • clinical effectiveness
  • community assessment
  • drug use
  • ecosystem monitoring
  • health program
  • hospital
  • hospital policy
  • human
  • incidence
  • intervention study
  • methicillin resistant Staphylococcus aureus
  • outcome assessment
  • primary health care
  • protocol compliance
  • regression analysis
  • retrospective study
  • secondary health care
  • therapy delay
  • time series analysis
  • treatment outcome
  • trend study
  • antibiotic resistance
  • Article
  • bacterium identification
  • community care
  • controlled study
  • health care policy
  • health impact assessment
  • high risk population
  • nonhuman
  • risk assessment
  • risk factor
  • risk reduction
  • Anti-Bacterial Agents
  • Cephalosporins
  • Clindamycin
  • Cross Infection
  • Drug Utilization
  • Humans
  • Incidence
  • Intervention Studies
  • Methicillin-Resistant Staphylococcus aureus
  • Northern Ireland
  • Primary Health Care
  • Retrospective Studies
  • Staphylococcal Infections


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