@article {5175,
	title = {Differences in the changes in resistance patterns to third- and fourth-generation cephalosporins and piperacillin/tazobactam among Klebsiella pneumoniae and Escherichia coli clinical isolates following a restriction policy in a Greek tertiary care hospita},
	journal = {Int J Antimicrob Agents},
	volume = {29},
	year = {2007},
	month = {2007 Jan},
	pages = {34-8},
	abstract = {The aim of the present study was to investigate whether replacement of broad-spectrum cephalosporins (CEPs) by piperacillin/tazobactam (TZP) as first-line empirical therapy may have an effect on beta-lactam resistance among Klebsiella pneumoniae and Escherichia coli in a tertiary care hospital. Data regarding CEP and TZP consumption and resistance were collected on a bimonthly basis during an open-label 2-year (1 year observational and 1 year interventional) study. Consumption of ceftazidime was reduced by 64.5\%. In contrast, consumption of the other third-generation CEPs (cefotaxime and ceftriaxone) remained almost stable, whereas an increase in consumption of TZP by 2.8-fold was observed. A significant decrease in resistance to third-generation cephalosporins among K. pneumoniae isolates was observed, and the incidence of extended-spectrum beta-lactamase-producing isolates was notably reduced. These findings were less evident among E. coli isolates. Despite the significant increase in TZP consumption, the respective resistance rates of both bacterial species examined have remained almost unchanged.},
	keywords = {Anti-Bacterial Agents, beta-Lactamase Inhibitors, beta-Lactamases, Cephalosporin Resistance, Cephalosporins, Cross Infection, Drug Resistance, Bacterial, Drug Utilization, Enterobacteriaceae Infections, Enzyme Inhibitors, Escherichia coli, Greece, Humans, Klebsiella pneumoniae, Microbial Sensitivity Tests, Penicillanic Acid, Penicillin Resistance, Piperacillin, Prospective Studies, Time Factors},
	issn = {0924-8579},
	doi = {10.1016/j.ijantimicag.2006.08.042},
	author = {Petrikkos, George and Markogiannakis, Antonios and Papaparaskevas, Joseph and Papapareskevas, Joseph and Daikos, George L and Stefanakos, George and Zissis, Nicholas P and Avlamis, Athina}
}
