Drugs of Last Resort? The Use of Polymyxins and Tigecycline at US Veterans Affairs Medical Centers, 2005–2010
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{"title"=>"Drugs of last resort? the use of polymyxins and tigecycline at us veterans affairs medical centers, 2005-2010", "type"=>"journal", "authors"=>[{"first_name"=>"Benedikt", "last_name"=>"Huttner", "scopus_author_id"=>"24512026400"}, {"first_name"=>"Makoto", "last_name"=>"Jones", "scopus_author_id"=>"26025923400"}, {"first_name"=>"Michael A.", "last_name"=>"Rubin", "scopus_author_id"=>"7402540730"}, {"first_name"=>"Melinda M.", "last_name"=>"Neuhauser", "scopus_author_id"=>"7005048039"}, {"first_name"=>"Adi", "last_name"=>"Gundlapalli", "scopus_author_id"=>"6506223668"}, {"first_name"=>"Matthew", "last_name"=>"Samore", "scopus_author_id"=>"7004341520"}], "year"=>2012, "source"=>"PLoS ONE", "identifiers"=>{"pui"=>"364837283", "doi"=>"10.1371/journal.pone.0036649", "isbn"=>"1932-6203 (Electronic)\\r1932-6203 (Linking)", "pmid"=>"22615789", "issn"=>"19326203", "scopus"=>"2-s2.0-84861213713", "sgr"=>"84861213713"}, "id"=>"8130d426-6088-3a63-aa8d-99cbfdd789a9", "abstract"=>"Multidrug-resistant (MDR) and carbapenem-resistant (CR) Gram-negative pathogens are becoming increasingly prevalent around the globe. Polymyxins and tigecycline are among the few antibiotics available to treat infections with these bacteria but little is known about the frequency of their use. We therefore aimed to estimate the parenteral use of these two drugs in Veterans Affairs medical centers (VAMCs) and to describe the pathogens associated with their administration. For this purpose we retrospectively analyzed barcode medication administration data of parenteral administrations of polymyxins and tigecycline in 127 acute-care VAMCs between October 2005 and September 2010. Overall, polymyxin and tigecycline use were relatively low at 0.8 days of therapy (DOT)/1000 patient days (PD) and 1.6 DOT/1000PD, respectively. Use varied widely across facilities, but increased overall during the study period. Eight facilities accounted for three-quarters of all polymyxin use. The same statistic for tigecycline use was twenty-six VAMCs. There were 1,081 MDR or CR isolates during 747 hospitalizations associated with polymyxin use (1.4/hospitalization). For tigecycline these number were slightly lower: 671 MDR or CR isolates during 500 hospitalizations (1.3/hospitalization) (p = 0.06). An ecological correlation between the two antibiotics and combined CR and MDR Gram-negative isolates per 1000PD during the study period was also observed (Pearson's correlation coefficient r = 0.55 polymyxin, r = 0.19 tigecycline). In summary, while polymyxin and tigecycline use is low in most VAMCs, there has been an increase over the study period. Polymyxin use in particular is associated with the presence of MDR Gram-negative pathogens and may be useful as a surveillance measure in the future.", "link"=>"http://www.mendeley.com/research/drugs-last-resort-polymyxins-tigecycline-veterans-affairs-medical-centers-20052010", "reader_count"=>32, "reader_count_by_academic_status"=>{"Professor > Associate Professor"=>3, "Researcher"=>10, "Student > Doctoral Student"=>1, "Student > Ph. D. Student"=>7, "Student > Postgraduate"=>1, "Student > Master"=>3, "Other"=>2, "Student > Bachelor"=>4, "Lecturer"=>1}, "reader_count_by_user_role"=>{"Professor > Associate Professor"=>3, "Researcher"=>10, "Student > Doctoral Student"=>1, "Student > Ph. D. Student"=>7, "Student > Postgraduate"=>1, "Student > Master"=>3, "Other"=>2, "Student > Bachelor"=>4, "Lecturer"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>3, "Biochemistry, Genetics and Molecular Biology"=>2, "Nursing and Health Professions"=>1, "Mathematics"=>1, "Agricultural and Biological Sciences"=>8, "Medicine and Dentistry"=>10, "Pharmacology, Toxicology and Pharmaceutical Science"=>1, "Computer Science"=>2, "Immunology and Microbiology"=>2, "Economics, Econometrics and Finance"=>2}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>10}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>2}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>2}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>8}, "Computer Science"=>{"Computer Science"=>2}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>1}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>2}, "Mathematics"=>{"Mathematics"=>1}, "Unspecified"=>{"Unspecified"=>3}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>1}}, "reader_count_by_country"=>{"United States"=>2, "Taiwan"=>1, "Spain"=>1}, "group_count"=>2}

Scopus | Further Information

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/637296"], "description"=>"<p>Dot plot of tigecycline and polymyxin use by facility in DOT per 1000 PD in fiscal year 2010. Each dot represents one facility (n = 127).</p>", "links"=>[], "tags"=>["tigecycline", "polymyxin", "1000", "pd", "represents"], "article_id"=>307777, "categories"=>["Microbiology", "Infectious Diseases", "Biotechnology"], "users"=>["Benedikt Huttner", "Makoto Jones", "Michael A. Rubin", "Melinda M. Neuhauser", "Adi Gundlapalli", "Matthew Samore"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0036649.g002", "stats"=>{"downloads"=>0, "page_views"=>12, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Dot_plot_of_tigecycline_and_polymyxin_use_by_facility_in_DOT_per_1000_PD_in_fiscal_year_2010_Each_dot_represents_one_facility_n_8202_8202_127_/307777", "title"=>"Dot plot of tigecycline and polymyxin use by facility in DOT per 1000 PD in fiscal year 2010. Each dot represents one facility (n = 127).", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-02-20 05:05:08"}
  • {"files"=>["https://ndownloader.figshare.com/files/637596"], "description"=>"<p>Only isolates recovered between the 7th day before and the 1st day after the first day of polymyxin or tigecycline use were included.</p>", "links"=>[], "tags"=>["types", "resistant", "cr"], "article_id"=>308086, "categories"=>["Microbiology", "Infectious Diseases", "Biotechnology"], "users"=>["Benedikt Huttner", "Makoto Jones", "Michael A. Rubin", "Melinda M. Neuhauser", "Adi Gundlapalli", "Matthew Samore"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0036649.t002", "stats"=>{"downloads"=>8, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Culture_sample_types_by_resistant_MDR_CR_or_XDR_pathogen_/308086", "title"=>"Culture sample types by resistant (MDR, CR or XDR) pathogen.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-02-20 05:06:49"}
  • {"files"=>["https://ndownloader.figshare.com/files/637192"], "description"=>"<p>Trends in the use of polymyxin and tigecycline in days of therapy (DOT) per 1000 patient days (PD) by fiscal year.</p>", "links"=>[], "tags"=>["polymyxin", "tigecycline", "days", "1000"], "article_id"=>307670, "categories"=>["Microbiology", "Infectious Diseases", "Biotechnology"], "users"=>["Benedikt Huttner", "Makoto Jones", "Michael A. Rubin", "Melinda M. Neuhauser", "Adi Gundlapalli", "Matthew Samore"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0036649.g001", "stats"=>{"downloads"=>1, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Trends_in_the_use_of_polymyxin_and_tigecycline_in_days_of_therapy_DOT_per_1000_patient_days_PD_by_fiscal_year_/307670", "title"=>"Trends in the use of polymyxin and tigecycline in days of therapy (DOT) per 1000 patient days (PD) by fiscal year.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-02-20 05:04:32"}
  • {"files"=>["https://ndownloader.figshare.com/files/637403"], "description"=>"<p>a) when polymyxins (1,145 hospitalizations) or b) tigecycline (3,125 hospitalizations) were used. Only <i>Acinetobacter spp.</i>, <i>E. coli</i>, <i>Klebsiella spp.</i> and <i>P. aeruginosa*</i> are included <b>MDR:</b> multi-drug resistance (non-susceptibility to > = 3 drug classes) <b>CR:</b> carbapenem resistance (non-susceptibility to carbapenems; ertapenem not considered for non-fermenters) <b>XDR:</b> non-susceptibility to all tested classes except to polymyxins (definitions of MDR, CR and XDR adapted from reference <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0036649#pone.0036649-Magiorakos1\" target=\"_blank\">[22]</a>) *In 206/225 cases where tigecycline was given and a Pseudomonas was isolated, the patient had at least one anti-pseudomonal spectrum agent (definition of anti-pseudomonal activity based on reference <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0036649#pone.0036649-Magiorakos1\" target=\"_blank\">[22]</a>).</p>", "links"=>[], "tags"=>["public health and epidemiology", "Infectious diseases", "microbiology"], "article_id"=>307889, "categories"=>["Microbiology", "Infectious Diseases", "Biotechnology"], "users"=>["Benedikt Huttner", "Makoto Jones", "Michael A. Rubin", "Melinda M. Neuhauser", "Adi Gundlapalli", "Matthew Samore"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0036649.g003", "stats"=>{"downloads"=>1, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Pathogens_isolated_/307889", "title"=>"Pathogens isolated.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-02-20 05:05:45"}
  • {"files"=>["https://ndownloader.figshare.com/files/637637"], "description"=>"<p>Characteristics of the 127 hospitals October 2005 through September 2010.</p>", "links"=>[], "tags"=>["127", "hospitals", "october", "2005", "september"], "article_id"=>308122, "categories"=>["Microbiology", "Infectious Diseases", "Biotechnology"], "users"=>["Benedikt Huttner", "Makoto Jones", "Michael A. Rubin", "Melinda M. Neuhauser", "Adi Gundlapalli", "Matthew Samore"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0036649.t001", "stats"=>{"downloads"=>12, "page_views"=>12, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Characteristics_of_the_127_hospitals_October_2005_through_September_2010_/308122", "title"=>"Characteristics of the 127 hospitals October 2005 through September 2010.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-02-20 05:07:01"}
  • {"files"=>["https://ndownloader.figshare.com/files/637514"], "description"=>"<p>Extreme polymyxin use outlier excluded.</p>", "links"=>[], "tags"=>["days", "1000", "mdr", "cr", "gram-negative", "pathogens", "pd"], "article_id"=>307995, "categories"=>["Microbiology", "Infectious Diseases", "Biotechnology"], "users"=>["Benedikt Huttner", "Makoto Jones", "Michael A. Rubin", "Melinda M. Neuhauser", "Adi Gundlapalli", "Matthew Samore"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0036649.g004", "stats"=>{"downloads"=>3, "page_views"=>19, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Correlation_between_polymyxin_tigecycline_use_in_days_of_therapy_DOT_per_1000_patient_days_PD_and_MDR_amp_CR_Gram_negative_pathogens_per_1000_PD_aggregated_over_the_entire_study_period_/307995", "title"=>"Correlation between polymyxin/tigecycline use in days of therapy (DOT) per 1000 patient days (PD) and MDR & CR Gram-negative pathogens per 1000 PD (aggregated over the entire study period).", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-02-20 05:06:21"}

PMC Usage Stats | Further Information

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  • {"unique-ip"=>"13", "full-text"=>"13", "pdf"=>"7", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"4", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"3"}
  • {"unique-ip"=>"24", "full-text"=>"24", "pdf"=>"11", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"2"}
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  • {"unique-ip"=>"12", "full-text"=>"13", "pdf"=>"0", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"11"}
  • {"unique-ip"=>"10", "full-text"=>"11", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"12"}
  • {"unique-ip"=>"6", "full-text"=>"7", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"1"}
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  • {"unique-ip"=>"9", "full-text"=>"6", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"4"}
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  • {"unique-ip"=>"8", "full-text"=>"6", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"4", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"5"}
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  • {"unique-ip"=>"10", "full-text"=>"11", "pdf"=>"11", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"3"}
  • {"unique-ip"=>"10", "full-text"=>"12", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"2"}
  • {"unique-ip"=>"12", "full-text"=>"14", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"8"}
  • {"unique-ip"=>"12", "full-text"=>"13", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"9"}
  • {"unique-ip"=>"6", "full-text"=>"6", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2015", "month"=>"10"}
  • {"unique-ip"=>"10", "full-text"=>"8", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"7"}
  • {"unique-ip"=>"11", "full-text"=>"7", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"8"}
  • {"unique-ip"=>"10", "full-text"=>"8", "pdf"=>"5", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"9"}
  • {"unique-ip"=>"5", "full-text"=>"4", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"10"}
  • {"unique-ip"=>"5", "full-text"=>"4", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"2"}
  • {"unique-ip"=>"14", "full-text"=>"12", "pdf"=>"10", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"11"}
  • {"unique-ip"=>"5", "full-text"=>"4", "pdf"=>"8", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"12"}
  • {"unique-ip"=>"5", "full-text"=>"7", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"1"}
  • {"unique-ip"=>"15", "full-text"=>"12", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"4", "supp-data"=>"0", "cited-by"=>"2", "year"=>"2015", "month"=>"11"}
  • {"unique-ip"=>"6", "full-text"=>"4", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"12"}
  • {"unique-ip"=>"2", "full-text"=>"2", "pdf"=>"0", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"1"}
  • {"unique-ip"=>"8", "full-text"=>"7", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"3"}
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  • {"unique-ip"=>"2", "full-text"=>"2", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"5"}
  • {"unique-ip"=>"6", "full-text"=>"5", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"6"}
  • {"unique-ip"=>"6", "full-text"=>"5", "pdf"=>"0", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"5", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"7"}
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  • {"unique-ip"=>"6", "full-text"=>"8", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"9"}
  • {"unique-ip"=>"6", "full-text"=>"6", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"10"}
  • {"unique-ip"=>"1", "full-text"=>"1", "pdf"=>"0", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"11"}
  • {"unique-ip"=>"2", "full-text"=>"4", "pdf"=>"0", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"12"}
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Relative Metric

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