Lan C.-K.PO-REN HSUEHWong W.-W.Fung C.-P.Lau Y.-T.Yeung J.Y.K.Young G.T.Su C.-C.2020-12-182020-12-1820030253-2662https://scholars.lib.ntu.edu.tw/handle/123456789/528937With the overuse of expanded-spectrum cephalosporins, especially ceftazidime, outbreaks of extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae and Escherichia coli infections have been reported. In this prospective observational study, we demonstrated that the addition of piperacillin/tazobactam to the formulary and the restriction of ceftazidime were associated with a decrease in the percentage of ceftazidime-resistant isolates. When the use of ceftazidime decreased by 96.43%, and the use of piperacillin/tazobactam increased by over 50% during the 9-month study period, a concomitant decrease was found in the percentage of colonization and infection by ESBL-producing E. coli or K. pneumoniae in patients admitted to the intensive care unit. Results from this 9-month intervention study support the concept that levels of local and institutional use of ceftazidime are of substantial importance to the emergence and persistence of endemic ceftazidime-resistant K. pneumoniae.[SDGs]SDG3ampicillin; antibiotic agent; beta lactamase; cefepime; cefoxitin; ceftazidime; ceftriaxone; cephalosporin derivative; gentamicin; imipenem; minocycline; piperacillin; piperacillin plus tazobactam; sultamicillin; antibiotic resistance; article; bacterial colonization; bacterial infection; bacterium isolate; drug utilization; endemic disease; epidemic; Escherichia coli; human; incidence; intensive care unit; Klebsiella pneumoniae; major clinical study; nonhuman; persistent infection; prospective study; Anti-Bacterial Agents; beta-Lactamases; Ceftazidime; Cephalosporin Resistance; Drug Resistance, Bacterial; Escherichia coli; Escherichia coli Infections; Female; Humans; Klebsiella Infections; Klebsiella pneumoniae; Male; Penicillanic Acid; Piperacillin; Prospective Studies; Taiwanjournal article145825622-s2.0-0142106837