ABSTRACT
This chapter examines the definition of antibiotic cycling, the evidence to support this intervention, and the potential limitations. It discusses the implementation of an antibiotic cycling program. The antibiotics utilized in a cycling program should be guided by the hospital antibiogram, local surveillance data, and known efficacy of a particular antibiotic for common infections encountered in the population. Aminoglycoside cycling was one of several control measures instituted by Saravolatz to combat an outbreak of gentamicin-resistant Klebsiella pneumoniae in a neonatal intensive care unit. The class-switching studies seem to be effective in reducing endemic resistance over finite periods of time, but an ongoing, dynamic program of antibiotic management will potentially be more effective in preventing the appearance of new resistance determinants. The study by S. J. Bradley was motivated by an increase in glycopeptide-resistant enterococci in a hematology-oncology unit.
