Chonnam Med J.  2008 Dec;44(3):137-143. 10.4068/cmj.2008.44.3.137.

Relationship between Antibiotic Use and Antibiotic Resistance in Major Nosocomial Pathogens at a University Hospital

• Song YA
• Jung SI
• Chang MO
• Ban HJ
• Jin NC
• Kim HK
• Park KH
• Shin JH
• Bae SY

• KMID: 2172292
• DOI: http://doi.org/10.4068/cmj.2008.44.3.137

Abstract

This study was performed to evaluate the prescribing pattern of antibiotics and the relationship between antibiotic use and antibiotic resistance in major nosocomial pathogens at a university hospital in Korea. Data on annual patient-days and annual consumption (defined daily dose (DDD)/1,000 patient-days) of all antibiotics from 2000 to 2006 were analyzed. The antibiotic resistance in major nosocomial pathogens was determined by disc diffusion or automated systems. Spearman's correlation coefficient was used to determine the relationship between antibiotic use and resistance. Increasing trend on incidences of Klebsiella pneumoniae causing nosocomial bloodstream infections was noted from 2000 to 2006 (r=0.786, p=0.036). Even though the annual patient-days of the hospital did not change (r=-0.107, p=0.819), the annual usage of antibiotics significantly increased from 2000 to 2006 (r=0.929, p=0.003). A significant stepwise increase in consumption (r>0.72 and p<0.05) was found for several broad-spectrum antibiotics such as ceftriaxone, piperacillin/tazobactam, imipenem, and vancomycin. The rise in piperacillin/tazobactam-resistant Serratia marcenscens (r=0.893, p=0.007) and piperacillin/tazobactam-resistant Pseudomonas aeruginosa (r=1.000, p=0.000) was significantly correlated with increased consumption of piperacillin/tazobactam respectively. Increased ciprofloxacin-resistant S. marcescens was significantly associated with increased usage of ciprofloxacin (r=0.919, p=0.003). This study demonstrated the significant changes in antibiotic use and positive relationship between antibiotic use and antibiotic resistance in several nosocomial pathogens. Continuous surveillance of antibiotic use is needed to encourage appropriate use of antibiotics and to reduce antibiotics resistance.

Keyword

Anti-bacterial agents; Utilization; Vascular resistance; Hospitals

MeSH Terms

Anti-Bacterial Agents
Ceftriaxone
Ciprofloxacin
Diffusion
Drug Resistance, Microbial
Imipenem
Incidence
Klebsiella pneumoniae
Korea
Pseudomonas aeruginosa
Serratia
Vancomycin
Vascular Resistance
Anti-Bacterial Agents
Ceftriaxone
Ciprofloxacin
Imipenem
Vancomycin

Figure

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  Fig. 1 Incidence (episodes per 10,000 patient-days) of nosocomial bloodstream infection caused by major nosocomial pathogens from patients treated at Chonnam National University Hospital in Korea from 2000~2006.

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  Fig. 2 Annual consumption and proportional use of several representative classes of antimicrobial agents at Chonnam National University Hospital in Korea, 2000~2006. BLBLI, β-lactam /β-lactamase inhibitor.

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