Correlation between antibiotic consumption and bacterial resistance as quality indicator of proper use of these drugs in inpatients

Veličković‐Radovanović, Radmila; Petrović, Jasmina; Kocić, Branislava; Antić, Snežana; Ranđelović, Gordana

doi:10.2298/vsp0904307v

Cited by 15 publications

(12 citation statements)

References 16 publications

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“…Promising data were obtained regarding fluoroquinolone resistance of E. coli in our hospital (21.7%), which was similar to the values reported by Austria (22%) and Germany (22.1%), but lower than the rate reported in 2007 from another clinical center in the northern part of Serbia (28.6%) [14]. This could be the reaction to extensive ciprofloxacin use in the period from 2003 to 2007 in Serbia and the favoring of third-generation cephalosporins over fluoroquinolones in the following years in the treatment of hospital-acquired E. coli bloodstream infections [15].…”

Section: Discussionsupporting

confidence: 84%

Antimicrobial resistance of selected invasive bacteria in a tertiary care center: results of a prospective surveillance study

Djurić

Jovanović

Stošović

et al. 2016

J Infect Dev Ctries

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Introduction: We aimed to report the distribution and resistance patterns of eight invasive clinically relevant bacteria surveyed in the Clinical Center of Serbia (CCS) in Belgrade. Methodology: A total of 477 clinical blood stream isolates of Staphylococcus aureus, Streptococcus pneumoniae, Enterococcus faecium, Enterococcus faecalis, Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter spp. were collected in the period from January to December 2013. Antimicrobial susceptibility testing was performed using standard methods and interpreted using the Clinical and Laboratory Standards Institute (CLSI) breakpoint criteria. Results: Acinetobacter spp. was the most prevalent bacteria encountered (37%), followed by K. pneumoniae (25.7%). Multidrug resistance was observed in 92.5% of all isolates. Out of 177 strains of Acinetobacter spp., 97.7% were resistant to fluoroquinolones and carbapenems. Resistance to aminoglycosides, fluoroquinolones, and third-generation cephalosporins was 97.1%, 95.4%, and 95.8% among K. pneumoniae and 21.4%, 21.7%, and 31% among E. coli isolates, respectively. In total, 65.1% of K. pneumoniae and 12.1% of E. coli isolates were determined to be extended-spectrum beta-lactamase (ESBL) positive. High-level aminoglycoside resistance of E. faecalis was 71.4%, and glycopeptide resistance of E. faecium was 95%. Out of 66 strains of S. aureus, 63.4% were methicillin resistant. Conclusions: The majority of bloodstream isolates of clinically relevant bacteria in CCS were multidrug resistant. The biggest concerns are carbapenem-resistant Acinetobacter spp., K. pneumoniae, and P. aeruginosa; third-generation cephalosporin-resistant E. coli; vancomycinresistant E. faecium; and methicillin-resistant S. aureus. Stricter measures of infection control and antibiotic use are needed.

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Section: Discussionsupporting

confidence: 84%

Antimicrobial resistance of selected invasive bacteria in a tertiary care center: results of a prospective surveillance study

Djurić

Jovanović

Stošović

et al. 2016

J Infect Dev Ctries

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“…The use of antibiotics is now in the spotlight for several reasons: it has been significantly increased during recent decades, they were often administered for the treatment of a viral infection, and unclear cases of fever 1,9 . This resulted in an increase in pathogen resistance, with consequent narrowing of choice of antibiotics and often the lack of therapeutic success 10,11 . That is why an international network such as ESAC was created, which aimed to monitor and compare the use of antibiotics among the countries, and to start with educational or administrative measures in case of excessive use of antibiotics [12][13][14] .…”

Section: Disscusionmentioning

confidence: 99%

Relationship between outpatient antibiotic use and the prevalence of bacterial infections in Montenegro

Sahman-Zaimovic

Vukmirović

Tomić

et al. 2017

VSP

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Use of antibiotics in Montenegro in 2012 was more than double than necessary according to prevalence of bacterial infections and average duration of treatment. The structure of antibiotics was not in full compliance with the national good practice guidelines, but it was in accordance with data on bacterial antibiotic resistance in outpatient practice. It is necessary to initiate measures to rationalize the use of antibiotics both in terms of quantity and in terms of the structure of the most used antibiotics.

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“…Overuse and misuse of antibiotics have been proven to be primary causes of antibiotic resistance [3]. Monitoring antibiotic use can help health authorities to implement structured surveillance programs for antibiotic resistance [1,4].…”

Section: Introductionmentioning

confidence: 99%

Antibiotic use in Albania between 2011 and 2012

Hoxha

Malaj

2015

J Infect Dev Ctries

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Introduction: Health institutions in Albania have recently reported an increase in antibiotic misuse and microbial resistance. Until now, there have been no comprehensive studies that analyzed the overall use of antibiotics in Albania. The aim of this study was to analyze the overall antibiotic use in Albania between 2011 and 2012, using standardized methodology of measurement, based on World Health Organization guidelines. Methodology: Data from 2011 and 2012 on antibiotic use from ambulatory and hospital sector were examined. Antibiotics were divided based on anatomic therapeutic chemical classification. Defined daily dose (DDD) for each drug was assigned, and DDD per 1,000 inhabitants per day (DID) was used as a measurement unit. In cases of antibiotic combinations for which DDD were not available, unit doses were assigned. Results: In 2011–2012, total antibiotic use decreased from 24.25 to 20.66 DID. Penicillin’s were the most used antibiotic class, with 10.62 DID (2011) and 10.51 DID (2012). Tetracycline use decreased from 5.45 DID (2011) to 0.98 DID (2012). Macrolides increased from 1.36 to 1.88 DID, quinolones from 1.72 to 2.51 DID. The overall antibiotic use was significantly higher than the reimbursed antibiotic use – 3.17 DID (2011) and 2.79 DID (2012) – based on the official data for the same period. Conclusions: This study enables policymakers to further analyze the quality of antibiotic prescriptions and draw comparisons to other countries. The analyzed data suggest there are different factors influencing out-of-pocket use of antibiotics and wrongly prescribed antibiotics. Further studies are necessary to evaluate these factors.

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Correlation between antibiotic consumption and bacterial resistance as quality indicator of proper use of these drugs in inpatients

Abstract: These results confirm an association between the use of antibiotics and the prevalence of resistance. This methodology could provide good quality indicators of rational drug use and serve for local monitoring of antibiotics use and resistance, as well as for external comparison.

Cited by 15 publications

References 16 publications

Antimicrobial resistance of selected invasive bacteria in a tertiary care center: results of a prospective surveillance study

Antimicrobial resistance of selected invasive bacteria in a tertiary care center: results of a prospective surveillance study

Relationship between outpatient antibiotic use and the prevalence of bacterial infections in Montenegro

Antibiotic use in Albania between 2011 and 2012

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