Abstract
Background Irrational use of antimicrobials (ATMs) triggers microbial resistance (AMR) which has severe consequences for human health. ATM consumption varies among countries and within each territory. These data should be known, in order to perform local policies towards AMR reduction. This work aimed to expose the association of the level of consumption of carbapenems and fluoroquinolones with their resistance rates in Pseudomonas aeruginosa in Argentina. Method Consumption of antimicrobials was expressed by defined daily dose (DDD)/1000 inhabitants for each ATM during one year period, discriminating by each country region. Resistance of P. aeruginosa to carbapenems/fluoroquinolones groups was recorded. Consumption/resistance ratio “R” was calculated for each region of the country, comparing results with other countries. Results P. aeruginosa resistance rate to fluoroquinolone (F) was 26.4% in blood samples and 29.7% in urine samples, whereas resistance rates to carbapenems (C) were 19.9 and 17.7% in blood and urine, respectively. Correlation between consumption and resistance was demonstrated for both antimicrobials (C : R = 0.58; p=0.003 and F : R = 0.77; p=0.0001). Great fluctuations of resistance levels were seen among regions within the country, always correlating resistance with areas in which a higher level of ATM consumption was detected. Conclusion P. aeruginosa resistance to fluoroquinolone/carbapenems in Argentina directly correlated with antimicrobial consumption levels. A great heterogeneity in resistance profile was observed among areas where ATMs were widely used. Global data at the national level might mask local realities that require specific health policies in order to control the irrational use of ATMs.
Highlights
Over the years, as science developed new antimicrobials (ATMs), microorganisms have developed mechanisms of defense against them
We compiled and analyzed data of consumption from all sales of ATM products performed by the pharmaceutical industry in 23 Argentine provinces and the Autonomous City of Buenos Aires (CABA) between January and December 2018. e study included all the sales made in Argentina limited to human medicine applications, which is the entire universe of fluroquinolones and carbapenems from the “Watch” group commercialized in the country according to their ATC and “Aware” classifications [19]
We collected information about the type of ATM according to the anatomical, therapeutic, chemical (ATC) classification system; consumption of defined daily doses (DDDs) as defined by the World Health Organization; geographical territory in which consumption/sale distribution was registered; and data related to the level of resistance for the different ATMs, according to the national registry generated periodically by the Malbran Institute [20]
Summary
As science developed new antimicrobials (ATMs), microorganisms have developed mechanisms of defense against them. E AMR complexity forces countries to adopt policies that limit the use of certain ATMs, that the World Health Organization classified as “Watch” or “Reserve” groups, in an attempt to reduce the clinical and economic consequences for the health system. Is bacterium is naturally resistant to many antimicrobials and can acquire antibiotic resistance through mutations in chromosomal genes and lateral gene transfer [6] It could be associated with different types of human infections and because of its emerging multidrug-resistant strains, these types of infections are considered major global problem for the public health [7]. P. aeruginosa resistance to fluoroquinolone/carbapenems in Argentina directly correlated with antimicrobial consumption levels.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Interdisciplinary Perspectives on Infectious Diseases
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
