Abstract
Introduction: Antibiotics are the most frequently used drugs in hospitalized patients, but studies have shown that the prescribed antibiotics may be inappropriate and may contribute to bacterial resistance. The aim of this work is the evaluation of antibiotic consumption in Clinical Centre Nis, Serbia from 2011 to 2014, with the focus on the monitoring of the ceftriaxone (CTX) and ciprofloxacin (CIP) utilization. Secondly, we screened bacterial resistance towards monitored antibiotics used for intra-abdominal infection (IAI) and urinary tract infection (UTI) in tertiary healthcare institution. Methods: Antibiotics consumption and antimicrobial resistance were monitored in the tertiary care university hospital-Clinical Centre Nis from 2011 to 2014. Data on the use of antibiotics in inpatients were obtained and expressed as defined daily doses per 100 bed days (DBD). Bacterial resistances were given as percentages of resistant isolates. Results: During the investigation period the use of cephalosporins increased by 6.39 %, from 2011 to 2013, but in 2014 there was a reduction in its consumption by 16.46 %. Penicillins consumption had a decreasing trend, whereas quinolones consumption was variable during observation period. The resistance of K. pneumoniae to CTX and CIP for the isolates from IAI, and resistance of E. coli to analyze antibiotics for isolates from UTI showed increasing trend within observed period of time. Conclusions: Our findings shows that cephalosporins were the most frequently used antibiotics in Clinical Centre Nis, and they were followed by penicillins and quinolones. Additionally, K. pneumoniae resistance to CTX and CIP increased markedly in IAI, while E. coli resistance showed an increasing trend to CTX and CIP in UTI over the study period.
Highlights
Antibiotics are the most used drugs within hospitalized patients and represents 15 – 30 % of all prescribed drugs at the hospitals
During the investigation period the use of cephalosporins increased by 6.39 %, from 2011. to 2013, but in 2014. there was a reduction in its consumption by 16.46 %
Our analysis showed that cephalosporins were the most frequently prescribed antibiotics, followed by penicillins and quinolones (Figure 1)
Summary
Antibiotics are the most used drugs within hospitalized patients and represents 15 – 30 % of all prescribed drugs at the hospitals. The increasing rate of antibiotic resistance represents an increasing global public health problem in Europe and worldwide leading to less effective treatment of bacterial infections, growing costs and mortality [3,4]. European countries try to implement actions to control antimicrobial resistance in the community and the hospitals as well, providing rational use of antimicrobials [5]. Intra- and inter-hospital spread of resistant microorganisms, community contribution to resistance, and infection control policies and practices, may play a role in determining the burden of resistance in a hospitals [6]. Adequate empiric therapy of these bacterial infections appears to be crucial for reducing postoperative complications and mortality rates, but carries the risk of increased bacterial resistance [9]
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