Evolution of the antibiotic consumption and antimicrobial resistance in a hospital of Argentina
Keywords:
antibióticos, Doses Diárias Definida, resistênciaAbstract
Objective: To describe and analyze trends in antibiotic consumption and its relationship to resistance in relevant microorganisms isolated in our environment in the period under study.
Methods: A Cross-sectional, retrospective, decriptive-analytic study was made. The evolution of antibiotic consumption, in Defined Daily Doses (DDD), during the years 2010, 2011 and 2012 in adult patiens hospitalized in clinical ,surgical and critical wards of a tertiary general hospital was described and analyzed. Consumption was related to the evolution of resistance in germs epidemiologically relevant in our environment. The existence of statistically significant differences in the years studied was analyzed by the chi square test.
Results: There was a decrease in overall antibiotic consumption (75.98 DDD/100 beds-days in 2010 a 65.01 DDD/100 beds-days in 2012) . Analysis by treatment group showed increased consumption of penicillins + IBL, polymyxins (colistin) and tetracyclines (tigecycline). Active substance analysis showed increased cefepime, piperacillin + tazobactam, colistin and tigecycline and a decrease in consumption of ceftriaxone, ceftazidime, ciprofloxacin and imipenem. These results were correlated with the appearance of Acinetobacter spp and Klebsiella pneumoniae emerging resistance.
Conclusions: Changes were detected in the pattern of use with an increase in antibiotic prescription for multidrug-resistant microorganisms. It was especially noted the upward trend of Acinetobacter carbapenem resistance which explains the increase in consumption of colistin and tigecycline. Through such drugs use studies, the hospital pharmacist contributes to continuous surveillance and monitoring of antibiotic use and provides a useful tool to promote their rational use.
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