Changes in the Consumption of Antibiotics and Resistance Rate of Escherichia coli after Special Rectification as Well as Their Correlation Analysis in Inpaitents of Our Hospital / 中国药房

ABSTRACT

OBJECTIVE:To provide reference for rational use of antibiotics in clinic.METHODS:The quarterly information about the consumption of antibiotics in inpatients of our hospital during Jan.2012-Dec.2016 were collected from Center for Antibacterial Surveillance.DDDs of various antibiotics and Escherichia coli were analyzed statistically;the detection of E.coli,producing ESBLs and drug resistance during the same period were also analyzed statistically.The correlation between DDDs of antibiotics and resistance rate was investigated by Pearson test.RESULTS:During 2012-2016,DDDs of cephalosporins was the highest in inpatients of our hospital,followed by cephamicins and macrolides.Total DDDs of antibiotics showed a decreasing trend and a slight rebound in 2016.After 2013,DDDs of most antibiotics were basically same to the change of total DDDs.However,DDDs of compound preparations of penicillin and β-lactamase inhibitors,cephalomycm,carbapenems and glycopeptides showed an upward trend.In 2012,DDDs of second-generation cephalosporin was the highest among cephalosporins;since 2013,DDDs of first-generation cephalosporin was the highest in this category.Anti-E.coli drugs included piperacillin sodium and tazobactam sodium,ceftazidime,ceftriaxone,cefepime,cefoxitin,aztreonam,meropenem,gentamicin,levofloxacin.Among anti-E.coli drugs,DDDs of cefatriaxone was the highest in 2012,while that of cefoxitin was the highest in 2016;the consumption of aztreonam decreased most obviously.During 2012-2016,110,132,104,131,243 strains of E.coli were detected in our hospital respectively.The rate of producing ESBLs decreased to 56.6％,57.0％,50.6％,48.4％,45.0％.E.coli was highly resistant to ampicillin,cefazolin,ceftriaxone and compound sulfamethoxazole,while poorly resistant to piperacillin sodium and tazobactam sodium,cefoxitin,imipenem and amikacin.Resistance rate of piperacillin sodium and tazobactam sodium was positively correlated with DDDs of ceftriaxone,aztreonam,gentamicin,levofloxacin,cephalosporins (fast-,third-generation cephalosporins),tetracyclines,quinolones and total DDDs (r were 0.880 to 0.929,P＜0.05).Resistance rate of ceftazidime was positively correlated with DDDs of ceftriaxone,aztreonam,gentamicin,levofloxacin,cephalosporins (fast-,second-,third-generation cephalosporins),tetracyclines,quinolones and total DDDs (r were 0.888 to 0.991,P＜0.05).Resistance rate of cefepime was positively correlated with DDDs of aminoglycosides(r was 0.901,P＜0.05).Resistance rate of gentamicin was negatively correlated with DDDs of compound preparations of penicillin and β-lactamase inhibitors,cefepime (r were-0.914,-0.921,P＜0.05).Resistance rate of imipenem was negatively correlated with DDDs of ceftriaxone,aztreonam,gentamicin,levofloxacin,cephalosporins (fast-,second-,third-generation cephalosporins),aminoglycosides,tetracyclines,quinolones and total DDDs (r were-0.994 to-0.878,P＜0.05).Resistance rates of anti-E.coli drugs were all independent from their DDDs (P＞0.05).The rate of E.coli producing enzyme was positively correlated with resistance rate of gentamicin(r was 0.955,P＜0.05),while was independent from resistance rate or DDDs of other drugs (P＞0.05).CONCLUSIONS:After antibiotics special rectification,total consumption of antibiotics in inpatients of our hospital show a downward trend,and the varieties also change greatly.Although drug resistance is serious,the rate of producing enzyme is decreasing.Antibiotics should be selected carefully according to the monitoring data of bacterial resistance,drug sensitivity test results,the correlation between the consumption of antibiotics and resistance rate so as to reduce the occurrence of bacterial resistance.