Intra-hospital differences in antibiotic use correlate with antimicrobial resistance rate in Escherichia coli and Klebsiella pneumoniae : a retrospective observational study

• Published in: Antimicrobial resistance & infection control 2018-07, Vol.7 (1), p.89-89, Article 89
• Main Authors: Cusini, Alexia, Herren, David, Bütikofer, Lukas, Plüss-Suard, Catherine, Kronenberg, Andreas, Marschall, Jonas
• Format: Article
• Language: English
• Subjects: Acids; Amoxicillin; Analysis; Antibiotic resistance; Antibiotic use; Antibiotics; Antimicrobial agents; Bacteria; Bacterial pneumonia; Care and treatment; Correlation; Departments; Disease control; Drug resistance; Drug resistance in microorganisms; E coli; Gram-negative bacteria; Infections; K. pneumoniae; Laboratories; Observational studies; Otolaryngology; Pneumonia; Public health; Studies; Surgery; Surveillance; Thoracic surgery; Urogenital system
• ISSN: 2047-2994; 2047-2994
• DOI: 10.1186/s13756-018-0387-0

Monitoring antimicrobial use and resistance in hospitals are important tools of antimicrobial stewardship programs. We aimed to determine the association between the use of frequently prescribed antibiotics and the corresponding resistance rates in and among the clinical departments of a tertiary care hospital. We performed a retrospective observational study to analyse the use of nine frequently prescribed antibiotics and the corresponding antimicrobial resistance rates in hospital acquired and isolates from 18 departments of our institution over 9 years (2008-2016). The main cross-sectional analysis assessed the hypothetical influence of antibiotic consumption on resistance by mixed logistic regression models. We found an association between antibiotic use and resistance rates in for amoxicillin-clavulanic acid (OR per each step of 5 defined daily dose/100 bed-days 1.07, 95% CI 1.02-1.12;  = 0.004), piperacillin-tazobactam (OR 2.11, 95% CI 1.45-3.07;