The influence of rational antibiotic prescribing on bacterial resistance at General hospital Celje

Background: Antimicrobials are among the most commonly prescribed drugs in hospitals, received by 49 % to 61 % of General’s Hospital Celje inpatients, depending on time of observation. Methods: The World Health Organization recommends that the consumption of antimicrobial agents in hospitals should be presented as the Defined Daily Dose per 100 bed days. The project presents the available data on the consumption of antibacterial drugs at the level of general hospital. The data provide a basis for the study of ecological impact of antibiotic consumption, evaluation of the association between antibiotic consumption and resistance, assessment of quality indicators for antibiotic consumption and improvement in the prescribing of antibiotics. Results: Trends of antimicrobial resistance were followed by comparing the rates of resistance of the five frequent bacteria isolated in General Hospital Celje between years 2000 and 2005. The usage of fluoroquinolones and macrolides increased gradually throughout the study period, while usage of aminoglycosides decreased. The relationships between antibacterial drug use and bacterial susceptibility showed different patterns. The investigation showed a decrease in amoxicyllin/clavulanic acid resistance of Escherichia coli and Klebsiella pneumoniae despite increasing its use. The increased ciprofloxacin resistance of Pseudomonas aeruginosa and Acinetobacter spp. was followed by increased consumption of quinolones. Conclusions: The analysis of resistance levels and antibacterial consumption in the present study suggest different mechanisms for increased resistance. The significant trend of increased resistance to antibacterials over time constitutes an important warning system.