University Hospital Centre Osijek, Huttlerova 4, 31000 Osijek, Croatia.
Int J Antimicrob Agents. 2010 Oct;36(4):369-73. doi: 10.1016/j.ijantimicag.2010.05.019. Epub 2010 Aug 5.
High use of amoxicillin/clavulanic acid (AMC) at the University Hospital Osijek (Croatia) contributed to high rates of resistance in Enterobacteriaceae, in particular Escherichia coli (50%). Thus, in order to decrease bacterial resistance, AMC use was restricted. We present results of the restriction on resistance amongst antibiotics accounting for 90% of antibiotic use [drug utilisation 90% (DU90%)]. Data were analysed on antibiotic use and microbiological susceptibility of E. coli during two 9-month periods, before and after the restriction of AMC use. Drug use was presented as numbers of defined daily doses (DDDs) and DDDs/100 bed-days. Resistance of E. coli to antibiotics was presented as percentages of isolated strains in the DU90% segment. Use of AMC was 16 DDDs/100 bed-days or 30% of all antibiotics before the intervention. Use of AMC fell to 2 DDDs/100 bed-days or 4% after the intervention, and resistance of E. coli fell from 37% to 11%. In conclusion, restricted use of AMC resulted in a significant decrease of E. coli resistance. DU90% resistance profiles are simple and useful tools in highlighting problems in antibiotic use and resistance but may also be useful in long-term follow-up of antibiotic policy.
在奥西耶克大学医院（克罗地亚），阿莫西林/克拉维酸（AMC）的高使用率导致肠杆菌科，尤其是大肠杆菌（50%）的耐药率很高。因此，为了降低细菌耐药性，限制了 AMC 的使用。我们介绍了限制 AMC 使用对占抗生素使用 90%的抗生素的耐药性的影响[抗生素使用 90%（DU90%）]。在限制 AMC 使用前后的两个 9 个月期间，分析了大肠杆菌的抗生素使用和微生物药敏数据。药物使用以特定日剂量（DDD）和 DDD/100 床日数表示。大肠杆菌对抗生素的耐药性以 DU90%部分分离株的百分比表示。干预前 AMC 的使用量为 16 DDD/100 床日或所有抗生素的 30%。干预后，AMC 的使用量降至 2 DDD/100 床日或 4%，大肠杆菌的耐药率从 37%降至 11%。总之，限制 AMC 的使用导致大肠杆菌耐药性显著下降。DU90%耐药谱是突出抗生素使用和耐药问题的简单而有用的工具，但在抗生素政策的长期监测中也可能有用。
