South Carolina College of Pharmacy, Charleston, SC, 29425, USA,
Infect Dis Ther. 2013 Dec;2(2):209-15. doi: 10.1007/s40121-013-0016-4. Epub 2013 Oct 22.
The use of aminoglycosides has decreased dramatically over several decades in the United States due to the introduction of safer Gram-negative agents. This study was conducted to assess possibly changing aminoglycoside susceptibility rates between 2006 and 2012 and in reference to 1992 use in the context of aminoglycoside use volume.
Quarterly adult use of amikacin, gentamicin and tobramycin were determined from the Medical University of South Carolina Medical Center, Charleston, South Carolina, USA, pharmacy drug use database and expressed as total aminoglycoside defined daily doses per 1,000 patient days for the years 1992 and 2006 through 2012. Annual susceptibility of Pseudomonas aeruginosa, Escherichia coli, and Klebsiella pneumoniae, for the years 1992, 2006, and 2008 through 2012 were retrieved from our hospital's clinical microbiology database (duplicate isolates were excluded). Quarterly and annualized aminoglycoside usage rates were compared to the other years of interest. Likewise, susceptibility rates of the target organisms to each aminoglycoside were also compared across the same timeframe.
While total use of aminoglycosides decreased slightly from 1992 to 2006, it increased by about 40% between 2006 and 2008 and then stabilized. Changes in susceptibility rates between 1992 and 2006 were all ≤±9% with the exception of K. pneumoniae susceptibility to amikacin (-17%). Changes in susceptibility from 1992 to 2012 were also all ≤±9%. Tobramycin remained the most active versus P. aeruginosa (% susceptible = 90), while amikacin remained most active versus E. coli and K. pneumoniae (% susceptible = 98 and 98, respectively).
With low level use of aminoglycosides in our institution over the past 2 decades, the susceptibility of key Gram-negative pathogens has remained relatively stable, preserving these agents as potential alternative therapies as resistance arises to other frequently used antibiotics.
几十年来，由于更安全的革兰氏阴性药物的引入，美国氨基糖苷类药物的使用量大大减少。本研究旨在评估 2006 年至 2012 年期间氨基糖苷类药物敏感性可能发生的变化，并参考 1992 年的氨基糖苷类药物使用量来评估。
从美国南卡罗来纳医科大学查尔斯顿医疗中心的药房药物使用数据库中确定了成人每季度使用阿米卡星、庆大霉素和妥布霉素的情况，并将其表示为 1992 年和 2006 年至 2012 年每 1000 个患者天的总氨基糖苷类药物定义日剂量。从我们医院的临床微生物学数据库中检索了 1992 年、2006 年和 2008 年至 2012 年期间铜绿假单胞菌、大肠埃希菌和肺炎克雷伯菌的年度敏感性（排除重复分离株）。将每季度和每年的氨基糖苷类药物使用率与其他感兴趣的年份进行比较。同样，在同一时间范围内，还比较了目标生物体对每种氨基糖苷类药物的敏感性。
虽然氨基糖苷类药物的总用量从 1992 年到 2006 年略有下降，但从 2006 年到 2008 年增加了约 40%，然后趋于稳定。1992 年至 2006 年之间的敏感性变化均≤±9%，除肺炎克雷伯菌对阿米卡星的敏感性下降 17%外。1992 年至 2012 年之间的敏感性变化也均≤±9%。妥布霉素对铜绿假单胞菌的活性最强（%敏感=90），而阿米卡星对大肠埃希菌和肺炎克雷伯菌的活性最强（%敏感=98 和 98）。
在过去 20 年中，我院氨基糖苷类药物的使用量较低，关键革兰氏阴性病原体的敏感性保持相对稳定，在其他常用抗生素产生耐药性时，这些药物仍可作为潜在的替代治疗药物。
Zotero 插件