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一个国家内抗菌药物消费与耐药性的差异：以阿根廷的β-内酰胺类药物为例。

Disparities in antimicrobial consumption and resistance within a country: the case of beta-lactams in Argentina.

作者信息

Boni Silvia, Marin Gustavo H, Campaña Laura, Marin Lupe, Corso Alejandra, Risso-Patron Soledad, Gabriel Fernanda, Garay Valeria, Limeres Manuel

机构信息

National Administration of Drugs, Food and Technology Buenos Aires Argentina National Administration of Drugs, Food and Technology, Buenos Aires, Argentina.

National University La Plata-CUFAR-CONICET La Plata Argentina National University La Plata-CUFAR-CONICET, La Plata, Argentina.

出版信息

Rev Panam Salud Publica. 2021 Jul 26;45:e76. doi: 10.26633/RPSP.2021.76. eCollection 2021.

DOI:10.26633/RPSP.2021.76
PMID:34322161
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8312146/
Abstract

OBJECTIVE

To describe bacterial resistance and antimicrobial consumption ratio at the subnational level in Argentina during 2018, considering beta-lactams group as a case-study.

METHODS

Antimicrobial consumption was expressed as defined daily doses (DDD)/1000 inhabitants. Resistance of and to beta-lactams was recorded. Resistance/consumption ratio was estimated calculating "R" for each region of Argentina, and this data was compared with other countries.

RESULTS

The most widely consumed beta-lactams in Argentina were amoxicillin (3.64) for the penicillin sub-group, cephalexin (0.786) for first generation cephalosporins, cefuroxime (0.022) for second generation; cefixime (0.043) for third generation and cefepime (0.0001) for the fourth generation group. Comparison between beta-lactams consumption and bacterial resistance demonstrated great disparities between the six regions of the country.

CONCLUSIONS

The case-study of Argentina shows that antimicrobial consumption and resistance of the most common pathogens differed among regions, reflecting different realities within the same country. Because this situation might also be occurring in other countries, this data should be taken into account to target local efforts towards better antimicrobial use, to improve antimicrobial stewardship programs and to propose more suitable sales strategies in order to prevent and control antimicrobial resistance.

摘要

目的

以β-内酰胺类药物为例，描述2018年阿根廷国内各地区的细菌耐药性及抗菌药物消耗率。

方法

抗菌药物消耗量以限定日剂量（DDD）/每千居民表示。记录肺炎链球菌和金黄色葡萄球菌对β-内酰胺类药物的耐药情况。通过计算阿根廷各地区的“R”来估算耐药/消耗率，并将此数据与其他国家进行比较。

结果

阿根廷使用最广泛的β-内酰胺类药物中，青霉素亚组的阿莫西林（3.64）、第一代头孢菌素的头孢氨苄（0.786）、第二代的头孢呋辛（0.022）、第三代的头孢克肟（0.043）以及第四代的头孢吡肟（0.0001）。β-内酰胺类药物消耗量与细菌耐药性之间的比较显示，该国六个地区之间存在巨大差异。

结论

阿根廷的案例研究表明，各地区最常见病原体的抗菌药物消耗量和耐药性有所不同，反映了同一国家内不同的实际情况。由于其他国家可能也存在这种情况，应考虑这些数据，以便针对当地情况努力改善抗菌药物的使用，完善抗菌药物管理计划，并提出更合适的销售策略，以预防和控制抗菌药物耐药性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b5a/8312146/1ec690eaed3b/rpsp-45-e76_Figure4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b5a/8312146/8c43d42b840e/rpsp-45-e76_Figure1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b5a/8312146/5207af208e1c/rpsp-45-e76_Figure2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b5a/8312146/f97cdcd6bd0a/rpsp-45-e76_Figure3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b5a/8312146/1ec690eaed3b/rpsp-45-e76_Figure4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b5a/8312146/8c43d42b840e/rpsp-45-e76_Figure1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b5a/8312146/5207af208e1c/rpsp-45-e76_Figure2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b5a/8312146/f97cdcd6bd0a/rpsp-45-e76_Figure3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b5a/8312146/1ec690eaed3b/rpsp-45-e76_Figure4.jpg

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