[Development of resistance and utilization of fluoroquinolones in a university hospital].

The results of a retrospective study in the Faculty Hospital, Hradec Králové (FHHK) show a steep increase in the consumption of fluoroquinolones in the course of six years. Since 1989, when 360 defined daily doses (DDD) were administered, the consumption increased to 2,825 DDDs in 1992 and 52,162 DDDs in 1995. At the same time, resistance to ofloxacine and ciprofloxacine was increased many times in some bacterial species isolated from patients admitted to FHHK. In the strains Pseudomonas aeruginosa, resistance to ofloxacine increased from 3% to 38% in 1995, in Serratia marcescens from 13% in 1992 to 30% in 1995. A marked increase was observed also in Acinetobacter calcoaceticus. In the naturally highly sensitive species E. coli and Klebsiella pneumoniae no increase in resistance has been observed yet, in Enterobacter cloaceae resistance slightly increased (from 0% in 1992 to 7% in 1995). Due to the fact that in FHHK fluoroquinolones take the first place in the consumption of antibiotics at present, an increase in resistance can be expected also in these bacteria in the future. Investigation of changes in resistance due to the consumption of fluoro-quinolones is a suitable model of a pharmacoepidemiological study (DUE-Drug Utilisation Evaluation) as the relationship of the consumption of a drug and its effect can be observed practically since the introduction of fluoroquinolones into the market.