Effect On Antimicrobial Resistance Of Pathogens By Antimicrobial Stewardship Application In Intensive Care Unit Of A Tertiary Hospital

Subject To evaluate the effect of applying antimicrobial stewardship in our hospital, including the state of antimicrobial usage and antibiotic resistance of the common Pathogenic bacteria in our intensive care unit. Method The Affiliated Hospital of Taishan Medical College is a tertiary teaching hospital with 700 beds. From August in 2011, antimicrobial stewardship strategies were put into practice, including formulary restrictions, preauthorization requirements, preoperative quinolone restriction and control of total antibiotic consumption. Collect the demographic and clinical data of patients (2010-2013) hospitalized in ICU and the quarterly antibacterial use density and Percentage (%) of isolates resistant. Analyze the data with SPSS 11.0 to evaluate the state of antimicrobial usage and antibiotic resistance of the common Pathogenic bacteria in our intensive care unit, including Escherichia coli,Klebsiella pneumoniae Pseudomonas aeruginosa,Acinetobacter baumannii and Staphylococcus aureus.Result From2010 to 2013,the percentage of using antibiotics before ICU decreased significantly, the antibacterial use density declined from 163.46DDDs per 100 patient-days(2010)and 190.01 DDDs per 100 patient-days(2011) tol 14.36 DDDs per 100 patient-days(2012) and 96.4 DDDs per 100 patient-days(2013).The consumption of other Beta-Lactams,Aminoglycosides, Macrolides, Quinolones and Imidazoles decreased significantly(P<0.05).The antibiotic resistance of the common Pathogenic bacteria improved widely. While, compared the data of 2012 and 2013,the state was not so good. Only E.coli resistant to Amikacin, P aeruginosa resistant to Ciprofloxacin, S aureus resistant to Oxacillin. Kpneumonia decreased significantly (P<0.05) except A baumannii. K pneumoniae resistant to Ampicillin/Sulbactam increased On the contrary. Conclusion The antimicrobial consumption decreased,the constitution of the Antimicrobial agents tended to be more reasonable and the antibiotic resistance of the common Pathogenic bacteria improved widely after applying antimicrobial stewardship in the intensive care unit of our hospital from 2010 to 2013.While,compared the data of 2012 and 2013,the state was not so good. K pneumoniae resistant to Ampicillin/Sulbactam increased On the contrary. So the long-term effect of antimicrobial stewardship consist of formulary restrictions mainly is not clear. Making the usage of Antimicrobial agents more reasonable and the deterioration rate of antibiotic resistance slow down is easier to implement. A more wide and long-term evaluation is necessary to antimicrobial stewardship.