| Objective This study was conducted to evaluate the relationship between antimicrobial resistance and antimicrobial usage and the effect of the antimicrobial interventional treatment; The optimum cycle to monitor the the data on antimicrobial susceptibility and adjust the use of antibiotics were researched.Methods A cross section investigetion method was used to survey the date. In a 260-bed department of a university hospital, We implemented antimicrobial intervetion stratigies and also monitored the data on the quarterly patient-days and the quarterly consumption (defined daily dose (DDD) per 1000 patient days) the consumption of antibiotics of extended-spectrum cephalosporins ( cefotaxime,ceftriaxone, ceftazidime,ceftizoxime,cefpiramid,cefmenoxime,cefodizime,cefoperazone,cefixime,cefepime,latamoxef) ,β-lactam-β-lactamase inhibitor combinations (ampicillin/sulbactam,piperacillin/tazobactam,Cefoperazone/sulbactam), carbapenems(imipenem,meropenem),fluoroquinolone(ciprofloxacin,oflo-xacin,levofloxacin,norfloxacin,lomefloxacin,fleroxacin,sparfloxacin,mox- ifloxacin,gatifloxacin,pazufloxacin,enoxacin)from 2002.10 to 2006.6 were analysed. Disk susceptibility data of Pseudomonas aeruginosa(PA), Klebsiella pneumoniae(KP), Acinetobacter spp. (AC), Escherichia coli(ECO), Enterobacter cloacae(ECL) causing nosocomial infections were evaluated.The timely antimicrobial interventional treatment was based on the outcome of antimicrobial susceptibility.Results (1)Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter spp., Escherichia coli, Enterobacter cloacae are the main Gram-negative bacilli causing nosocomial infections in our department. (2)The quarterly patient-days of our department significantly increased from 19240 in the fourth quarter of 2002 to 21722 in the second quarter of 2006 (P<0.05). The all consumption of extended-spectrum cephalo -sporins, fluoroquinolones,β-lactam-β-lactamase inhibitor combinations and carbapenems did not significantly increased by the quarter.(3)We restricted the consumption of aminoglycosides and controlled the use of carbapenems, ciprofloxacin, cefotaxime, ceftazidime and ampicillin/ sulbactam.We reduced the usage of levofloxacin, cefoperazone, ceftizoxime and increased the consumption of piperacillin/tazobactam, cefepime, cefpiramid, pazufloxacin and latamoxef(p<0.05).(4) Decreasing trends of imipenem-susceptible, meropenem-susceptible AC and cefepime-susceptible,piperacillin/tazobactam-susceptible ECO.However, Increasing trends of amikacin-susceptible, ceftazidime-susceptible,cefe- pime-susceptible and imipenem- susceptible PA were noted from 2003 to 2006 (P<0.05). (5)The fall in cefepime-susceptible ECO was significantly correlated with increased consumption of cefepime (p<0.001) ,cefpiramid(p<0.01) , pazufloxacin (p<0.01) ;The fall in piperacillin/tazobactam-susceptible ECO was significantly correlated with increased consumption of piperacillin/ tazobactam (p<0.01) , cefepime (p<0.001) , ciprofloxacin(p<0.001) ; The fall in imipenem-susceptible AC was significantly correlated with increased consumption of cefpiramid and pazufloxacin(p<0.01) .Conclution (1) This study in a hospital demonstrated significant changes in antimicrobial use, which may have affected antimicrobial susceptibility in certain Gram-negative bacteria at the hospital; (2)We suggest that the cycle we monitor the the data on antimicrobial susceptibility and adjust the use of antibiotics be not more than one quarter in a department; (3)The consumption of one antibiotic should be not more than 3 times between two adjacent quarters in a department; (4) It is very indispensable and feasible to implement antimicrobial intervetional stratigies with institute characteristics to guide the use of antibiotics. Implementation of long-range, appropriate and synthetical antimicrobial intervetion stratigies to control antimicrobial use and optimize the duration of empirical therapy appears to help control antimicrobial resistance rates in certain Gram-negative bacteria at the hospital.
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