Analysis Of Antibiotic Drug Usage In Respiratory Department Of Our Hospital During 2003～2007

Background The problem of bacterial resistance has become the focus of the global. The mechanisms of bacterial resistance is complex and irrational drug use is the basic reason of bacterial resistance. The inappropriate initial administration can lead to infection control negative and bacterial resistance. So Empiric Therapy plays a crucial role in anti-infection treatment of respiratory department. The antibiotic de-escalation therapy is a Empiric Therapy base on evidence-based medicine. That avoids repeated change drug and assurance the treatment efficacy.Objective To establish the monitor database about the antibiotic use and the bacterial resistance in respiratory department of the Chinese PLA general hospital,then analysis and study the data of the change about the antibiotic consumption and bacterial distribution in respiratory department nearly 5 years for instructing rational application of antibiotics clinically and reduce the level of bacterial resistance.Methods 1.A retrospective cohort study was conducted on patients with infection and using antibiotics from Jan2003 to Dec 2007 in respiratory department of the Chinese PLA general hospital.2.All the medical chart review was conducted and extracted related data,involving more than 20 variables.3.An electronic surveillance systems was designed using antibiotic and microbiologic culture utilization data to analysis the relationship of them and to calculate the DDDs.Then statistical analysisthe change of the infectious disease distribution,the antibiotics consumption,the relation between disease and drug consumption.Results The predominant bacteria was Gram-negative bacteria,which mainly included Neisseria pseudomonas aeruginosa,Bauamnnii haemolyticus, Esch-erichia coli,Klebsiella pneumoniae. Gram-positive bacteria mainly included Streptococcus viridans , Staphylococcus aureus , Staphylococcus epidermidis. The antibiotics of the largest consumption in respiratory department were cephalosporin/β-lactamase inhibitors, laevomycetin/β-lactamase inhibitors, carbapenem and polypeptide antibiotics remained at a relatively low level.Conclusion The predominant bacteria was Gram-negative bacteria,which mainly included Neisseria pseudomonas aeruginosa,Bauamnnii haemolyticus, Esch-erichia coli,Klebsiella pneumoniae. Gram-positive bacteria mainly included Streptococcus viridans, Staphylococcus aureus, Staphylococcus epidermidis.We have not yet found resistant Staphylococcus aureus and enterococci. Sputum culture, which is interfere with normal bacterium, is not enough to find the pathogenic bacteria .so the Empiric Therapy is more important. The antibiotics of the largest consumption in respiratory department were cephalosporin/β-lactamase inhibitors, laevomycetin/β-lactamase inhibitors, carbapenem and polypeptide antibiotics remained at a relatively low level. Theβ-lactamase antibiotic is the mainly effective drug to therapy infection.