Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Sep;59(3):469-479.
doi: 10.20471/acc.2020.59.03.11.

Antibiotic Consumption in Hospitals and Resistance Rate of Klebsiella pneumoniae and Escherichia coli in Montenegro

Gordana Mijović  1 , Lidija Čizmović  1 , Mirjana Nedović Vuković  1 , Siniša Stamatović  1 , Milena Lopičić  1
Affiliations

Antibiotic Consumption in Hospitals and Resistance Rate of Klebsiella pneumoniae and Escherichia coli in Montenegro

Gordana Mijović et al. Acta Clin Croat. 2020 Sep.

Abstract

Inappropriate use of antibiotics leads to an increase in antibiotic resistance. Infections caused by antibiotic-resistant gram-negative bacteria are a serious threat to public health. This study aimed to compare data on inpatient antibiotic consumption with antimicrobial resistance (AMR) rate of Klebsiella pneumoniae and Escherichia coli invasive strains in Montenegro and provide targets for improving antibiotic use. We used the national data on antibiotic consumption from 2009 to 2015, Point Prevalence Survey data on inpatient antibiotic consumption from 2015, and national AMR data on 79 Klebsiella pneumoniae and 68 Escherichia coli isolates collected from 8 hospitals from 2016 to 2018. The most commonly used antibiotics were third-generation cephalosporins with a median annual consumption of 0.66 DDD/1000/day. Ceftriaxone was the most frequently prescribed antibiotic in the treatment of community/hospital acquired infections and surgical/medical prophylaxis. The highest resistance rates were recorded for Klebsiella pneumoniae to ceftriaxone, ceftazidime and gentamicin (93.59%, 90.79% and 89.87%, respectively), and Escherichia coli to aminopenicillins, ceftriaxone and ceftazidime (89.06%, 70.15% and 61.54%, respectively). High consumption of broad-spectrum antibiotics in Montenegro is accompanied by the high rate of resistance of Klebsiella pneumoniae and Escherichia coli to these agents. Antibiotic misuse demands the introduction of an antimicrobial stewardship program in Montenegrin hospitals.

Keywords: Antibiotics, consumption; Antibiotics, resistance; Escherichia coli; Klebsiella pneumoniae; Montenegro.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Inpatient antibiotic consumption in Montenegro 2009-2015 (p=0.946).
Fig. 2
Fig. 2
Inpatient use of antibiotics according to indication (source: Point Prevalence Survey conducted in Montenegro in 2015).
Fig. 3
Fig. 3
Antibiotic use according to type of treatment and indications (source: Point Prevalence Survey conducted in Montenegro in 2015). CAI = community acquired infections; HAI = hospital acquired infections
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Toner E, Adalja A, Gronvall GK, Cicero A, Inglesby TV. Antimicrobial resistance is a global health emergency. Health Secur. 2015;13(3):153–5. 10.1089/hs.2014.0088 - DOI - PMC - PubMed
    1. Van Boeckel TP, Gandra S, Ashok A, Caudron Q, Grenfell BT, Levin SA, et al. Global antibiotic consumption 2000 to 2010: an analysis of national pharmaceutical sales data. Lancet Infect Dis. 2014;14:742–50. 10.1016/S1473-3099(14)70780-7 - DOI - PubMed
    1. Versporten A, Zarb P, Caniaux I, Gros MF, Drapier N, Miller M, et al. on behalf of the Global-PPS network. Antimicrobial consumption and resistance in adult hospital inpatients in 53 countries: results of an internet-based global point prevalence survey. Lancet Glob Health. 2018;6(6):e619–29. 10.1016/S2214-109X(18)30186-4 - DOI - PubMed
    1. Kritsotakis EI, Gikas A. Surveillance of antibiotic use in hospitals: methods, trends and targets. Clin Microbiol Infect. 2006;12(8):701–4. 10.1111/j.1469-0691.2006.01415.x - DOI - PubMed
    1. Štefkovičová M, Litvová S, Meluš V, Krištúfková Z, Bražinová A. Point prevalence study of antimicrobial usage in acute care hospitals in the Slovak Republic. J Hosp Infect. 2016;93(4):403–9. 10.1016/j.jhin.2016.02.017 - DOI - PubMed

Substances