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
. 2023 Jan 28;12(2):259.
doi: 10.3390/antibiotics12020259.

Impact of Antibiotic Consumption on Antimicrobial Resistance to Invasive Hospital Pathogens

Deana Medic  1   2 , Bojana Bozic Cvijan  3 , Milica Bajcetic  3   4
Affiliations

Impact of Antibiotic Consumption on Antimicrobial Resistance to Invasive Hospital Pathogens

Deana Medic et al. Antibiotics (Basel). .

Abstract

The aim of our investigation is to correlate the wholesale data on antibiotic consumption expressed in daily doses per 1000 inhabitants per day (DID) with the resistance rate of invasive pathogen bacteria from 2017 to 2021. The data on antimicrobial resistance were collected from an analysis of the primary isolates of hospitalized patients. According to the CAESAR manual, the selected pathogens isolated from blood culture and cerebrospinal fluids were tested. The consumption of antibiotics for systematic use showed a statistically significant increasing trend (β = 0.982, p = 0.003) from 21.3 DID in 2017 to 34.5 DID in 2021. The ratio of the utilization of broad-spectrum to narrow-spectrum antibiotics increased by 16% (β = 0.530, p = 0.358). The most consumed antibiotic in 2021 was azithromycin (15% of total consumption), followed by levofloxacin (13%) and cefixime (12%). A statistically positive significant correlation was discovered between the percentage of resistant isolates of K. pneumoniae and consumption of meropenem (r = 0.950; p = 0.013), ertapenem (r = 0.929; p = 0.022), ceftriaxone (r = 0.924; p = 0.025) and levofloxacin (r = 0.983; p = 0.003). Additionally, the percentage of resistant isolates of E. coli and consumption of ertapenem showed significant correlation (r = 0.955; p = 0.011). Significant correlation with consumption of the antibiotics widely used at the community level, such as levofloxacin, and resistance isolated in hospitals indicates that hospital stewardship is unlikely to be effective without a reduction in antibiotic misuse at the community level.

Keywords: antibiotics; consumption; pathogen; resistance.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Total consumption of antibiotics for systemic use according to WHO AWaRe classification, percentage by class from 2017 to 2021.
Figure 2
Figure 2
The correlation of meropenem consumption and the resistance to meropenem in bacteria during 2017–2021.
Figure 3
Figure 3
The correlation of ceftriaxone consumption and the resistance to ceftriaxone in bacteria during 2017–2021.
Figure 4
Figure 4
The correlation of ertapenem consumption and the resistance to ertapenem in bacteria during 2017–2021.
Figure 5
Figure 5
The correlation of levofloxacin consumption and the resistance to levofloxacin in bacteria during 2017–2021.
See this image and copyright information in PMC

References

    1. Hou J., Long X., Wang X., Li L., Mao D., Luo Y., Ren H. Global trend of antimicrobial resistance in common bacterial pathogens in response to antibiotic consumption. J. Hazard. Mater. 2023;442:130042. doi: 10.1016/j.jhazmat.2022.130042. - DOI - PubMed
    1. Antimicrobial Resistance Collaborators Global burden of bacterial antimicrobial resistance in 2019: A systematic analysis. Lancet. 2022;399:629–655. doi: 10.1016/S0140-6736(21)02724-0. - DOI - PMC - PubMed
    1. Rizk N.A., Moghnieh R., Haddad N., Rebeiz M.C., Zeenny R.M., Hindy J.R., Orlando G., Kanj S.S. Challenges to Antimicrobial Stewardship in the Countries of the Arab League: Concerns of Worsening Resistance during the COVID-19 Pandemic and Proposed Solutions. Antibiotics. 2021;10:1320. doi: 10.3390/antibiotics10111320. - DOI - PMC - PubMed
    1. WHO Regional Office for Europe Antimicrobial Medicines Consumption (AMC) Network: AMC Data 2014–2018. [(accessed on 15 November 2022)]. Available online: https://apps.who.int/iris/bitstream/handle/10665/342930/9789289055567-en....
    1. Šuljagić V., Bajčetić M., Mioljević V., Dragovac G., Mijović B., Janićijević I., Đorđević Z., Krtinić G., Rakić V., Ćirković I., et al. A nationwide assessment of the burden of healthcare-associated infections and antimicrobial use among surgical patients: Results from Serbian point prevalence survey, 2017. Antimicrob. Resist. Infect. Control. 2021;10:47. doi: 10.1186/s13756-021-00889-9. - DOI - PMC - PubMed

LinkOut - more resources