OBJECTIVES

The objectives of the study were to determine the antibiotic consumption of restricted antibiotics and to correlate this with resistance rate.

A retrospective review of pharmacy dispensing records was conducted in the adult internal medicine wards of a tertiary level teaching hospital in the Philippines between March 2019 to February 2020. Antibiotic consumption was determined using Defined Daily Dose (DDD) per 1000 patient-days (PD). Correlations between antibiotic consumption and antibiotic resistance of restricted antibiotics were done. Outcomes were compared between Ward 1 (with the presence of a unit-dose pharmacist) and Ward 3 (without a unit-dose pharmacist).

Both wards showed decreasing trends of piperacillin-tazobactam consumption and increasing trends of ceftazidime consumption from quarter 1 to quarter 4. It was observed that levofloxacin was the most prescribed fluoroquinolone with the highest consumption recorded from March to May 2019 in Ward 3 of 350.2 DDD/1000 PD as compared with ciprofloxacin which has the highest consumption (23.3 DDD/1000 PD) during the period June to August 2019 in Ward 1. Antibiotic resistance of Acinetobacter baumannii against ciprofloxacin, levofloxacin, and piperacillin-tazobactam were statistically significantly different between the wards. In Ward 1, ciprofloxacin consumption was strongly positively correlated with Escherichia coli resistance (r = 0.90). In Ward 3, a significantly moderately positive association was observed for ceftazidime consumption and A. baumannii resistance (r = 0.61), positive correlation between piperacillin-tazobactam and E. coli resistance (r = 0.65), and a strong positive correlation in Ward 3 between levofloxacin and Pseudomonas aeruginosa resistance (r = 0.71).

The restriction and pre-authorization strategy of the AMS program has greatly contributed to the decrease in the consumption of almost all restricted antibiotics. This strategy has been helpful in minimizing unnecessary antibiotic use associated with inappropriate drug therapy. The success of the AMS program has been based on the collective efforts of the AMS team with the implementation of hospital policies, such as the AMS program, across the different sites in the hospital in order to achieve optimum patient health outcomes. It was noted that the resistance rates of A. baumannii against ciprofloxacin, levofloxacin, and piperacillin-tazobactam were higher in Ward 3 compared to Ward 1 which makes infections very difficult to treat which may result to prolonged hospital stay, increased health-care costs and increased mortality rate. This study has supported the involvement of pharmacists in the AMS team by conducting auditing activities that promote safe compliance of restricted antibiotic use among patients. Pharmacists can greatly participate on either prospective or retrospective review of antibiotic utilization and analyze trends of antibiotic consumption data to provide feedback to prescribing physicians on prescribing patterns and possible correlation with occurrence of antibiotic resistance.

No Abstract Available.
Drug Resistance* ; Korea*

Background: Reasonably and safe antibiotic uses not only benefit patients, but also limit the development of antibiotic-resistant bacteria. Objectives: To total up all antibiotics and their brand names used at Viet Duc Hospital; To describe and preliminarily evaluate the uses of antibiotics according to Altemeier classification. Subjects and method: The cross-sectional study was caried out on all patients at 11 clinical departments, who were treated by antibotics. Review medical records for information of antibiotic use and some related factors (pre-operative and post-operative diagnoses, kind of operations, type of operation according to Altemeier classification). Results and Conclusion: There were 9 classes of antibiotics with 25 antibiotics and 31 bran names used in Viet Duc Hospital. Antibiotics of beta-lactam class and imidazol were most commonly used. The rate of antibiotic prophylaxis was low, although clean wounds have been used many strong antibiotics such as cephalosporin III. In infected wounds, combination of Cefotaxom + Flagyl was used more common, but it notes that the situation of production ESBLs by bacteria was rather high in hospital settings. Microbiological tests weren\u2019t applied widely for infected operations.
Drug Resistance ; Bacterial ;

The definitive diagnosis of nasopharyngeal carcinoma (NPC) depends on the examination of tissue or cells obtained from either the primary site or a metastatic focus. 1120 patients suffering from NPC were reviewed. 880 patients (76.52%) had fine needle aspiration (FNA) in cervical lymph nodes (positive: 84.83%, Se: 95.52%, Sp: 100%, PV(+): 100%, PV(-):57.14%, A:94.37%) 132 patients (11.79%) performed on smears collected from biopsy tissue (positive rate: 63.64%, Se: 84%, SP: 100%, PV(+): 100%, PV(-): 66.67%, A: 87.88%.
Cross Infection ; Drug Resistance

119 isolates of Shigella with multi-drug resistant (100 Shigella flexneri) to chloramphenicol (Cm), ampicillin (Ap), tetracyclin (Te), trimethoprim (Tr), sulfamethoxazole (Su) from Northern, Central and Southern regions of Viet Nam during a period of 1995-1997 were investigated for the ability to transfer gene trains by method of conjugation. 59.2% strains were transferable in vitro to E.coli K12 with frequence from 10-7 to 10-5 (65.8% strains from Northern, 54.8% strains from Central and 57.5% strains from Southern regions). Almost all the antibiotic resistance genes were transfered with 10 different patterns of resistance; Ap, Tr, Su being the most frequent patters: 45.7% strains fro Northern, 30.8% strains from Southern and 25.6% strains from Central regions.
Drug Resistance ; shigella

Outline on the antibiotic resistance of Streptococcus pneumoniae isolated during 1989-1995 in Viet Nam based on the data of antimicrobial susceptibility tests of NIHE and ASTS project. Comparing to the data from countries in South East Asis/India we found that: Str.pneumoniae is still susceptible to benzylpenicillin. B-lactams, macrolides, chloramphenicol. In many countries the reported incidence of drug-resistant Str.Pneumoniae has increased in the last year. The frequency and patterns of resistance vary in different geographic regions, countries and over different periods.
Drug Resistance ; Streptococcus pneumoniae

129 isolates of S.typhi multi-drug resistant to Cm, Ap, Te, Tr, Su from Northern, Southern and Central regions of Vietnam during 1995-1997 were examined to detect the ability to transfer gene encoding the resistance to antibiotics and to study molecular characters of it’s R-plasmids. Results indicated the presence of self-transferable plasmid in 90% S.typhi strains from Southern, and 100% strains from Northern and Central regions. These strains carried from 1 to 2 plasmids of molecular weighed 110 MD and 80 MD. Gene encoding the resistance to Cm, Ap, Te, Tr, and Su were found to be located on a large plasmid of 100 MD. All S.typhi strains from 3 regions showed to have large plasmids with identical molecular structure, this indicated the same origin of these S.typhi strains.
Drug resistance ; Salmonella typhi

126 multiply resistant S.typhi isolates were screened among 363 isolates collected from Northern, Central and Southern regions of Vietnam during the period 1995-1997. Transfer experiments of the resistance to E.coli K12-J53 from these S.typhi isolates were performed to determine their transferable capacity of resistance factors and its frequency. The results indicated that 74.78% of multiply resistant S.typhi isolates (AM, CL, TE, TR, SU) have R-factors, most of them contained all resistance genes characterizing the resistance of wild strains. The frequency of transfer of the resistance varied from 10-5 to 10-8.
Drug resistance ; Salmonella typhi

252 pathogenic bacterial strains have been isolated in Friendship hospital in 1997. Almost strains (66%) are gram negative. The majority of bacteria that caused urinary tract infection are gram negative rods. Gram positive cocci are predominant in the strains isolated from pus, exudates. All strains are tested for antibiotic sensitivity. Enterobacteriaceae are still sensitive to the third generation of cephalosporin, morfloxacin, gentamyxin, netilmixin. Pseudomonas aeruginosa are only sensitive to Amikaxin. Staphylococcus aureus are resistant to oxacillin in high level (54.6%), but still susceptible to bactrim, gentamyxin, vancomyxin.
Bacterial Infections ; drug resistance

No abstract available.
Cholangitis ; Drug Resistance, Microbial