Correlation between Antibiotic Resistance of Main Gram-Negative Pathogens and Antibiotic Consumption in a General Hospital of China

Abstract Purpose Our hospital is a newly established hospital in China, which is located in the tropics. Better depicting antibiotic consumption and antibiotic resistance may help better develop and implement an antibiotic stewardship with regional characteristics.Methods Total antibiotic prescriptions, patient days and microbiological data from January 2014 to December 2017 were collected. Antibiotic use density (AUD) was expressed as daily defined dose (DDD) and normalized per 100 patient-days. The resistance rates of Gram-negative pathogens against commonly used antibiotics were calculated. The relationship between antibiotic consumption and bacterial resistance rate was described by Pearson’s correlation coefficient.Results Different from mainland China, A. baumannii was the leading Gram-negative pathogen, followed by K. pneumoniae , E. coli and P. aeruginosa . The AUD was gradually increased from 2014 to 2016, while it was slowly decreased in 2017. Ceftazidime/tazobactam, levofloxacin and meropenem were the top three consumed antibiotics. The proportion of multidrug resistant (MDR) Gram-negative bacteria was increased (>40%) before 2016, and it was decreased in 2017. The prevalence of MDR A. baumannii and MDR P. aeruginosa was correlated with the AUD of β-lactam/lactamase inhibitors, fluoroquinolones and carbapenems. The increased AUD of meropenem had positive effects on the incidence of carbapenem-resistant A. baumannii and P. aeruginosa .Conclusions Our study showed that there was an association between the resistance density of Gram-negative pathogens and the consumption of β-lactam/lactamase inhibitors, carbapenems and fluoroquinolones. Collectively, a multifaceted antimicrobial stewardship is necessary to decrease resistance density of available antibiotics.