Author/Editor		Šibanc, Branko; Lešničar, Gorazd; Čretnik-Žohar, Tjaša; Tratar, Franci; Štorman, Alenka
Title		Vpliv nadzorovanega predpisovanja protibakterijskih zdravil na odpornost bakterij v Splošni bolnišnici Celje
Translated title		The influence of controlled antibacterial prescribing on bacterial resistance at General hospital Celje
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 43, št. Suppl 2
Publication year		2004
Volume		str. 53-60
Language		slo
Abstract		Bacterial antibacterial drugs resistance and antibacterial drugs consumption were investigated at the General Hospital Celje. During observed period, the usage of antibacterial drugs for systemic use, expressed as the defmed daily dose per 100 bed days, increased from 50,73 DDD/100 BD in 1995 to 73,8 DDD/100 BD in 2002. The greatest increase in use was in the penicilin group, the usage of cephalosporins decreased overall. The usage of fluoroquinolones and macrolides increased gradually throughout the study period, while usage of aminoglycosides decreased. The relationships between antibacterial drug use and bacterial susceptibility showed different patterns. The investigation showed a decrease in amoxicyllin/clavulanic acid resistance of Escherichia coli and Klebsiella pneumoniae despite the increase of its use. The increased ciprofloxacin resistance of Pseudomonas aeruginosa and Acinetobacter spp. was followed by increased consumption of quinolones. The analysis of resistance levels and antibacterial drugs consumption in the present study suggest different mechanisms for increased resistance. The significant trend of increased resistance to antibiotics over time constitutes an important warning system.
Summary		V Splošni bolnišnici Celje smo preučevali bakterijsko protimikrobno odpornost in porabo protibakterijskih zdravil. Poraba sistemskih protibakterijskih zdravil, izražena v dnevnih definiranih odmerkih na sto bolnišnično oskrbnih dni (DDD/100 BOD), je v času opazovanja porasla s 50,73 DDD/100 BOD v letu 1995, na 73,83 DDD/100 BOD v letu 2002. Pri tem je bil največji porast porabe v skupini penicilinskih antibiotikov, medtem ko je skupna poraba cefalosporinov upadla. Tekom študije smo opazovali vztrajen porast porabe kinolonov in makrolidov, medtem ko se poraba aminoglikozidov še zmanjšuje. Odnosi med porabo protibakterijskih zdravil in bakterijsko odpornostjo kažejo različne vzorce. Tako kljub večji porabi amoksicilin/klavulanske kisline opazujemo zmanjšanje odpornosti bakterij Escherichia coli in Klebsiella pneumoniae proti temu zdravilu. Poraba kinolonov narašča, z njo pa opazujemo tudi vzporedni porast odpornosti bakterij Pseudomonas aeruginosa in Acinetabacter spp. proti ciprofloksacinu. Analiza odvisnosti bakterijske odpornosti glede na porabo protibakterijskih zdravil nakazuje različne mehanizme pridobivanja bakterijske odpornosti. Spremljanje trendov naraščanja bakterijske odpornosti proti protibakterijskim zdravilom lahko predstavlja mehanizem sprožanja ustreznih protiukrepov.
Descriptors		ANTIBIOTICS DRUG RESISTANCE, MICROBIAL DRUG UTILIZATION REVIEW HOSPITALS, GENERAL PENICILLINS