骨科抗菌药物使用强度与细菌耐药率的变化趋势研究

目的 研究骨科抗菌药物使用强度与临床常见致病菌耐药率的变化趋势.方法 采用能够准确反映抗菌药物使用强度的DDD/(100人·d)对2006-2009年医院骨科抗菌药物使用情况进行了统计,并分析同期常见致病菌耐药的变化趋势.结果 头孢地嗪的使用强度2006-2009年分别为7.81、7.66、2.92和0.84,呈下降趋势,大肠埃希菌、鲍氏不动杆菌、铜绿假单胞菌和金黄色葡萄球菌对头孢地嗪的耐药率也出现了相应的下降；头孢哌酮/舒巴坦的使用强度分别为3.92、3.55、3.40和0.90,2009年下降幅度较大,2009年大肠埃希菌、鲍氏不动杆菌、铜绿假单胞菌和金黄色葡萄球菌对头孢哌酮/舒巴坦的耐药率也出现了较大幅度的下降:头孢他啶和左氧氟沙星的使用强度变化趋势与大肠埃希菌、鲍氏不动杆菌、铜绿假单胞菌对其耐药率的变化相一致；头孢呋辛和头孢曲松作为主要预防性抗菌药物,其使用强度的变化趋势与主要致病菌对其耐药率的变化无一致性.结论 细菌耐药趋势与部分抗菌药物使用强度的变化有一定关系.

Study on use density of antibiotics and variation of bacterial resistance rate in orthopedics department

OBJECTIVE To investigate the variation of antibiotics use density(AUD) and antibiotic resistance in orthopedics department.METHODS By retrospective study,the data of drug use and antibiotic resistance were collected and analyzed from 2006 to 2009.Taking DDDs/100 patient-days as the unit,AUD was calculated and the change of common pathogenic bacteria was analyzed.RESULTS The AUD of cefodizime were 7.81,7.66,2.92 and 0.84 from 2006 to 2009 respectively,keeping downward tendency.The drug resistant rates of Escherichia coli,Acinetobacter baumannii,Pseudomonas aeruginosa and Staphylococcus aureus to cefodizime were decreased gradually.The AUD of cefoperazone/sulbactam were 3.92,3.55,3.40 and 0.90 respectively.The resistant rates of E.coli,A.baumannii,P.aeruginosa and S.aureus to cefoperazone/sulbactam were decreased.The drug resistant variation of E.coli,A.baumannii,P.aeruginosa to ceftazidime and levofloxacin were consistent to their AUD;cefuroxime and ceftriaxone as the major prophylactic antibiotics,the variation of their AUD were not consistent with the variation of the drug resistance rates of the main pathogens.CONCLUSION The AUD of some antibacterial agents has somewhat correlation with the development of antibiotic resistance.