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Broad-spectrum antimicrobial consumption trends and correlation with bacterial infections and antimicrobial

Renata A P Sakata1, Rodrigo Cayô da Silva2, Ana C Gales3

  • 1Universidade Federal de São Paulo (UNIFESP), Laboratório Especial de Microbiologia Clínica (LEMC), Division of Infectious Diseases, Department of Internal Medicine, Escola Paulista de Medicina (EPM), São Paulo, SP, Brazil.

Journal of Global Antimicrobial Resistance
|December 21, 2021
PubMed
Abstract

Insights

Reducing broad-spectrum antimicrobial use, including meropenem and polymyxin B, in ICUs correlated with changes in Gram-negative bacilli resistance. Decreased meropenem consumption was linked to reduced resistance in Acinetobacter spp.

Area of Science:

  • Infectious Diseases
  • Clinical Pharmacy
  • Microbiology

Background:

  • Antimicrobial resistance (AMR) is a major global health threat, particularly in intensive care units (ICUs).
  • Understanding the relationship between antimicrobial consumption patterns and the emergence of resistant pathogens is crucial for effective stewardship.

Purpose of the Study:

  • To investigate the consumption trends of four broad-spectrum antimicrobials: meropenem (MEM), polymyxin B (PMB), piperacillin/tazobactam (TZP), and cefepime (FEP).
  • To explore the correlation between the consumption of these antimicrobials and antimicrobial resistance in Gram-negative bacilli (GNB) isolates from ICUs between 2013 and 2017.

Main Methods:

  • Consumption of MEM, PMB, TZP, and FEP was quantified in defined daily doses per 1000 patient-days (DDD/1000PD).
  • Infection-related GNB isolates were categorized by specific resistance profiles.
  • Time series analysis was employed to assess the parametric correlation between antimicrobial consumption and resistant GNB isolates.

Main Results:

  • A significant linear decline in the consumption of meropenem (MEM) and polymyxin B (PMB) was observed.
  • A significant decrease in MEM-non-susceptible Acinetobacter spp. was noted, correlating positively with MEM consumption.
  • An increase in FEP-non-susceptible Escherichia coli was observed, with a significant correlation to FEP consumption.

Conclusions:

  • Reducing the consumption of broad-spectrum antimicrobials can influence the prevalence of infection-related isolates.
  • The findings highlight a complex interplay between antimicrobial prescribing practices and the development of antimicrobial resistance in GNB within the ICU setting.
Keywords:
Antimicrobial resistanceDDDDefined daily dosesGram-negative bacilliHealthcare-associated infectionIntensive care unit

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