The Analysis Of Antibiotic Consumption And Bacterial Resistance As An Indicator Of Their Proper Use At The Urology Department In The Health Centre “Studenica” Kraljevo

The objective of the study was to analyze antibiotic consumption and determine bacterial resistance rates as an indicator of the rational utilization of this drug group at the urology department in the Health Centre “Studenica” Kraljevo.

Over a two-year period, the average antibiotic consumption was 104.55 DDD/100BD. Of the total financial assets used for medical treatment, the antibiotic group JO1 had a share of 49.52% in 2011 and 47.53% in 2012. Antibacterial drugs from a group of β-lactamic antibiotics were consumed most commonly, at 54.02% (2011) and 43.44% (2012). First-generation cephalosporins, quinolones and aminoglycosides were the most frequently used drug groups, while cephalexin was the antibiotic with the highest individual consumption. E. coli was the most frequently isolated bacterium in 2011, while in 2012, Klebsiella pneumoniae was the most frequently isolated bacterium. The total bacterial resistance both in 2011 and 2012 was above 50%. Gram-negative bacteria showed a higher resistance rate (2011, 59.3%; 2012, 58.9%) than Gram-positive bacteria (2011, 44.4%; 2012, 40.6%). Klebsiella pneumoniae was the bacterium with the highest resistance (75.3%) in 2011, while in 2012, there was a resistance increase in Pseudomonas aeruginosa (71.4%), especially to carbapenems. A correlation was determined between the consumption of individual antibiotics and bacterial strain resistance in 2011 (r=0.433, p=0.044) and in 2012 (r=0.478, p=0.024).

The high resistance rate shown in the bacterial strains, which was correlated with antibiotic consumption, as well as the great financial assets used for this group of drugs suggest the necessity for the rationalization of their utilization. Empirical therapy with Gram-negative bacteria should be based on carbapenems utilization, except with Pseudomonas aeruginosa, where piperacillin/tazobactam should be used.