Analysis of antibacterial drug use and bacterial resistance in psychiatric hospital in the epidemic

疫情期间精神病院抗菌药物使用及细菌耐药性分析

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Abstract

Analyze the use of antibacterial drugs and bacterial resistance in psychiatric hospital during the epidemic. Using the hospital information system and the National Antibacterial Drug Clinical Application Monitoring Network, we retrospectively collected data on the use of antibacterial drugs and bacterial resistance in psychiatric hospitals during the 2022 epidemic. During the 2022 epidemic, our hospital had an antibiotic use rate of 5.00%, a usage intensity of 3.07, a combined medication rate of 11.11%, a cumulative DDDs of 12,039.04, and antibiotic costs accounting for 3.95% of total drug costs. These are much lower than the levels in Jiangsu Province and nationwide. However, the rate of microbiological submission for antibacterial drug use was 77.78%, higher than that of Jiangsu Province and nationwide. The main antibiotics used in our hospital were third-generation cephalosporins, penicillins, and quinolone antibiotics, with the most commonly used being cefodizime, amoxicillin, and piperacillin-tazobactam. The results showed that Gram-negative bacteria mainly exhibited resistance to penicillins, cephalosporins, and quinolones, especially ampicillin, amoxicillin-clavulanic acid, ceftazidime, ceftriaxone, amikacin, and ciprofloxacin. Gram-positive bacteria mainly resisted penicillins, macrolides, and quinolones, especially penicillin, benzylpenicillin, erythromycin, levofloxacin, and ciprofloxacin. This study reveals a complex relationship between the rational use of antibacterial drugs and bacterial resistance in the psychiatric hospital. Although antimicrobial usage during the pandemic was generally appropriate, increased use in psychiatric settings correlated with rising bacterial resistance, thereby impacting treatment outcomes and patient prognosis. Therefore, it is recommended to enhance monitoring of bacterial resistance and regularly analyze resistance data to optimize antimicrobial use in psychiatric hospitals. This approach aims to ensure effective treatment while minimizing the development of resistant strains, ultimately improving the overall value of healthcare services.

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