Consumption of ceftriaxone in a hospital and Enterobacteriaceae resistance to cephalosporins - the theory of parallel damage

Fedorenko А.: North-Western State Medical University named after I.I. Mechnikov, Saint-Petersburg

Burbello A.: North-Western State Medical University named after I.I. Mechnikov, Saint-Petersburg

Pokladova M.: North-Western State Medical University named after I.I. Mechnikov, Saint-Petersburg

Korosteleva M.: North-Western State Medical University named after I.I. Mechnikov, Saint-Petersburg

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Summary

Aim

To evaluate the relationship between consumption of ceftriaxone in a hospital and changes in resistance of enterobacteria to 3rd generation cephalosporins.

Material and methods

Over 2014 to 2018, we estimated ceftriaxone consumption in a multidisciplinary hospital using ATX/DDD analysis and changes in the occurrence of resistance to 3rd generation cephalosporins among Enterobac - teriaceae spp. We studied medical records of patients to assess the indications for ceftriaxone administration.

Results

The results of ATC/DDD analysis and local microbiological data suggested that the use of ceftriaxone for antibiotic prophylaxis in surgical departments was associated with changes in resistance of Enterobacteriaceae. Implementation of antibiotic prophylaxis protocols and education of surgeons were shown to reduce consumpiton of cetriaxone. Four-fold reduction of ceftriaxone use in intensive care unit and 30-fold reduction of its use in surgical departments resulted in 11-20% decrease in the rate of infections induced by cephalosporin resistant enterobacteria.

Conclusion

Restriction of cetriaxone administration may prevent an increase in resistance of enterobacteria to cephalosporins. Antibiotic prophylaxis protocols and educational measures are essential for effective control of microorgansims resistance in a hospital.

Key words

Ceftriaxone, resistance, ATC/DDD analysis, local microbiological monitoring.