title: [Evolution of antibiotic consumption in an intensive care burn department].
abstract: BACKGROUND
  The increasing consumption of antibiotics in hospitals and the economic implications of this increase lead to survey this consumption in the various hospital units.
  
  
  OBJECTIVE
  Our study proposes to measure the annual antibiotic use and antimicrobial resistance in an intensive care Burn department in order to manage the control measures.
  
  
  METHODS
  The study was conducted during a 5 year period (1 January 2000 to 31 December 2004). The average number of admissions was 204/year and the mean number of hospitalisation was 4036/year. Antimicrobial susceptibility testing was performed by disk diffusion method. Susceptibility testing data were stored in a laboratory data base using whonet 5.3 software. The consumption of following antibiotics: imipenem, ceftazidime, ofloxacin, ciprofloxacin, piperacillin-tazobactam was measured by antimicrobial density (AD) witch takes into account the quantity of antibiotics in Grams converted to daily defined dose (DDD) and number of hospitalization days. The daily defined dose (DDD) was proposed by WHO. The calculation of the AD for each molecule was carried out according to the following formula: [AD = Quantity consumed in grams for the particular antimicrobial X 1000]/[DDD for that antimicrobial X number of days hospitalizations].
  
  
  RESULTS
  There was statistically significant relationship between increasing use of ceftazidime and ceftazidime resistant Klebsiella pneumoniae (rs=0.93; p=0.02). The use of ceftazidime was not significantly associated with resistance to this molecule in P. aeruginosa (rs=0.76 ; p=0.13). Concerning the fluoroquinolones, there was statistically significant relation ship between increasing use of ciprofloxacin and rate ciprofloxacin resistant P. aeruginosa (rs=0.89,P=0.043). Furthermore, the consumption of ciprofloxacin was significantly correlated to imipenem resistance in P. aeruginosa (rs=0.87, p=0.05 ). However, the consumption of imipenem was not significantly correlated to resistance of this drug in P. aeruginosa (rs=0.45; P=0,4).
  
  
  CONCLUSIONS
  The monitoring of both antibiotic consumption andantibiotic resistance is necessary to set up targeted policies and to control their effectiveness. Nevertheless this monitoring must be integrated into global policy of good use and control of antibiotics.
authors.affiliation: Laboratoire Résistance aux antibiotiques, Faculté de Médecine de Tunis.
authors.forename: Lamia
authors.initials: L
authors.lastname: Thabet
authors.forename: Kamel
authors.initials: K
authors.lastname: Bousselmi
authors.forename: Salima
authors.initials: S
authors.lastname: Oueslati
authors.forename: Monia
authors.initials: M
authors.lastname: Memmi
authors.forename: Saida
authors.initials: S
authors.lastname: Ben Redjeb
authors.forename: Amen Allah
authors.initials: AA
authors.lastname: Messadi
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002053:Burn Units / Q000706:statistics & numerical data*; D002056:Burns / Q000188:drug therapy*; D004352:Drug Resistance, Microbial; D004363:Drug Utilization / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay; D008826:Microbial Sensitivity Tests; D008962:Models, Theoretical; D012984:Software; D013997:Time Factors; D014416:Tunisia; D014944:World Health Organization
chemical_list: D000900:Anti-Bacterial Agents