title: The impact of a nationwide antibiotic restriction program on antibiotic usage and resistance against nosocomial pathogens in Turkey.
abstract: OBJECTIVE
  Antimicrobial resistance among microorganisms is a global concern. In 2003, a nationwide antibiotic restriction program (NARP) was released in Turkey. In this study we evaluated the effect of NARP on antibiotic consumption, antimicrobial resistance, and cost.
  
  
  METHODS
  The data obtained from all of the four university hospitals, and one referral tertiary-care educational state hospital in Ankara. Antimicrobial resistance profiles of 14,233 selected microorganisms all grown in blood cultures and antibiotic consumption from 2001 to 2005 were analyzed retrospectively.
  
  
  RESULTS
  A negative correlation was observed between the ceftriaxone consumption and the prevalence of ceftriaxone resistant E.coli and Klebsiella spp. (rho:-0.395, p:0.332 and rho:-0.627, p:0.037, respectively). The decreased usage of carbapenems was correlated with decreased carbapenems-resistant Pseudomonas spp. and Acinetobacter spp (rho:0.155, p:0.712 and rho:0.180, p:0.668, respectively for imipenem). Methicillin resistance rates of S.aureus were decreased from 44% to 41%. After two years of NARP 5,389,155.82 USD saving occurred.
  
  
  CONCLUSIONS
  NARP is effective in lowering the costs and antibiotic resistance.
authors.affiliation: Department of Clinical Microbiology and Infectious Disease, Ankara University, School of Medicine, Ibni Sina Hospital 06100, Ankara, Turkey.
authors.forename: Adalet
authors.initials: A
authors.lastname: Altunsoy
authors.forename: Cenk
authors.initials: C
authors.lastname: Aypak
authors.forename: Alpay
authors.initials: A
authors.lastname: Azap
authors.forename: Önder
authors.initials: Ö
authors.lastname: Ergönül
authors.forename: Ismail
authors.initials: I
authors.lastname: Balık
mesh_terms: D000150:Acinetobacter / Q000187:drug effects; D000900:Anti-Bacterial Agents / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use*; D000077723:Cefepime; D002442:Ceftazidime / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use; D002443:Ceftriaxone / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use; D002511:Cephalosporins / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use; D017046:Cost Savings / Q000706:statistics & numerical data; D003428:Cross Infection / Q000188:drug therapy* / Q000453:epidemiology; D016527:Drug Costs / Q000706:statistics & numerical data; D011307:Drug Prescriptions / Q000592:standards*; D024881:Drug Resistance, Bacterial; D004363:Drug Utilization / Q000191:economics / Q000706:statistics & numerical data; D004925:Escherichia / Q000187:drug effects; D006291:Health Policy; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D015378:Imipenem / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use; D007709:Klebsiella / Q000187:drug effects; D000077731:Meropenem; D016106:Methicillin Resistance; D010397:Penicillanic Acid / Q000031:analogs & derivatives / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use; D010878:Piperacillin / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use; D000077725:Piperacillin, Tazobactam Drug Combination; D011549:Pseudomonas / Q000187:drug effects; D013211:Staphylococcus aureus / Q000187:drug effects; D017334:Teicoplanin / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use; D013845:Thienamycins / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use; D014421:Turkey; D014640:Vancomycin / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D013845:Thienamycins; D000077725:Piperacillin, Tazobactam Drug Combination; D017334:Teicoplanin; D014640:Vancomycin; D015378:Imipenem; D002443:Ceftriaxone; D000077723:Cefepime; D010397:Penicillanic Acid; D002442:Ceftazidime; D000077731:Meropenem; D010878:Piperacillin