title: Antibiotic utilization and Pseudomonas aeruginosa resistance in intensive care units.
abstract: Pseudomonas aeruginosa is one of the most frequent and dangerous pathogens involved in the etiology of severe nosocomial infections. A retrospective observational study was conducted at all intensive care units of the University Hospital in Olomouc, Czech Republic (155 ICU beds). Complete antibiotic utilization data of the ICUs in the period of 1999 to 2008 were processed according to ATC/DDD system and expressed in defined daily doses per 100 bed-days (DBD). Utilization of meropenem, imipenem, ciprofloxacin, ofloxacin, pefloxacin, gentamicin, amikacin, ceftazidime, cefoperazone, cefoperazone/sulbactam and piperacillin/tazobactam was measured. Pseudomonas aeruginosa strains were isolated from clinical material obtained from patients hospitalized in ICUs. During the ten-year period, utilization of the entire group of antibiotics monitored grew. It increased from 23.52 DBD in 1999 to 27.48 DBD in 2008 with a peak of 33.04 DBD in 2007. P. aeruginosa accounted for as much as 42% of pneumonias and 23% of surgical wound infections. Our results show that P. aeruginosa strains became gradually resistant to all antibiotics used in the treatment of the infections caused by them, with the exception of amikacin and piperacillin/tazobactam.
authors.affiliation: Department of Pharmacology, Faculty of Medicine, Palacky University and University Hospital Olomouc, Czech Republic.
authors.forename: Vladimíra
authors.initials: V
authors.lastname: Vojtová
authors.forename: Milan
authors.initials: M
authors.lastname: Kolár
authors.forename: Kristýna
authors.initials: K
authors.lastname: Hricová
authors.forename: Radek
authors.initials: R
authors.lastname: Uvízl
authors.forename: Jan
authors.initials: J
authors.lastname: Neiser
authors.forename: Ladislav
authors.initials: L
authors.lastname: Blahut
authors.forename: Karel
authors.initials: K
authors.lastname: Urbánek
mesh_terms: D000583:Amikacin / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002438:Cefoperazone / Q000494:pharmacology; D002442:Ceftazidime / Q000494:pharmacology; D002939:Ciprofloxacin / Q000494:pharmacology; D018153:Czech Republic; D024901:Drug Resistance, Multiple, Bacterial; D005839:Gentamicins / Q000494:pharmacology; D007362:Intensive Care Units; D008826:Microbial Sensitivity Tests; D010397:Penicillanic Acid / Q000031:analogs & derivatives / Q000494:pharmacology; D010878:Piperacillin / Q000494:pharmacology; D011550:Pseudomonas aeruginosa / Q000187:drug effects*; D013407:Sulbactam / Q000494:pharmacology; D000078142:Tazobactam
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins; D002939:Ciprofloxacin; D002438:Cefoperazone; D000583:Amikacin; D010397:Penicillanic Acid; D002442:Ceftazidime; D013407:Sulbactam; D000078142:Tazobactam; D010878:Piperacillin