title: Relationship between Antimicrobial Consumption and the Incidence of Antimicrobial Resistance in Escherichia coli and Klebsiella pneumoniae Isolates.
abstract: BACKGROUND
  Gram negative organisms are one of the major causes of nosocomial diseases. Development of resistance to antibiotics by these organisms increases their risk in clinical treatment of patients. It also affects morbidity and mortality hence needs to be monitored and controlled.
  
  
  OBJECTIVE
  The aim of the present study was to analyse the correlation between consumption of parenteral antibiotics and the rates of antimicrobial resistance among the Escherichia coli and Klebsiella pneumoniae isolates collected during Dec 2010 - Jun 2013 from JIPMER hospital.
  
  
  METHODS
  Consumption data of parenteral antibiotics in J01 category of Anatomical Therapeutic Chemical (ATC) in JIPMER was obtained and expressed in Defined Daily Doses (DDD) per 1000 inhabitants. Valid consumption and resistance data during the period Dec 2010 to Jun 2013 were obtained at 6 month intervals and were correlated to draw a relationship between antimicrobial consumption and its impact on drug resistance for Escherichia coli and Klebsiella pneumoniae.
  
  
  RESULTS
  Escherichia coli isolates showed high resistance for increased use of gentamycin and ciprofloxacin. Increase in antibiotic consumption increases the resistance for Escherichia coli except for amikacin. Among the Klebsiella isolates, meropenem and gentamycin showed high correlations followed by ceftazidime, amikacin, ceftriaxone and ciprofloxacin.
  
  
  CONCLUSIONS
  In summary, a statistically significant association was noticed between consumption of the studied antimicrobials and resistance of Escherichia coli isolates, except for amikacin and ceftazidime. In the case of Klebsiella pneumoniae, there was a statistically significant association between the resistance rates and consumption of gentamycin, ceftazidime and meropenem. Further, a linear relationship was noted between antimicrobial consumption and resistant isolates of Escherichia coli and Klebsiella pneumoniae, except for Escherichia coli resistance to amikacin.
authors: Assistant Professor, Department of Microbiology, JIPMER , Pondicherry, India .
authors: Noyal Mariya
authors: NM
authors: Joseph
authors: Pharmacological Analyst, Department of Pharmacy, JIPMER , Pondicherry, India .
authors: B
authors: B
authors: Bhanupriya
authors: Professor, Department of Pharmacology, JIPMER , Pondicherry, India .
authors: Deepak Gopal
authors: DG
authors: Shewade
authors: Head of Department, Department of Microbiology, JIPMER , Pondicherry, India .
authors: Belgode Narasimha
authors: BN
authors: Harish
keywords: Antimicrobial drug resistance; Daily defined doses; Drug utilization; Escherichia coli; Klebsiella pneumoniae