title: Monitoring of antibiotic consumption and development of resistance by enterobacteria in a tertiary care hospital.
abstract: OBJECTIVE
  Antibiotics are the most frequently used drugs in hospitalized patients, but studies have shown that the prescribed antibiotics may be inappropriate and may contribute to antibiotic resistance. We carried out a survey of antibiotic consumption and antibiotic resistance in our tertiary care university hospital, from 2005 to 2013. We focus on cephalosporins, one of the most prescribed groups of antibiotics in the tertiary health care. The objective was to identify any relationship between ceftriaxone consumption and resistance by enterobacteria.
  
  
  METHODS
  Antibiotics consumption and antimicrobial resistance were monitored in the tertiary care university hospital from 2005 to 2013. Data on the use of antibiotics in surgical inpatients were obtained and expressed as defined daily doses per 100 bed days. Bacterial resistances were given as percentages of resistant isolates.
  
  
  CONCLUSIONS
  There was an increasing trend in cephalosporins consumption from 9·56 DBD (2005) to 23·32 DBD (2013), with ceftriaxone as the most frequently used cephalosporin, 3·6 DBD (2005) to 10·78 DBD (2013). E. coli and P. mirabilis resistance to ceftriaxone increased significantly from 22% in 2005 to 47% in 2013 and from 31% in 2005 to 60% in 2013, respectively. We found a significant correlation between ceftriaxone consumption and E. coli resistance (r = 0·895, P < 0·05).
  
  
  CONCLUSIONS
  Our study shows that cephalosporin consumption increased from 2005 to 2013, with ceftriaxone as the most prescribed antibiotic. E. coli and P. mirabilis resistance to ceftriaxone increased significantly over the study period. E. coli resistance increased with ceftriaxone consumption.
authors.affiliation: Faculty of Medicine, University of Nis, Nis, Serbia.|Clinical Centre Nis, Nis, Serbia.
authors.forename: R
authors.initials: R
authors.lastname: Veličković-Radovanović
authors.affiliation: Faculty of Medicine, University of Nis, Nis, Serbia.
authors.forename: N
authors.initials: N
authors.lastname: Stefanović
authors.affiliation: Faculty of Medicine, University of Nis, Nis, Serbia.
authors.forename: I
authors.initials: I
authors.lastname: Damnjanović
authors.affiliation: Faculty of Medicine, University of Nis, Nis, Serbia.|Institute for Public Health Nis, Nis, Serbia.
authors.forename: B
authors.initials: B
authors.lastname: Kocić
authors.affiliation: Institute for Public Health Nis, Nis, Serbia.
authors.forename: S
authors.initials: S
authors.lastname: Antić
authors.affiliation: Faculty of Medicine, University of Nis, Nis, Serbia.|Institute for Public Health Nis, Nis, Serbia.
authors.forename: M
authors.initials: M
authors.lastname: Dinić
authors.affiliation: Clinical Centre Nis, Nis, Serbia.
authors.forename: J
authors.initials: J
authors.lastname: Petrović
authors.affiliation: Clinical Centre Nis, Nis, Serbia.
authors.forename: R
authors.initials: R
authors.lastname: Mitić
authors.affiliation: Faculty of Medicine, University of Nis, Nis, Serbia.
authors.forename: A
authors.initials: A
authors.lastname: Catić-Djordjević
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D002511:Cephalosporins / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D024881:Drug Resistance, Bacterial; D004755:Enterobacteriaceae / Q000187:drug effects*; D006801:Humans; D062606:Tertiary Care Centers
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins
keywords: antibiotic consumption; bacterial resistance; ceftriaxone; cephalosporins; enterobacteria