不同剂量左氧氟沙星使用频度与细菌耐药率相关性研究

Correlation Between Consumption of Levofloxacin in Different Dosages and the Resistance Rate in 8 Kinds of Bacterium

目的:了解不同剂量左氧氟沙星使用频度与8种细菌耐药率的相关性,为临床合理用药提供依据。方法:分别统计2002～2009年0.3 g、0.4 g、0.5 g 3种剂量左氧氟沙星、总左氧氟沙星及喹诺酮类抗菌药的用药频度与8种细菌对左氧氟沙星的耐药率,采用SPSS13.0统计软件进行相关性分析。结果:8种细菌中肺炎克雷伯菌对左氧氟沙星的耐药率最低(17.3%～35.4%),耐甲氧西林金黄色葡萄球菌和产ESBL大肠埃希菌对左氧氟沙星耐药率较高,分别为75.4%～95.6%和81.1%～92.6%。左氧氟沙星(0.5 g)的用药频度与大肠埃希菌、铜绿假单胞菌耐药率呈负相关(r=-0.997 4,P<0.01;r=-1.000 0,P<0.01);左氧氟沙星(0.3 g)、总左氧氟沙星、喹诺酮类抗菌药的用药频度与产ESBL肺炎克雷伯菌耐药率呈负相关(r=-0.867 8,P<0.05;r=-0.846 5,P<0.05;r=-0.785 7,P<0.05);左氧氟沙星(0.3 g)和总左氧氟沙星的用药频度分别与金黄色葡萄球菌和鲍曼不动杆菌的耐药率呈正相关(r=0.725 6,P<0.05,r=0.821 4,P<0.05)。结论:不同剂量左氧氟沙星、总左氧氟沙星、喹诺酮类抗菌药用药频度与细菌耐药率存在相关性,临床应注意合理使用不同剂量的左氧氟沙星。

Objective： To evaluate the correlation between consumption of levofloxacin in different dosages and the antimicrobial resistance, to provide theoretical evidence for clinical antimicrobial medication choices. Method ：The annual consumption frequencies of levofloxaein（0.3 g ,0.4 g,0.5 g） ,total levofloxacin and quinolone in DDD per 1 000 patients/days and their resistance rate of 8 kinds of bacteria were respectively calculated from 2002 to 2009 and the correlation analysis, made by SPSS 13.0. Result：The lowest resistance rate in 8 tested bacteria was Klebsiella pneumoniae which varied from 17.3% to 35.4% ,but the resistance rates of methicillin-resistant Staphylococcus aureus and extended spectrum-lactamase-producing Escherichia coli were much higher which varied from 75.4% to 95.6% and 81.1% to 92.6% respectively. There was a significant negative correlation between levofloxacin consumption （0.5 g） and the resistance rate in Escherichia coli and Pseudomonas aeruginosa （ r = - 0. 997 4, P 〈 0.01 ; r = - 1. 000, P 〈 0.01 ） ; a similar negative correlation was also showed in consumption of levofloxacin （0.3 g）,total levofloxacin,quinolone and the resistance rate in extended spectrum β-lactamase-producing KlebsieUa pneumoniae （ r = - 0.867 8, P 〈 0.05 ; r = - 0. 846 5, P 〈 0.05 ; r = - 0.785 7, P 〈0.05 ） . The consumption of levofloxacin（0.3 g） and total levofloxacin was positively correlated with the resistance in Staphylococcus aureus and Acinetobacter baumannii （ r = 0.747 5, P 〈 0.05 ; r = 0.821 4, P 〈 0.05 ）. Conclusion： There was a correlation between the consumption of levofloxacin in different dosages, total levofloxacin, quinolone and antimicrobial resistance against 8 tested kinds of bacteria. Clinically, different dosage of levofloxaein should be used rationally.