停用头孢他啶降低革兰阴性细菌耐药率的效果分析

Reducing Gram Negative Bacterial Resistance Related Results Analysis by Discontinuation of Ceftazidine

目的 分析停用头孢他啶前后对革兰阴性细菌耐药的变化。方法 对2011年∽2013年期间,我院对抗菌药物进行干预管理和监督,即停用头孢他啶,与未实行任何管理方式的2010年比较,观察医院大肠杆菌、铜绿假单胞菌、肺炎克雷伯菌、鲍曼不动杆菌耐药产生情况。结果 大肠埃希菌对头孢他啶耐药率由2010年82.99%降低至2013年27.34%,对铜绿假单胞菌耐药率由55.68%降低至23.29%,对肺炎克雷伯菌耐药率由81.25降低至43.29%,对鲍曼不动杆菌耐药率由84.87降低至57.14%,全部统计结果（P〈0.01）,具有显著性差异。结论 建立细菌耐药预警机制,采取合理干预监管措施停用细菌耐药率超过75%的抗菌药物,可在3年内降低其耐药率并恢复其敏感性。

Objective To investigate on change of bacterial resistance before and after discontinuation of ceftazidine. Methods Comparing bacterial resistance of Escherichia coli, Pseudomonas aeruginosa, klebsiella pneumonia and Aeinetobaeter baumannii from no intervention in 2010 to intervention management, supervise drugs resistance and discontinuation of ceftazidine between 2011 to 2013. Results E.coli resisted.rate to antibiotic Ceftazidine dramatically decreases from 82.99% to27.34%. As for P. aeruginosa, antibiotic resistant rate goes down significantly from 55.68% to23.29%.And antibiotic resistant rate of klebsiella pneumonia reduces from 81.25% to43.29%. In addition, antibiotic resistant rate of Acinetobacter baumannii drops from 84.87% to 57.14%. There is significant difference of drug resistance between years （P〈0.01）. Conclusion Estabished bacterial resistant alarming mechanism and take comprehensive measures to discontinue of antibiotics with drug resistance over 75% can significantly reduce drug resistance rates and restore drug sensitivities within 3 years.