Analysis of antibiotic utilization and bacterial resistance changes in a surgical clinic of Clinical Centre, Nis.

What is known and Objective: There is little published information about antibiotic utilization and resistance amongst hospital inpatients in Serbia. The purpose of this study was to analyse the variation of antibiotic utilization and the relation between antibiotic utilization and bacterial resistance. Methods: This analysis was performed in the surgical clinic of one of the biggest Serbian tertiary hospitals, during 2005-2008. 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. Following the implementation of a restriction policy in 2005, the prescription of reserve antibiotics was placed under control. Results and Discussion: During the investigation period the total consumption of antibiotics decreased significantly by 37.8%. Hospital aminoglycoside consumption continued to decrease from 25.1% of the total consumption in 2005 to 5.1% in 2008. During the same period there was a substantial decrease in the use of ceftriaxone (47.8%), ciprofloxacin and metronidazole. Reduction in Escherichia coli resistance to gentamicin correlated significantly with its utilization, while the resistance for all isolates decreased from 58.5% to 44.8%. What is new and Conclusion: This analysis confirms the association between the use of antibiotics and the prevalence of resistance in a surgical clinic. Surveillance of bacterial resistance should be done periodically according to local guidelines for antibiotic therapy of surgical infections, as well as for external comparison.