Correlating Antibiotic ConsumptionWith Antimicrobial Resistance Of Uropathogens In A University Teaching Hospital In Lagos, Nigeria

Abstract

This study was carried out to correlate the antibiotic consumption rates with the antibiotic resistance rates of uropathogens in Lagos University Teaching Hospital.
Urine specimens obtained over 18 months (between January 2005 and June 2006) were
processed for microscopy culture and sensitivity, and records of antibiotics dispensed during the same periods were reviewed. Significant bacteriuriawas performed by the standard loopmethod. Isolation and identification of organisms was by standard laboratory methods. The antibiotic consumption calculator of Monnet (ABC calc version 3) was used to classify the antibiotics into ATC classes and to calculate the numbers of daily defined doses. The 6-monthly antibiotic resistance and consumption rates were compared using Pearson\'s
correlation coefficient. For analysis, the period of studywas divided into three.
Except for co-trimoxazole the rates of consumption of all antibioticswere higher in the second period than the first period of the study and highest in the 3 period for ciprofloxacin, and ceftazidime. This correlated with an increase in the rates of resistance for some antibiotics during the 2 and 3 periods. While a steady increase in consumption of ciprofloxacin correlatedwith a steady increase in the resistance rates from the 1 to
the 3 periods, a steady increase in consumption of ceftazidimewas associatedwith an increased resistance rate fromthe 2 to 3 periods. Increased consumption of the antibiotics tested, most noticeably, ciprofloxacin and ceftazidime correlated with increased resistance rates. There is need for urgent interventions like formulation of antibiotic policies and education of staff on the appropriate use of antibiotics to reduce the development of resistance.

Keywords: Antibiotic Resistance, Antibiotic Consumption

Nigerian Jouranl of Clinical Practice Vol. 11 (4) 2008: pp. 305-308