Current Situation of Antibiotic Usage and Antibiotic Susceptibility in a Regional Hospital in Hsinchu, Taiwan

新竹某區域醫院抗生素使用與感受性現況

林恆卉(Heng-Hui Lin) ； 張玉慧(Yu-Huey Chang) ； 壽瑋瑾(Wei-Jiin Shou)

《臺灣臨床藥學雜誌》 22卷4期 (2014/12) Pp. 197-206

https://doi.org/10.6168/FJCP.2014.2204.01

摘要

目的：我們為了對抗感染疾病而廣泛使用抗生素。但微生物可藉由快速繁殖與交換抗藥基因資訊獲得抗藥性，不適當使用抗生素會導致抗藥性上升。因此我們想評估本院抗生素感受性（敏感性）模式與使用現況。方法：本院利用Kirby-Bauer試驗法（紙錠瓊脂擴散法）測試抗生素感受性。我們蒐集2010至2012三年來關於抗生素感受性與使用量的資訊。結果：全院共34,657個由臨床檢體分離到的菌株其感受性資料（1／1／2010至31／12／2012，36個月），其中挑選抗生素感受性上升或下降10%者加以分析。結果顯示，整體而言本院革蘭氏陰性菌感受性下降，我們將此現象與抗生素使用（以定義每日劑量表示）討論。此外，抗生素使用金額占總藥品費用有年年增加的趨勢。結論：抗生素感受性模式可能隨著地區而不同，這現象與當地抗生素使用與微生物流行病學息息相關。本篇文章的重要性在於這是本院初次長期大規模分析抗微生物製劑感受性與使用習慣。我們希望這些資訊可以幫助醫療同仁瞭解本院細菌抗藥性現況，並且更合理謹慎使用抗微生物製劑。

關鍵字

抗生素感受性 ； 敏感性 ； 抗藥性

並列摘要

Objective: Antibiotics are widely used against infectious diseases. However, the improper use of antibiotics often causes drug resistance in microorganisms, due to the microbial capacity for rapid multiplication and genetic information exchange. The purpose of our study was to evaluate the usage and susceptibility (sensitivity) pattern of antibiotics in a regional hospital in Hsinchu, Taiwan. Methods: Antibiotic susceptibility was determined by the Kirby-Bauer disk diffusion antibiotic sensitivity testing method. Information regarding antibiotic consumption and microbial susceptibility was collected between 2010 and 2012. Results: In total, 34,657 bacterial isolates were obtained between January 1, 2010 and December 31, 2012 (36 months), which were subjected to the Kirby-Bauer susceptibility test. Isolates showing a 10% increase or decrease in the susceptibility patterns were chosen for analysis. We observed a decrease in susceptibility of gram-negative bacteria over time in the samples collected from the hospital. Additionally, the susceptibility patterns were analyzed with respect to the antibiotic usage. We also observed a steady increase in the ratio of antibiotics to total drug cost over the 3 year-study period. Conclusions: Antibiotic susceptibility patterns may vary with location, and is closely related to antibiotic usage and microbial epidemiology. To our knowledge, no other comprehensive long-term local study, illustrating the changes in antibiotic susceptibility and usage, has been conducted in this hospital. This study may aid in advancing the knowledge of health care workers regarding the current state of bacterial resistance, subsequently resulting in the controlled administration of antimicrobials.

並列關鍵字

Antibiotic Susceptibility ； Sensitivity ； Resistance