Int J Med Sci 2011; 8(4):339-344. doi:10.7150/ijms.8.339 This issue

Research Paper

The Impact of a Nationwide Antibiotic Restriction Program on Antibiotic Usage and Resistance against Nosocomial Pathogens in Turkey

Adalet Altunsoy1, Cenk Aypak2✉, Alpay Azap1, Önder Ergönül3, İsmail Balık1

1. Department of Clinical Microbiology and Infectious Disease, Ankara University, School of Medicine, Ibni Sina Hospital 06100, Ankara, Turkey
2. Department of Family Medicine, Ankara University, School of Medicine, Ibni Sina Hospital 06100, Ankara, Turkey
3. Department of Clinical Microbiology and Infectious Disease, Marmara University, School of Medicine, 34662, Istanbul, Turkey

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Citation:
Altunsoy A, Aypak C, Azap A, Ergönül Ö, Balık İ. The Impact of a Nationwide Antibiotic Restriction Program on Antibiotic Usage and Resistance against Nosocomial Pathogens in Turkey. Int J Med Sci 2011; 8(4):339-344. doi:10.7150/ijms.8.339. Available from https://www.medsci.org/v08p0339.htm

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Abstract

Purpose: Antimicrobial resistance among microorganisms is a global concern. In 2003, a nationwide antibiotic restriction program (NARP) was released in Turkey. In this study we evaluated the effect of NARP on antibiotic consumption, antimicrobial resistance, and cost.

Materials and Methods: The data obtained from all of the four university hospitals, and one referral tertiary-care educational state hospital in Ankara. Antimicrobial resistance profiles of 14,233 selected microorganisms all grown in blood cultures and antibiotic consumption from 2001 to 2005 were analyzed retrospectively.

Results: A negative correlation was observed between the ceftriaxone consumption and the prevalence of ceftriaxone resistant E.coli and Klebsiella spp. (rho:-0.395, p:0.332 and rho:-0.627, p:0.037, respectively). The decreased usage of carbapenems was correlated with decreased carbapenems-resistant Pseudomonas spp. and Acinetobacter spp (rho:0.155, p:0.712 and rho:0.180, p:0.668, respectively for imipenem). Methicillin resistance rates of S.aureus were decreased from 44% to 41%. After two years of NARP 5,389,155.82 USD saving occurred.

Conclusion: NARP is effective in lowering the costs and antibiotic resistance.

Keywords: Antibiotic consumption, antimicrobial resistance surveillance, restriction policy.