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KMID : 0604020080230010025
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Korean Journal of Critical Care Medicine
2008 Volume.23 No. 1 p.25 ~ p.29
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Change of Antibiotics Resistance Pattern of Microorganism Cultured in Tracheal Aspirate in Mechanical Ventilated Patients after Antibiotics Restriction Policy
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Ma Jeong-Eun
Kim Soo-Kyoung
Kang Min-Kyung
Jeong Yi-Yeong
Kim Ho-Cheol
Lee Jong-Deog
Hwang Young-Sil
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Abstract
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Background: To reduce production of resistant bacteria by over-use of antibiotics, an antibiotics restriction policy
became effective in several hospitals. However, there are different views on its effect. This study aims to examine
antibiotic resistance of pathogenic organisms cultured in tracheal aspirates of the patients who need to maintain mechanical ventilation in medical intensive care unit before and after the antibiotics restriction policy.
Methods: Before and after 2 years from August 2003, when carried out the antibiotics restriction policy in
Gyeongsang university hospital, it was retrospectively investigated the antibiotic resistance pattern of bacteria cultured
in tracheal aspirates of the patient who is maintained by mechanical ventilation more than 48 hours in the medical
intensive care unit. Restricted antibiotics are ceftazidime, piperacillin/tazobactam, imipenem, meropenem, vancomycin,
and teicoplanin.
Results: Before the antibiotics restriction policy, (Sep 2001∼Aug 2003) and after, (Sep 2003∼Aug 2005), there
were 306 and 565 patients applied in each case and the total use of antibiotics, except piperacillin/tazobactam, was
reduced and that of cefotaxime and ceftriaxone was increased. There was no significant change in antibiotic resistance
among Acinetobacter, Pseudomonas, and Enterobacter species.
Conclusions: The result of this study shows that the antibiotics restriction policy does not reduce production of
antibiotic resistant bacteria in tracheal aspirate in a medical intensive care unit. However, it is considered that
long-term observation may be necessary.
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KEYWORD
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Antibiotic resistant, Antibiotics restriction, Intensive care unit, Tracheal aspirate
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