Correlational Study Between Discontinuation Of The Fourth-Generation Cephalosporin And The Dosage Of Broad-Spectrum Antibacterial Agents As Well As Resistance Rates Of Pseudomonas Aeruginosa Against Antimicrobials

Objective: To retrospectively investigate the correlation between the discontinuation of the fourth-generation cephalosporin and the dosage of other broad-spectrum antibacterial agents as well as resistance rate of Pseudomonas aeruginosa. Methods: Data on in vitro susceptibilities detected by disk diffusion test, the dosage of various antimicrobial agents which was expressed as defined daily dose (DDD) per 100 patients-days, and the discontinuation of the fourth-generation cephalosporin were collected during 2009 to 2015. The relationship between the use of fourth-generation cephalosporin and the dosage of other broad-spectrum antibacterials as well as the resistance rate of Pseudomonas aeruginosa against broad-spectrum antibacterials were evaluated by the parametric Pearson's or nonparametric Spearman's correlation coefficient. Results: There was a significant negative correlation between the dosage of the fourth-generation cephalosporin and the dosage of piperacillin-tazobactam (P = 0.015), and a significant positive correlation between the antibiotic use density (AUD) of the fourth-generation cephalosporin and the resistance rates of Pseudomonas aeruginosa against cefepime (P = 0.000). Meanwhile, there was also a significant positive correlation between resistance rate of Pseudomonas aeruginosa against levofloxacin and AUD of the fourth-generation cephalosporin (P = 0.001). Conclusion: In those hospitals or regions where Pseudomonas aeruginosa has high resistance rate against cefepime, application of the fourth-generation cephalosporin is the pressure of appearance of multidrug-resistant Pseudomonas aeruginosa.