Risk of Pseudomonas aeruginosa antimicrobial resistance using time series analysis of antibiotic usage

Background Antimicrobial resistance is emerging as one of the most potentially disastrous threats of the 21st century. Pseudomonas aeruginosa (P. aeruginosa) is a leading resistant pathogen and is clinically significant due to its limited available treatment using antibiotics. Rising resistance of P. aeruginosa is of increasing concern and it is currently listed as one of the top three critically resistant pathogens by the World Health Organization. It is currently known that resistance in P. aeruginosa is significantly linked with the consumption of all antibiotics, making usage surveillance of particular concern. Aim The aim of the current study was to model current and future antibiotic usage using available prescription data for antipseudomonal antibiotics. Method A time-series analysis was performed on Pharmaceutical Benefits Scheme/Repatriation Pharmaceutical Benefits Scheme data from January 2000-June 2020 using Facebook Prophet time-series methods in Python 3.9.14 to analyse and forecast trends to 2025. Ethical approval was not required for this research article as it used publicly available data and did not involve human subjects. Results The usage of antipseudomonal antibiotics decreased by 14.3% from 2014 to 2020 (95% confidence interval [CI] -30.4% to 2.3%) and is projected to further decrease by 11.7% by 2025 (95% CI -30.6% to 7.3%). Conclusion The current study showed a decline in the use of certain antipseudomonal antibiotics in Australia since 2015 and projects that their use will continue to decline. This is likely due to an increased judicious use of these antibiotics.