殷秀贞 姜思通 辛晓玮 (青岛大学医学院附属医院 山东青岛 266003)
摘 要 目的：探讨β-内酰胺类抗生素用药密度对G-菌耐药性变异的影响。方法：对15种β-内酰胺类抗生素进行2002~2005年用药密度统计；对 4种G-菌进行连续4年耐药率变化统计，将“用药”对“耐药”的影响进行量化对比。结果：抗生素应用的选择是导致细菌耐药变异的重要因素之一。2004年亚胺培南用量增长一倍，铜绿假单胞菌（PA）对其耐药率当年增长14.3%；哌拉西林/克拉维酸和头孢哌铜/舒巴坦分别列2003年、2004年各品种用量首位，PA及产ESBLs超广谱β-内酰胺酶菌株对其耐药率均增加10%以上。结论：抗生素用药密度与细菌耐药性增长呈正相关，合理用药并控制用量可以减缓或降低耐药率的上升。
关键词 β-内酰胺类抗生素；用药密度；耐药性变异
中图分类号：R978.1+1
文献标识码：A
文章编号：1008-049X(2007)09-0892-03
Change of Use Density of β-lactams on Variation of Antibiotic Resistance of Gram negative Bacteria
Yin Xiuzhen,Jiang Sitong,Xin Xiaowei(The Affiliated Hospital of Medical College, Qingdao University, Qingdao 266003, China)
ABSTRACT Objective: To investigate the influence of use density of β-lactams on the variation of drug resistance of gramnegative bacteria.Method: The use density of 15 kinds of β-lactams and the drug resistance rates of 4 species gramnegative bacteria were collected during 2002 ~ 2005, the results were compared by means of statistics.Result: The selective of the antibiotics usage was one of the main factors to the variation of drug resistance. In 2004 the consumption of imipenem increased one fold, while the drug resistance rates of PA increased 14.3%.As the consumption of piperacillin/clavulanate(in2003)and cefoperazone/sulbactam(in2004) were in first place respectively, the resistance rates of PA and ESBLs strains all increased more than 10%.Conclusion: The use density of antibiotics is positively relative to the increase of drug resisitance rates. Rational use of antibiotics and control the consumption may reduce the resistance rates.
KEY WORDS β-lactams; Use density of antibiotics; Variation of drug resistance
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