Abstract
Antimicrobial use density (AUD) and days of therapy (DOT) are widely used to evaluate antimicrobial consumption, with surveillance of antimicrobial use being important for predicting the emergence and spread of drug-resistant bacteria. The proportion receiving antimicrobial therapy (n/1,000 admissions) and the AUD/DOT ratio as the assumed average daily dose may be useful additional indicators; however, the correlation between these measurements and antimicrobial resistance remains unclear. While we found that, in univariate analysis, the total AUD/DOT ratios of IPM/CS, panipenem/betamipron (PAPM/BP) and biapenem (BIPM) group, MEPM and doripenem (DRPM) group, and the total proportion receiving antimicrobial therapy with IPM/CS, PAPM/BP and BIPM group were significantly correlated with carbapenem resistance, the aim of this study was to evaluate carbapenem use and daily dose trends for relationships with imipenem/cilastatin (IPM/CS) or meropenem (MEPM) resistance rates of Pseudomonas aeruginosa at our hospital between January 2009 and December 2017. Based on multiple regression analysis, the total AUD/DOT ratio of MEPM and DRPM group was the only significant indicator for resistance rates of IPM/CS (β = −0.818, P = 0.007) and MEPM (β = −0.796, P = 0.010). Furthermore, according to the sigmoid dose-response model analysis, the total AUD/DOT ratio of MEPM and DRPM group equivalent to one tenth of maximum resistance rate was 0.938, suggesting that the AUD/DOT ratio of carbapenem antibiotics is not only an indicator of daily dose, but also of Pseudomonas aeruginosa resistance.
