Impact of use of multiple antimicrobials on changes in susceptibility of gram-negative aerobes
Impact of use of multiple antimicrobials on changes in susceptibility of gram-negative aerobes
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DOI：
10.1086/514747
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发表时间：
1999-05-01
影响因子：
11.8
通讯作者：
Bosso, JA
中科院分区：
文献类型：
--
作者：
Friedrich, LV;White, RL;Bosso, JA
抗菌药物使用与敏感性关系的评价通常涉及单一药物。然而，敏感性特征可能受到多种药物的影响。从1992年到1996年，我们研究了药物使用与无硝酸不动杆菌（鲍曼不动杆菌）、产气肠杆菌、大肠埃希菌、阴沟肠杆菌、肺炎克雷伯菌、铜绿假单胞菌、奇异变形杆菌和粘质沙雷氏菌对22种药物的敏感性（仅敏感率大于或等于70%）之间的关系。使用线性回归来评估每种药物的使用与对其和所有药物的敏感性。仅评价了决定系数大于或等于0.5且斜率为负的关系，并将其分类为药物使用增加和敏感性降低（向上箭头D，向下箭头%S）或药物使用减少和敏感性增加（向下箭头D，向上箭头%S）。与敏感性变化相关的药物平均数量（范围）分别为1.7（0-14）和0.6（0-7），对于下箭头%S和下箭头D，上箭头%S关系。多种抗菌药物与其他药物的敏感性相关;因此，对这些关系的监测不应仅限于单一药物。
Evaluation of antimicrobial usage vs, susceptibility relationships typically involves single agents. However, susceptibility profiles may be affected by multiple drugs. From 1992 through 1996, we studied relationships between drug usage and the susceptibility (only susceptibility rates of greater than or equal to 70%) of Acinetobacter anitratus (baumannii), Enterobacter aerogenes, Escherichia coli, Enterobacter cloacae, Klebsiella pneumoniae, Pseudomonas aeruginosa, Proteus mirabilis, and Serratia marcescens to 22 agents. Linear regression was used to assess usage of each agent vs. susceptibility to it and to all agents. Only relationships with a coefficient of determination of greater than or equal to 0.5 and a negative slope were evaluated and classified as increasing drug use and decreasing susceptibility (up arrow D, down arrow%S) or decreasing drug use and increasing susceptibility (down arrow D, up arrow%S). The mean numbers (range) of drugs associated with a change in susceptibility were 1.7 (0-14) and 0.6 (0-7), respectively, for to, down arrow%S and down arrow D, up arrow%S relationships. Multiple antimicrobials are associated with susceptibility to other drugs; thus, surveillance of these relationships should not be limited to single drugs.