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目的了解某城市对第三代头孢菌素(简称TGC)的使用情况和使用水平以及临床分离的革兰阴性杆菌(G杆菌)对TGC的耐药现状,为科学合理使用该类抗生素提供必要参考依据。方法以5家有代表性的医院-3年间(2000—2002)对TGC的使用消耗情况以及临床药敏试验结果为分析样本,采用世界卫生组织(WHO)推荐的限定日剂量(defineddailydose,DDD)法分析各种抗菌药的用药频度(DDDs),即治疗日数;采用纸片扩散法、Microscan系统的Mic法进行药敏试验并严格按照美国临床实验室标准化委员会(NCCLS)1999年制定的规则进行操作及判读。结果摇3年来TGC总的DDDs为130.64万个治疗日,其中2000、2001、2002年的MF分别为33.35、43.12、54.17万个治疗日;3年来头孢曲松、头孢噻肟、头孢他啶、头孢哌酮的DDDs分别为73.39、25.66、21.65、9.94万个治疗日。3年来G杆菌对TGC的平均耐药率为40郾92%,其中2000、2001、2002年的耐药率分别为30郾04%、41郾05%、-42郾58%。G杆菌对头孢曲松、头孢噻肟、头孢他啶、头孢哌酮的耐药率分别为51郾43%、46郾02%、33郾17%、33郾08%。结-论摇TGC的使用过多过滥,细菌耐药水平高。DDDs增长过高过快,导致G杆菌对TGC的耐药率不断上升,且DDDs-值越大,细菌耐药率越高。提示临床应高度重视DDDs与细菌耐药的关系及其带来
Objective To understand the use status and usage of the third generation cephalosporin (referred to as TGC) in a city and the clinical status of clinical isolates of Gram-negative bacilli (G-bacteria) to TGC, so as to provide necessary reference for scientific and reasonable use of such antibiotics in accordance with. Methods Consumption of TGC and clinical susceptibility test results from 5 representative hospitals (2000-2002) in 5 representative hospitals were used as samples for analysis. DDD was used as recommended by the World Health Organization (WHO) Method to analyze the DDDs of various antimicrobial agents, that is, the number of days of treatment. Microdissection was performed by microdispersion method using the disk diffusion method and strictly in accordance with the rules established by the American Clinical Laboratory Standardization Committee (NCCLS) in 1999 Operate and interpret. Results The total DDDs of TGC during the three years of treatment were 1.3064 million treatment days, of which the MFs in 2000, 2001 and 2002 were 33.35, 4.1312 and 54.17 million treatment days, respectively. Ceftriaxone, cefotaxime, ceftazidime and cefoperazone The DDDs of ketones were 73.39, 25.66, 21.65 and 99.04 months respectively. In the past three years, the average rate of resistance to TGC was 40 郾 92%. Among them, the drug resistance rates in 2000, 2001 and 2002 were 30 郾 04%, 41 郾 05% and 42 郾 58%, respectively. The resistance rates of Ceftriaxone to ceftriaxone, cefotaxime, ceftazidime and cefoperazone were 51% to 43%, 46% to 02%, 33% to 17% and 33% to 08%, respectively. Results - on the use of TGC too much abuse, bacterial resistance level is high. DDDs increased too fast too fast, resulting in the resistance rate of G bacilli to TGC increasing, and the larger the DDDs-value, the higher the bacterial resistance rate. Prompted clinical should attach great importance to the relationship between DDDs and bacterial resistance and brought