目的 分析湛江中心人民医院肺炎克雷伯菌耐药性与抗菌药物用量的相关性,为临床合理用药提供参考.方法 采用回顾性调查方法,统计湛江中心人民医院2010-2014 年13 种抗菌药物的用药频度(DDDs)及同期肺炎克雷伯菌的耐药率,采用Pearson 法对肺炎克雷伯菌耐药性与抗菌药物用量的相关性进行统计分析.结果 肺炎克雷伯菌对亚胺培南的耐药率与亚胺培南用量呈显著正相关,与头孢噻肟用量呈显著负相关;对莫西沙星的耐药率与头孢哌酮/舒巴坦、头孢西丁用量呈显著正相关;对美罗培南的耐药率与头孢唑林、左氧氟沙星用量呈显著负相关(P< 0.05).结论 肺炎克雷伯菌对抗菌药物耐药水平变化与抗菌药物用量存在相关关系,临床应合理选用抗菌药物,以减少或延缓耐药菌株的产生.

Objective To analyze the correlation between drug resistance of Klebsiella pneumoniae and dose of antibiotics in Central People's Hospital of Zhanjiang, and to provide reference for rational drug use. Methods Defined daily doses (DDDs) of 13 antibiotics and drug resistance rate of K. pneumoniae in Central People's Hospital of Zhanjiang from 2010 to 2014 were reviewed, retrospectively. The correlation between drug resistance of K. pneumoniae and dose of antibiotics were analyzed by Pearson method. Results The resistance rate of K. pneumoniae against immipenam had positive correlation with the dose of immipenam, and negative correlation with the dose of cefotaxime. The resistance rate against moxifloxacin had positive correlation with the doses of cefoperazone/sulbactam and cefoxitin. The resistance rate against meropenem had negative correlation with the doses of cefozolin and levofloxacin, respectively (P < 0.05). Conclusions The resistance changes of K. pneumoniae have correlation with the doses of antibiotics. The proper choice of antibiotics could reduce or delay the development of antibiotic resistance.