Antibiotic use and association with bacterial resistance in a hospital in Southern Brazil

Fagner Klain Sanches, Lisiane Martins Volcão, Andrea von Groll, Flávio Manoel Rodrigues da Silva Júnior, Pedro Eduardo Almeida da Silva, Daniela Fernandes Ramos


Introduction. The increased production of new drugs is parallel with the bacterial adaptation to adverse conditions. There are several factors that have been pointed out as the cause of this, such as: globalization; the abusive use of antibiotics; and the arbitrary prescription of these drugs. Therefore, the objective of the present study was to evaluate antimicrobial usage with antibiotic resistance in 2012 and 2013 at a university hospital in Southern Brazil. Material and Methods. This study was performed at the University Hospital Dr. Miguel Riet Correa Jr. in Rio Grande/RS, Brazil. The data were collected between January 2012 and December 2013, using data from the medical clinic and two intensive care units. Results.  Were observed, 385 and 464 cases of bacterial infections, during the years of 2012 and 2013, respectively. Acinetobacter baumannii, Escherichia coli and Klebsiella pneumoniae were the most prevalent species. The total antibiotic consumption in the University Hospital (HU-FURG) in this period was 3.865 units/dose, with 1.995 units/dose in the year 2012 and 1.870 units/dose in the year 2013. Relationships between the rates of main resistant pathogens isolated and the annual consumption of the corresponding antibiotic (carbapenems, cephalosporins, sulfonamides and other β-lactams) were observed; however, they did not show significant positive associations in increased resistance associated with increased consumption. Conclusion. This study reveals the need for the dissemination and feedback of these data to clinicians and decision-makers at the hospital, as it may be crucial to improve policies on prescribing antibiotics and to implement effective infection control.


Antimicrobial; Bacterial; Nosocomial infection.

Full Text:



Barriere, S.L. (2015). Clinical, economic and societal impact of antibiotic resistance. Expert Opinion on Pharmacotherapy, 16(2). doi: 10.1517/14656566.2015.983077.

Crichton, H., O’Connell, N., Rabie, H., Whitelaw, A.C., & Dramowski, A. (2018). Neonatal and pediatric bloodstream infections: pathogens antimicrobial resistance patterns and prescribing practice at Khayelitsha District Hospital, Cape Town, South Africa. South African Medical Journal, 108(2). doi: 10.7196/SAMJ.2017.v108i2.12601.

Dasgupta, S., Das, S., Chawan, N.S., & Hazra, A. (2015). Nosocomial infections in the intensive care unit: incidence, risk factors, outcome and associated pathogens in a public tertiary teaching hospital of Eastern India. Indian Journal of Critical Care Medicina, 19(1). doi: 10.4103/0972-5229.148633.

Gaynes, R. (2017). The discovery of Penicillin – new insights after more than 75 years of clinical use. Emerging Infections Diseases, 23(5).

Harris, A.D., Pineles, L., Belton, B., Johnson, K.J., Shardell, M., Loeb, M., Newhouse, R.N., Dembry, L., Braun, B., Perencevich, E.N., Hall, K.K., Morgan, D.J., & the Benefits of Universal Glove and Gown (BUGG) Investigators. (2013). Universal glove and gowe use and acquisition of antibiotic-resistant bacteria in the ICU – A randomized trial. Journal of American Medical Society, 310(15). doi: 10.1001/jama.2013.277815.

Hawkey, P.M. (2015). Multidrug-resistant Gram-negative bacteria: a product of globalization. Journal of Hospital Infection, 89(4). doi: 10.1016/j.jhin.2015.01.008.

Helke, K.L., McCrackin, M.A., Galloway, A.M., Poole, A.Z., Salgado, C.D., & Marriot, B.P. (2016). Effects of antimicrobial use in agricultural animals on drug-resistant foodborne salmonellosis in humans: A systematic literature review. Critical Reviews in Food Science and Nutrition, 57(3). doi: 10.1080/10408398.2016.1230088.

Kalpoe JS, Sonnenberg E, Factor SH, Martin, J.R., Patel, T.S.G., & Huprikar, S. (2012). Mortality associated with carbapenem-resistant Klebsiella pneumoniae infections in liver transplant recipients. Liver Transplantation, 18(4). doi: 10.1002/lt.23374.

Lee, Y-J, Liu, H-Y, Lin, Y-C, Sun, K-L, Chun, C-L, Hsuehe, P-R. (2010). Fluoroquinolone resistance of Pseudomonas aeruginosa isolates causing nosocomial infection is correlated with levofloxacin but not ciprofloxacin use. International Journal of Antimicrobiol Agents, 35(3). doi: 10.1016/j.ijantimicag.2009.11.007.

Luepke, K.H., Suda, K.J., Boucher, S.H., Russo, R.L., Bonney, M.W., Hunt, T.D., & Mohr III, J.F. (2013). Past, present, and future of antibacterial economics: increasing bacterial resistance, limited antibiotic pipeline, and social implications. Pharmacotherapy, 37(1). doi: 10.1002/phar.1868.

MacGowan, Jr. J.E. (2012). Antimicrobial stewardship – the state of the art in 2011: focu on outcome and methods. Infection Control and Hospital Epidemiology, 33(4). doi: 10.1086/664755.

Marra, A.R., Camargo, L.F.A., Pignatari, A.C.C., Sukiennik, T., Behar, P.R.P., Medeiros, E.A.S., Ribeiro, J., Girão, E., Correa, L., Guerra, C., Brites, C., Pereira, A.P., Carneiro, I., Reis, M., Souza, M.A., Tranchesi, R., Barata, C.U., Edmond, M.B., & the Brazilian SCOPE Study Group. (2011). Nosocomial Bloodstream infections in Brazilian hospitals: analysis of 2,563 cases from a prospective nationwide surveillance study. Journal of Clinical Microbiology, 49(5). doi: 10.1128/JCM.00376-11.

Oliveira, A.C., Kovner, C.T., & da Silva, R.S. (2010) Nosocomial infection in an intensive care unit in a Brazilian university hospital. Revista Latino-Americana de Enfermagem, 18(2).

Paphitou, N.I. (2013). Antimicrobial resistance: action to combat the rising microbial. International Journal Antimicrobial Agents, 425(1). doi: 10.1016/j.ijantimicag.2013.04.00.

Raevuori, A., Lukkariniemi, L., Suokas, J.T.,Gissler, M., Suvisaari, J.M., & Haukka, J. (2016). Increased use of antimicrobial medication in bulimia nervosa and binge-eating disorder prior to the eating disorder treatment. International Journal of Eat Disorders, 49(6). doi: 10.1002/eat.22497.

Roberts, J.A., Joynt, G.M., & Choi, G.Y.S. (2012). How to optimize antimicrobial prescription in the Intensive Care Unit: principles of individualized dosing using pharmacokinetic and pharmacodynamics. International Journal of Antimicrobial Agents, 39(3). doi: 10.1016/j.ijantimicag.2011.11.002.

Sengupta, S., Chattopadhyay, M.K., & Grossart, H-P. (2012). The multifaceted roles of antibiotics and antibiotic resistance in nature. Frontiers Microbiology, 4(47). doi: 10.3389/fmicb.2013.00047.

Shah, G.S., Christensen, R.E., Wagner, D.S., Pearce, B.K., Sweeney, J., & Tait, A.R. (2014). Retrospective evaluation of antimicrobial prophylaxis in prevention of surgical site infection in the pediatric population. Pediatric Anesthesia, 24(9). doi: 10.1111/pan.12436.

Spellberg, B., Bartlett, J.G., & Gilbert, D.N. (2013). The future of antibiotics and resistance. New England Journal of Medicine, 368.

Van Boeckel, T.P., Gandra, S., Ashok, A., Caudron, Q., Grenfell, B.T., Levin, S.A., & Laxminarayan, R. (2014). Global antibiotic consumption 2000 to 2010: an analysis of national pharmaceutical sales data. Lancet Infectious Disease, 14(8). doi: 10.1016/S1473-3099(14)7078-7.

World Health Organization (WHO). High levels of antibiotic resistance found worldwide, new data shows. Published 2018. Acessed August 20, 2018.

Zowalaty, M.E.E., Belkina, T., Bahashwan, S.A., Zowalaty, A.E.E., Tebbens, J.D., Abdel-Salam, H.A., Khalil, A.I., Daghriry, S.I., Gahtani, M.A., Madkhaly, F.M., Nohi, N.I., Khodari, R.H., Sharahili, R.M., Dagreery, K.A., Khormi, M., Habibah, S.A., Medrba, B.A., Gahtani, A.A., Hifthi, R.Y., Zaid, J.M., Amshan, A.W., Alneami, A.A., Noreddin, A., & Vlček, J. (2016). Knowledge, awareness, and attitudes toward antibiotic use and antimicrobial resistance among Saudi population. International Journal of Clinical Pharmacy, 38. doi: 10.1007/s11096-016-0362-x.



  • There are currently no refbacks.

Base de Dados e Indexadores: Base, Diadorim,, DOI Crossref, Dialnet, Scholar Google, Redib, Doaj, Latindex, Portal de Periódicos CAPES

Research, Society and Development - ISSN 2525-3409

Licença Creative Commons
Este obra está licenciado com uma Licença Creative Commons Atribuição 4.0 Internacional

Rua Irmã Ivone Drumond, 200 - Distrito Industrial II, Itabira - MG, 35903-087 (Brasil)