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Background  The purpose of the study is to discuss the correlation between the resistance rate of gram negative bacteria to fluoroquinolones (FQ) and antibiotic consumption intensity of 145 China tertiary hospitals in 2014.    Methods  This retrospective study adopted national monitoring data from 2014. Each participating hospital required to report annual consumption of each antibiotic, and the resistance rate of gram negative bacteria to FQ. Then the correlation between antibiotic usage and fluoroquinolones –resistant (FQR) rate was consequently investigated.    Results  One hundred forty-five hospitals were included in the study, and the median antibiotic consumption intensity was 46.30 (23.93–115.39) defined daily dosages (DDDs) per 100 patient-days. Cephalosporins ranks first in the antibiotics consumption, followed by fluoroquinolones, penicillins, and carbapenems. Fluoroquinolones resistance rate varied from hospital to hospital. The correlation analysis showed significant relationship between the percentage of FQR  Escherichia coli  and the consumption of FQs (r = 0.308, p<0.01) and levofloxacin (r = 0.252,  p <0.01). For FQR  Klebsiella pneumoniae,  not only FQs (r = 0.291,  p <0.01) and levofloxacin (r = 0.260, p<0.01) use but also carbapenems (r = 0.242,  p <0.01) and overall antibiotics (r = 0.247,  p <0.01) use showed significant correlation. The resistant proportion of FQR  Pseudomonas aeruginosa  was observed to be correlated with the consumption of all antibiotics (r = 0.260,  p <0.01), FQs (r = 0.319, p<0.01) and levofloxacin (r = 0.377,  p <0.01). The percentage of levofloxacin-resistant  Acinetobacter baumannii  was significantly correlated with the consumption of all antibiotics (r = 0.282, p<0.01), third-generation cephalosporins excluding combinations with beta-lactamase inhibitors (r = 0.246, p<0.01), FQs (r = 0.254,  p <0.01) and levofloxacin (r = 0.336,  p <0.01). However, the correlation of the ciprofloxacin-resistant  A. baumannii  and the antibiotics consumption was not found .Conclusions  A strong correlation was demonstrated between the antibiotic consumption and the rates of FQR gram-negative bacteria. As unreasonable antibiotics usage remains crucial in the proceeding of resistant bacteria selection, our study could greatly promote the avoidance of unnecessary antibiotic usage.

bmc infectious diseases

Association between the rate of fluoroquinolones-resistant gram-negative bacteria and antibiotic consumption from China based on 145 tertiary hospitals data in 2014