{
  "abstract": "Background and Importance The emergence of multidrug-resistant bacteria (MDRB) represents a major public health challenge, often exacerbated by the inappropriate use of antibiotics (ATB).Aim and Objectives This study aimed to assess the relationship between antibiotic consumption and the evolution of MDRB rates in an orthopaedic institute over a 3-year period.Material and Methods A retrospective study was conducted in the pharmacy department between January 2022 and December 2024. Data on antibiotic consumption were extracted from the STKMED software and expressed as Defined Daily Doses (DDD) per 1000 Hospitalisation Days (HD). Microbiological data were collected using the MicroScan WalkAway 40 plus system. Statistical analyses were performed with Excel 2021 and SPSS version 25. Pearson’s correlation test was used to examine associations between antibiotic consumption and MDRB rates.Results The overall MDRB rate over the 3-year period was 15.82%, peaking at 18.56% in 2024. Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae were the most frequent isolates (40.58%). Antibiotic consumption reached its highest level in 2023, with 31,744.939 DDD/1000 HD.The highest DDD values were observed for glycopeptides (23,592.466 DDD/1000 HD), followed by carbapenems (18,378.767 DDD/1000 HD).MDRB distribution by department showed the highest rates in the infectious diseases unit (33.152%), followed by external consultation service (13.587%).Antibiotic consumption was also highest in the infectious diseases unit (58,241.020 DDD/1000 HD), followed by the intensive care unit (6,197.793 DDD/1000 HD).Significant correlations were found between MDRB rates and fluoroquinolone use (p<0.01) as well as oxazolidinone use (p=0.014). Moreover, carbapenemase-producing Klebsiella pneumoniae correlated significantly with carbapenem consumption (p<0.01), and methicillin-resistant Staphylococcus aureus (MRSA) rates were associated with glycylcycline use (p=0.041).Conclusion and Relevance This study highlights a concerning increase in MDRB rates in parallel with rising antibiotic consumption. These findings underscore the urgent need for implementing robust antimicrobial stewardship programs, reinforced by systematic pharmaceutical validation of prescriptions.Conflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "Mohamed Kassab Orthopaedic Institute, Pharmacy Department, Manouba, Tunisia"
      ],
      "name": "N Jegham"
    },
    {
      "affiliations": [
        "Mohamed Kassab Orthopaedic Institute, Microbiology Department, Manouba, Tunisia"
      ],
      "name": "H Miladi"
    },
    {
      "affiliations": [
        "Mohamed Kassab Orthopaedic Institute, Pharmacy Department, Manouba, Tunisia"
      ],
      "name": "S Mahfoudhi"
    },
    {
      "affiliations": [
        "Mohamed Kassab Orthopaedic Institute, Microbiology Department, Manouba, Tunisia"
      ],
      "name": "S Kaoual"
    },
    {
      "affiliations": [
        "Mohamed Kassab Orthopaedic Institute, Microbiology Department, Manouba, Tunisia"
      ],
      "name": "A Ghariani"
    },
    {
      "affiliations": [
        "Mohamed Kassab Orthopaedic Institute, Pharmacy Department, Manouba, Tunisia"
      ],
      "name": "M Laaribi"
    }
  ],
  "title": "4CPS-091 Correlation between antibiotic consumption and multidrug-resistant bacteria in an orthopaedic institute: a 3-year retrospective study",
  "uid": "4cc0f0a3-6576-5002-9d1d-c274d93d7114"
}