scholarly journals Rationalising antibiotic use after low-risk vaginal deliveries in a hospital setting in India

2021 ◽  
Vol 10 (Suppl 1) ◽  
pp. e001413
Author(s):  
Shakti Sharma ◽  
Nikita Kumari ◽  
Rinku Sengupta ◽  
Yashika Malhotra ◽  
Saru Bhartia
Keyword(s):  
Average Rate ◽  
Hospital Setting ◽  
Antibiotic Use ◽  
Multidrug Resistant ◽  
Antibiotic Usage ◽  
Low Risk ◽  
Care Providers ◽  
Antibiotic Policy ◽  
Case File ◽  
Vaginal Deliveries

BackgroundIn 2017, a postoperative multidrug resistant case of urinary tract infection made obstetricians at Sitaram Bhartia Institute of Science and Research introspect the antibiotic usage in labouring mothers. Random case file reviews indicated overuse and variability of practice among care providers. This prompted us to explore ways to rationalise antibiotic use.MethodsA multidisciplinary team of obstetricians, paediatricians and quality officers was formed to run this improvement initiative at a private hospital facility in India. Review of literature advocated formulating a departmental antibiotic policy. Creating this policy and implementing it using improvement methodology helped us rationalise antibiotic usage.InterventionsWe aimed to reduce the use of antibiotics from 42% to less than 10% in uncomplicated vaginal deliveries. We tested a series of sequential interventions using the improvement methodology of Plan–Do–Study–Act (PDSA) cycles, an approach recommended by the Institute for Healthcare Improvement. Learning from the PDSA cycle of the previous intervention helped decide the subsequent change ideas. The interventions included creation of a departmental antibiotic policy, staff engagement, and modification in documentation, concept of dual responsibility and team huddles as feedback opportunities. Information was analysed to understand the progress and improvement with change ideas.ResultsBackground analysis revealed that antibiotic usage ranged from 24% to 69% and average rate of antibiotic prophylaxis was high (42.28%) in low-risk uncomplicated vaginal deliveries. The sequential changes resulted in reduction in antibiotic usage to 10% in the target population by 4 months. Sustained improvement was noted in the following months.ConclusionWe succeeded in implementing a departmental antibiotic policy aligning it with existing international guidelines and our local challenges. Antibiotic stewardship was one of the first major steps in our journey to avoid multidrug-resistant infections. Sustaining outcomes will involve continuous feedback to ensure engagement of all stakeholders in a hospital setting.

scholarly journals Awareness of antibiotic usage and antimicrobial resistance among interns in a tertiary care hospital

2017 ◽  
Vol 6 (9) ◽  
pp. 2159
Author(s):  
Suchitra D. Akalu ◽  
Niveditha G. Belavadi
Keyword(s):  
Antibiotic Resistance ◽  
Antimicrobial Resistance ◽  
Health Care Providers ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Resistance Mechanisms ◽  
Antibiotic Usage ◽  
Care Hospital ◽  
Care Providers ◽  
Strongly Agree

Background: Antibiotic resistance is a global threat and new resistance mechanisms are emerging and spreading globally, threatening our ability to treat common infectious diseases. Reducing the incidence of drug resistant infections is crucial and is a top priority at global and national levels. A study was conducted among interns to assess the awareness related to antibiotic usage and resistance.Methods: The questionnaire was administered to a batch of 75 medical interns whereby their awareness regarding antibiotic use and resistance was assessed by a five point Likert scale, whose responses ranged from “strongly agree” to “strongly disagree”, and always to never. Some questions were of true and false type. The data was analysed by using simple descriptive statistics.Results: Out of the 78 interns, 75 participated in the study and completed the questionnaires. All the 75 (100%) interns believed that indiscriminate antibiotic use leads to antimicrobial resistance and 78.6% (n=59) believed that if antimicrobials are taken too often, they are less likely to work in the future. Majority (90.6%) of the interns knew of the fact that common cold and influenza are due to viral aetiology and not bacterial. Regarding the antibiotic practices of the interns, questionnaire addressed questions related to their practices related to use of antimicrobials, 66.6% (n=50) of the interns disagreed on the question that antibiotics are safe drugs, hence can be commonly used while 62.6% (n=47) do not believe that skipping one or two doses of the drug does not lead to antibiotic resistance.Conclusions: The antibiotic resistance crisis has been attributed to the overuse and misuse of these medications. Judicious use of antibiotics is the only solution for which awareness is required at the level of both health care providers and patients. Our study provides an important insight regarding the regarding awareness of antibiotic usage and antibiotic resistance among interns.

scholarly journals The Expectations of Low and High Risk Pregnant Women Who Seeking Obstetrical Care in a Highly Specialized Hospital

2014 ◽  
Vol 1 (1) ◽  
Author(s):  
Roxana Behruzi ◽  
Marie Hatem ◽  
Lise Goulet ◽  
William Fraser
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Care Provider ◽  
Hospital Setting ◽  
Tertiary Hospital ◽  
Low Risk ◽  
Care Providers ◽  
Obstetrical Care ◽  
Specialized Hospital ◽  
Low Risk Women

Background: In the context of a highly specialized hospital, birth care might be is expected to be more medicalized and technocratic for both low and high risk pregnant women.Objective: This study aimed to explore the expectation of low and high risk pregnant women who seeking an obstetrical care in a highly specialized hospital.Methods: A single case study design was chosen for this study. The case under study was a tertiary and university affiliated hospital in Montreal, Canada. The data were collected through semi-structured interviews, field notes, participant observations and self-administered questionnaire. An inductive qualitative content analysis was used.Results: As a whole 157 women were participated in the study. The analysis of data showed that both high and low risk women felt more satisfied with the care they received if they were provided with informed choices, had the right to participate in the decision-making process and were surrounded by competent care providers and obstetric technology. The presence of an attentive care provider during labour who humanly cared for women and her family considered as essential component of birth care by women participant.Conclusion: A birth care provider in a tertiary hospital setting should aim to meet both physiological and psychological aspects of birth care, including respect of the fears, beliefs, values, and needs of women and their families. Integration of competent and caring professionals, as well as the use of obstetric technology, could enhance the level of certainty and assurance in both high-risk and low risk women in a tertiary hospital.

Exploring the Validity and Operational Impact of Using Allied Health Assistants to Conduct Dysphagia Screening for Low-Risk Patients Within the Acute Hospital Setting

2020 ◽  
Vol 29 (4) ◽  
pp. 1944-1955 ◽  
Author(s):  
Maria Schwarz ◽  
Elizabeth C. Ward ◽  
Petrea Cornwell ◽  
Anne Coccetti ◽  
Pamela D'Netto ◽  
...  
Keyword(s):  
At Risk ◽  
Allied Health ◽  
Assessment Tool ◽  
Hospital Setting ◽  
Low Risk ◽  
False Negatives ◽  
Exact Agreement ◽  
Risk Patients ◽  
Impact Phase ◽  
Operational Impact

Purpose The purpose of this study was to examine (a) the agreement between allied health assistants (AHAs) and speech-language pathologists (SLPs) when completing dysphagia screening for low-risk referrals and at-risk patients under a delegation model and (b) the operational impact of this delegation model. Method All AHAs worked in the adult acute inpatient settings across three hospitals and completed training and competency evaluation prior to conducting independent screening. Screening (pass/fail) was based on results from pre-screening exclusionary questions in combination with a water swallow test and the Eating Assessment Tool. To examine the agreement of AHAs' decision making with SLPs, AHAs ( n = 7) and SLPs ( n = 8) conducted an independent, simultaneous dysphagia screening on 51 adult inpatients classified as low-risk/at-risk referrals. To examine operational impact, AHAs independently completed screening on 48 low-risk/at-risk patients, with subsequent clinical swallow evaluation conducted by an SLP with patients who failed screening. Results Exact agreement between AHAs and SLPs on overall pass/fail screening criteria for the first 51 patients was 100%. Exact agreement for the two tools was 100% for the Eating Assessment Tool and 96% for the water swallow test. In the operational impact phase ( n = 48), 58% of patients failed AHA screening, with only 10% false positives on subjective SLP assessment and nil identified false negatives. Conclusion AHAs demonstrated the ability to reliably conduct dysphagia screening on a cohort of low-risk patients, with a low rate of false negatives. Data support high level of agreement and positive operational impact of using trained AHAs to perform dysphagia screening in low-risk patients.

Urinary tract infections (UTIs); a leaflet for older adults, and carers: the development of a UTI leaflet for older adults and their carers

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X696833 ◽  
Author(s):  
Leah Ffion Jones ◽  
Emily Cooper ◽  
Cliodna McNulty
Keyword(s):  
Older Adults ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Care Home ◽  
Asymptomatic Bacteriuria ◽  
Theoretical Domains Framework ◽  
Antibiotic Use ◽  
Primary Care Providers ◽  
Care Providers ◽  
Tract Infections

BackgroundEscherichia coli bacteraemia rates are rising with highest rates in older adults. Mandatory surveillance identifies previous Urinary Tract Infections (UTI) and catheterisation as risk factors.AimTo help control bacteraemias in older frail patients by developing a patient leaflet around the prevention and self-care of UTIs informed by the Theoretical Domains Framework.MethodFocus groups or interviews were held with care home staff, residents and relatives, GP staff and an out of hours service, public panels and stakeholders. Questions explored diagnosis, management, prevention of UTIs and antibiotic use in older adults. The leaflet was modified iteratively. Discussions were transcribed and analysed using Nvivo.ResultsCarers of older adults reported their important role in identifying when older adults might have a UTI, as they usually flag symptoms to nurses or primary care providers. Information on UTIs needs to be presented so residents can follow; larger text and coloured sections were suggested. Carers were optimistic that the leaflet could impact on the way UTIs are managed. Older adults and relatives liked that it provided new information to them. Staff welcomed that diagnostic guidance for UTIs was being developed in parallel; promoting consistent messages. Participants welcomed and helped to word sections on describing asymptomatic bacteriuria simply, preventing UTIs, causes of confusion and when to contact a doctor or nurseConclusionA final UTI leaflet for older adults has been developed informed by the TDF. See the TARGET website www.RCGP.org.uk/targetantibiotics/

THE RELATION BETWEEN KNOWLEDGE AND ATTITUDE TOWARD BEHAVIOR OF ANTIBIOTIC USAGE ON SOCIETY IN TALANG JAWA HEALTH CENTER OF SOUTH LAMPUNG AUGUST PERIOD 2019

1970 ◽  
pp. 132-141
Author(s):  
Lilik Koernia Wahidah
Keyword(s):  
Health Center ◽  
Significant Relationship ◽  
Health Centre ◽  
Antibiotic Use ◽  
Antibiotic Usage ◽  
Bivariate Analysis ◽  
Chi Square ◽  
Public Health Centre ◽  
Knowledge And Attitude ◽  
Use Behavior

In developing countries, many antibiotics are used without a doctor's prescription, causing someone to use antibiotics incorrectly. Lack of knowledge about antibiotics is a major factor that triggers an increase in the rate of bacterial resistance to antibiotics. Knowledge and attitude become one of the social cognitive factors that influence antibiotic use behavior.This study aims to determine the relationship of knowladge and attitudes toward of antibiotic usage behavior in community of Talang jawa public health centre. The research is an observasional analytic research using cross sectional study design. sampling using non-probability sampling methode with type purposive sampling and instruments in the form of questionnaires. The data analysis was based univariate and bivariate analysis eqipped with chi square. The study was conducted on 100 community respondents in the Talang Jawa Health Center. The results showed respondents with good knowledge (25%), enough (27%) and less (48%). Respondents with positive attitudes (64%) and negative attitudes (35%). Respondents with positive behavior (43%) and negative behavior (57%). Chi square test result showed that there was a significant relationship between knowladge and antibiotic use behavior (p= 0,000) and there was a significant relationship between attitude and antibiotic use behavior (p= 0,000). This study has a meaningful relationship between and attitudes with antibiotic use behavior in Talang Jawa Health Center. Keywords: Antibiotics,Knowledge, Attitudes, Behavior

scholarly journals 180. Leveraging the Electronic Medical Record as a Method of Antibiotic Stewardship

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S97-S97
Author(s):  
Christina M Kaul ◽  
Eric Molina ◽  
Donna Armellino ◽  
Mary Ellen Schilling ◽  
Mark Jarrett
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Antibiotic Stewardship ◽  
Antibiotic Use ◽  
Antibiotic Usage ◽  
P Value ◽  
Inpatient Setting ◽  
Post Intervention ◽  
Paired Samples ◽  
Viable Method

Abstract Background Overutilization of antibiotics remains an issue in the inpatient setting. What is more, many protocols geared toward curbing improper antibiotic use rely heavily on resource- and personnel-intensive interventions. Thus, the potential for using the EMR to facilitate antibiotic stewardship remains largely unexplored. Methods We implemented a novel change for ordering certain antibiotics in our EMR: ceftriaxone, daptomycin, ertapenem, imipenem, meropenem, and piperacillin-tazobactam. When ordering one of these antibiotics, providers had to note a usage indication, which assigned a usage duration as per our Antibiotic Stewardship Committee guidelines. Pre-intervention, manual discontinuation was required if a provider did not enter a duration. The intervention was enacted August 2019 in 13 hospitals. Data was collected from January 2018 to February 2020. Antibiotic usage was reported monthly as rate per 1000-patient days. Monthly pre- and post-intervention rates were averaged, respectively. Paired samples t-tests were used to compare pre- and post-intervention rates per unit type per hospital. A p-value of less than 0.05 was considered significant. Units with minimal usage, as defined by a pre- or post-intervention mean of 0, were excluded from analysis. Example of Ordering an Antibiotic Prior to Intervention Example of Ordering an Antibiotic After Intervention Results Ertapenem was noted to have a statistically significant decrease in utilization in seven units at three hospitals. Piperacillin-tazobactam was found to have a decrease in utilization in 19 units at eight hospitals. Daptomycin was found to have a decrease in utilization in one unit. Significant decreases in the utilization of ceftriaxone, imipenem, and meropenem were not noted. Example of Statistically Significant Decreased Utilization in Piperacillin-Tazobactam on a Medical-Surglcal Unit Conclusion Our study showed a statistically significant decrease in use of ertapenem, piperacillin-tazobactam and daptomycin using a simple built-in EMR prompt that curtails provider error. This should allow for an increased ease of integration, as the protocol does not require a host of resources for maintenance. Of note is decreased utilization of piperacillin-tazobactam and ertapenem across multiple hospitals, most notably on the medical and surgical wards. Thus, usage of the EMR without personnel-intensive protocols is a viable method for augmenting antibiotic stewardship in health systems. Disclosures All Authors: No reported disclosures

scholarly journals SARS-CoV-2 detection status associates with bacterial community composition in patients and the hospital environment

Microbiome ◽  
2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Clarisse Marotz ◽  
Pedro Belda-Ferre ◽  
Farhana Ali ◽  
Promi Das ◽  
Shi Huang ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Rna Virus ◽  
Bacterial Community Composition ◽  
Hospital Setting ◽  
Amplicon Sequencing ◽  
Hospital Environment ◽  
Rrna Gene ◽  
Sequence Variant ◽  
Care Providers ◽  
Single Amplicon

Abstract Background SARS-CoV-2 is an RNA virus responsible for the coronavirus disease 2019 (COVID-19) pandemic. Viruses exist in complex microbial environments, and recent studies have revealed both synergistic and antagonistic effects of specific bacterial taxa on viral prevalence and infectivity. We set out to test whether specific bacterial communities predict SARS-CoV-2 occurrence in a hospital setting. Methods We collected 972 samples from hospitalized patients with COVID-19, their health care providers, and hospital surfaces before, during, and after admission. We screened for SARS-CoV-2 using RT-qPCR, characterized microbial communities using 16S rRNA gene amplicon sequencing, and used these bacterial profiles to classify SARS-CoV-2 RNA detection with a random forest model. Results Sixteen percent of surfaces from COVID-19 patient rooms had detectable SARS-CoV-2 RNA, although infectivity was not assessed. The highest prevalence was in floor samples next to patient beds (39%) and directly outside their rooms (29%). Although bed rail samples more closely resembled the patient microbiome compared to floor samples, SARS-CoV-2 RNA was detected less often in bed rail samples (11%). SARS-CoV-2 positive samples had higher bacterial phylogenetic diversity in both human and surface samples and higher biomass in floor samples. 16S microbial community profiles enabled high classifier accuracy for SARS-CoV-2 status in not only nares, but also forehead, stool, and floor samples. Across these distinct microbial profiles, a single amplicon sequence variant from the genus Rothia strongly predicted SARS-CoV-2 presence across sample types, with greater prevalence in positive surface and human samples, even when compared to samples from patients in other intensive care units prior to the COVID-19 pandemic. Conclusions These results contextualize the vast diversity of microbial niches where SARS-CoV-2 RNA is detected and identify specific bacterial taxa that associate with the viral RNA prevalence both in the host and hospital environment.

scholarly journals Animal and Human Multidrug-Resistant, Cephalosporin-ResistantSalmonella Isolates Expressing a Plasmid-Mediated CMY-2 AmpC β-Lactamase

2000 ◽  
Vol 44 (10) ◽  
pp. 2777-2783 ◽  
Author(s):  
P. L. Winokur ◽  
A. Brueggemann ◽  
D. L. DeSalvo ◽  
L. Hoffmann ◽  
M. D. Apley ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Plasmid Dna ◽  
Antibiotic Use ◽  
Multidrug Resistant ◽  
Geographic Region ◽  
Chromosomal Dna ◽  
Important Food ◽  
Food Borne ◽  
Clonal Spread ◽  
Resistance Rates

ABSTRACT Salmonella spp. are important food-borne pathogens that are demonstrating increasing antimicrobial resistance rates in isolates obtained from food animals and humans. In this study, 10 multidrug-resistant, cephalosporin-resistant Salmonellaisolates from bovine, porcine, and human sources from a single geographic region were identified. All isolates demonstrated resistance to cephamycins and extended-spectrum cephalosporins as well as tetracycline, chloramphenicol, streptomycin, and sulfisoxazole. Molecular epidemiological analyses revealed eight distinct chromosomal DNA patterns, suggesting that clonal spread could not entirely explain the distribution of this antimicrobial resistance phenotype. However, all isolates encoded an AmpC-like β-lactamase, CMY-2. Eight isolates contained a large nonconjugative plasmid that could transformEscherichia coli. Transformants coexpressed cephalosporin, tetracycline, chloramphenicol, streptomycin, and sulfisoxazole resistances. Plasmid DNA revealed highly related restriction fragments though plasmids appeared to have undergone some evolution over time. Multidrug-resistant, cephalosporin-resistant Salmonellaspp. present significant therapeutic problems in animal and human health care and raise further questions about the association between antimicrobial resistance, antibiotic use in animals, and transfer of multidrug-resistant Salmonella spp. between animals and man.

scholarly journals Arginine Is a Critical Substrate for the Pathogenesis of Pseudomonas aeruginosa in Burn Wound Infections

mBio ◽  
2017 ◽  
Vol 8 (2) ◽  
Author(s):  
Jake Everett ◽  
Keith Turner ◽  
Qiuxian Cai ◽  
Vernita Gordon ◽  
Marvin Whiteley ◽  
...  
Keyword(s):  
Antimicrobial Agents ◽  
Hospital Setting ◽  
Multidrug Resistant ◽  
Burn Patients ◽  
Burn Wound ◽  
Burn Wounds ◽  
Resistant Strains ◽  
High Doses ◽  
Ubiquitous Presence

ABSTRACT Environmental conditions affect bacterial behavior and can greatly influence the course of an infection. However, the environmental cues that elicit bacterial responses in specific infection sites are relatively unknown. Pseudomonas aeruginosa is ubiquitous in nature and typically innocuous. However, it is also one of the most prevalent causes of fatal sepsis in burn wound patients. The aim of this study was to determine the impact of environmental factors, specifically the availability of arginine, on the pathogenesis of P. aeruginosa in burn wound infections. Comparison of burned versus noninjured tissue revealed that l-arginine (l-Arg) was significantly depleted in burn wounds as a consequence of elevated arginase produced by myeloid-derived suppressor cells. We also observed that l-Arg was a potent chemoattractant for P. aeruginosa, and while low concentrations of l-Arg increased P. aeruginosa’s swimming motility, high concentrations resulted in diminished swimming. Based on these observations, we tested whether the administration of exogenous l-Arg into the burn wound could attenuate the virulence of P. aeruginosa in thermally injured mice. Administration of l-Arg resulted in decreased P. aeruginosa spread and sepsis and increased animal survival. Taken together, these data demonstrate that the availability of environmental arginine greatly influences the virulence of P. aeruginosa in vivo and may represent a promising phenotype-modulating tool for future therapeutic avenues. IMPORTANCE Despite our growing understanding of the pathophysiology of burn wounds and the evolution of techniques and practices to manage infections, sepsis remains a significant medical concern for burn patients. P. aeruginosa continues to be a leader among all causes of bacteremic infections due to its tendency to cause complications in immunocompromised patients and its ubiquitous presence in the hospital setting. With the unforgiving emergence of multidrug-resistant strains, it is critical that alternative strategies to control or prevent septic infections in burn patients be developed in parallel with novel antimicrobial agents. In this study, we observed that administration of l-Arg significantly reduced bacterial spread and sepsis in burned mice infected with P. aeruginosa. Given the safety of l-Arg in high doses and its potential wound-healing benefits, this conditionally essential amino acid may represent a useful tool to modulate bacterial behavior in vivo and prevent sepsis in burn patients. IMPORTANCE Despite our growing understanding of the pathophysiology of burn wounds and the evolution of techniques and practices to manage infections, sepsis remains a significant medical concern for burn patients. P. aeruginosa continues to be a leader among all causes of bacteremic infections due to its tendency to cause complications in immunocompromised patients and its ubiquitous presence in the hospital setting. With the unforgiving emergence of multidrug-resistant strains, it is critical that alternative strategies to control or prevent septic infections in burn patients be developed in parallel with novel antimicrobial agents. In this study, we observed that administration of l-Arg significantly reduced bacterial spread and sepsis in burned mice infected with P. aeruginosa. Given the safety of l-Arg in high doses and its potential wound-healing benefits, this conditionally essential amino acid may represent a useful tool to modulate bacterial behavior in vivo and prevent sepsis in burn patients.

Identification of bacteriological quality and antimicrobial resistance of microorganisms isolated from animal foods collected from the abattoir, butcher shops and local seafood market

Food Research ◽  
2021 ◽  
Vol 5 (3) ◽  
pp. 144-151
Author(s):  
P. Vijayalakshmi ◽  
A. Rajani Chowdary ◽  
P. Vidyullatha ◽  
M. Sharon Sushma
Keyword(s):  
Antimicrobial Resistance ◽  
Culture Media ◽  
Morphological Characteristics ◽  
Sampling Technique ◽  
Antibiotic Use ◽  
Multidrug Resistant ◽  
Resistance Pattern ◽  
Human Beings ◽  
Isolation And Characterization ◽  
Butcher Shops

The current study aimed to isolate bacteria that harbour various animal food products like meat, chicken and seafoods collected from the abattoir, butcher shops and local seafood market and to determine the antimicrobial resistance pattern of isolated pathogens which are responsible for various foodborne illnesses in human beings. A total of forty raw animal product samples were collected from the abattoir, butcher shops and local seafood market of Visakhapatnam. The samples selected for the study include raw chicken, meat, crab, prawns and different varieties of fish. A classic random sampling technique was employed to collect the study samples. All the samples were processed immediately using standard microbiological protocols. The bacteria isolation and characterization were done by studying morphological characteristics with staining methods, cultural characteristics by isolating and growing the pathogenic microorganisms in various selective and differential culture media. Antimicrobial susceptibility testing was performed by the Kirby -Bauer method by following Clinical and Laboratory Standards Institute (CLSI) guidelines. EDTA-Disc Potentiation Test and Imipenem-EDTA Double disc synergy test are used to detect the metallo beta-lactamase production of isolated pathogens. The highest number of isolates belong to Salmonella species (18), Pseudomonas aeruginosa (18) followed by Vibrio species (14) and few isolates belong to Enterobacter species (4). Majority of the microbial isolates obtained in the current study were multidrug resistant. The isolates from the abattoir environments, slaughterhouses, fish markets were found to exhibit variable resistance pattern to aminoglycosides, macrolides, β-lactams, cephalosporins, quinolone antibiotics used in the present study and at the same time most of them were sensitive to carbapenem antibiotic imipenem. Antimicrobial resistance (AMR) prevents the designing and assessment of effective interventions. If such a link can be established, then the tracking of antibiotic use and consumption data could be furthermore used as a surrogate indicator for the risk of potential antibiotic resistance (ABR) emergence.

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