This study identified the trend of antibiotic consumption, antibiotic resistance pattern, and the relationship between antibiotic consumption and antibiotic resistance in a critical group of bacteria in a general regional hospital. This ecological study was based on retrospective data from inpatient databases in a general regional hospital over three years (2017-2019). The relationship between total antibiotic consumption and the percentage of antibiotic resistance among four isolated critical bacteria (P. aeruginosa, A.baumannii, E.coli and K. pneumoniae) was explored in time series analysis and linear regression. The most frequently used antibiotic was ampicillin, ciprofloxacin, and ampicillin/sulbactam. There was a significant relationship between antibiotic consumption (ampicillin, ampicillin-sulbactam, ceftazidime, gentamicin, amikacin, and ciprofloxacin) in DDD/100 bed-days and antibiotic resistance in E. coli, K. pneumoniae, and P. aeruginosa (p<0.05) but not statically significant in A. baumannii (p=0.062). The relationship between antibiotic consumption and antibiotic resistance was significant in three out of four critical groups of bacteria.

Exblifep. contains two active substances, cefepime and enmetazobactam, is an antibiotic used in adults to treat:

• complicated (difficult to treat) infections of the urinary tract (parts of the body that collect and pass out urine), including pyelonephritis (kidney infection);
• hospital-acquired pneumonia (an infection of the lungs that is caught at the hospital), including ventilator-associated pneumonia (pneumonia that develops in patients who use a machine called a ventilator to help them breathe);
• bacteraemia (bacteria in the blood) when it is associated or suspected to be associated with complicated urinary tract infection or hospital-acquired pneumonia.

Prescribers should consider official guidance on the appropriate use of antibiotics.

To assess antimicrobial stewardship and national implementation measures currently in place for optimizing antimicrobial use and for slowing the spread of AMR, authors invited public health experts from 138 LMICs to participate in a Global Survey of Experts on Antimicrobial Resistance (GSEAR). Key coverage measures, as reported by experts, were compared across countries and also juxtaposed with estimates collected in the 2020-21 WHO-organized Tripartite AMR Country Self-Assessment Survey (TrACSS). A total of 352 completed surveys from 118 LMICs were analysed. Experts in 67% of the surveyed countries reported a national action plan (NAP) on AMR, 64% reported legislative policies on antimicrobial use, 58% reported national training programs for health professionals, and 10% reported national monitoring systems for antimicrobials. 51% of LMICs had specific targeted policies to limit the sale and use of protected or reserve antibiotics. While 72% of LMICs had prescription requirements for accessing antibiotics, getting antibiotics without a prescription was reported to be possible in practice in 74% of LMICs. On average, country efforts reported in TrACSS were substantially higher than those seen in GSEAR. Increased national efforts in the areas of enforcement and monitoring of antibiotic use as well as regular monitoring of national efforts are urgently needed to reduce inappropriate antibiotic use in LMICs and to slow the spread of AMR globally.