El uso de antibióticos y la amenaza de resistencia microbiana

Introduction: The inappropriate use of antibiotics drives the emergence of multidrug-resistant organisms, representing a major and growing challenge to public health systems worldwide. Compliance with World Health Organization (WHO) recommendations and the implementation of effective institutional policies are crucial steps to curbing antimicrobial resistance within hospital settings. Objective: To analyze trends in antibiotic consumption and bacterial resistance in a public hospital in Ica, Peru. Methods: A retrospective observational study was carried out, analyzing systemic antibiotic prescriptions (group J01) in hospitalized adult patients from January 2022 to June 2024. Antibiotic consumption was measured using defined daily doses per 100 occupied bed-days in the Departments of Emergency, Internal Medicine, GynecologyObstetrics, and Surgery. Data on clinical bacterial isolates and their antibiotic susceptibility profiles were obtained from the hospital’s Microbiology Service. Results: Antibiotic consumption increased by 25.95%, with cephalosporins and carbapenems representing the highest share (45.64%), followed by quinolones (17.52%) and macrolides/lincosamides (15.28%). The use of OMS-designated “Access” antibiotics also rose by 36.29%. Of the 13 280 processed samples, 3 186 bacterial strains were isolated, predominantly Gram-negative (82.86%), mainly Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Acinetobacter baumannii. High resistance levels were detected, particularly in ESBL-producing K. pneumoniae, E. coli, and A. baumannii. Conclusion: The increasing trend in antibiotic consumption and bacterial resistance highlights the urgent need to implement robust antimicrobial stewardship programs and enforce susceptibility-based therapeutic approaches.