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Abstract Purpose China launched a 3-year rectification scheme on the clinical use of antibiotics in 2011, and a specific scheme on carbapenem use in February 2017. This study investigated the trends in and correlations between antibiotic consumption and the prevalence of carbapenem-resistant Gram-negative bacteria (CRGN) at a tertiary hospital during these years, particularly in carbapenem consumption. Methods The data were collected calculated per quarter from 2011 to 2017. The trends in antibiotic consumption and resistance were analyzed by regression analysis, while Spearman correlation analysis was used to assess the correlations. Result The total consumption of antibiotics halved during the 7-year study period, from 770.15 DDDs/1000 PDs in quarter 1 of 2011 to 395.07 DDDs/1000 PDs in quarter 4 of 2017. Meantime, carbapenem consumption showed the significant increase, from 28.71 DDDs/1000 PDs to 49.2 DDDs/1000 PDs. The detection rates of CRGN (carbapenem-resistant Klebsiella pneumonia , Acinetobacter baumannii , and Pseudomonas aeruginosa) remained stable (P > 0.05). The positive correlation was only discovered between the resistance rate of carbapenem-resistant K. pneumonia and the usage of carbapenems, which included meropenem and imipenem, with coefficients of 0.543, 0.537, and 0.497 (P < 0.05), respectively. There was no more significant correlation in this study. Conclusion The total consumption of antibiotics reduced significantly in the analysed hospital, which could be related to the antimicrobial stewardship programme. However, the carbapenem consumption was increased. The specific index should be established to limit the application of carbapenems. This study identified the positive correlation between the detection rate of carbapenem-resistant K. pneumonia and carbapenem consumption. More research is needed to confirm the impact of restricting and appropriated use of carbapenems on the prevalence of CRGN. [ABSTRACT FROM AUTHOR]

Summary: Background: The number of reported cases of resistance to tigecycline is increasing. The aim of this study was to evaluate the current standard tigecycline dosage regimen from a pharmacokinetic/pharmacodynamic (PK/PD) perspective. Methods: Pharmacokinetic parameters and microbiological data were analyzed by Monte Carlo simulation in an evaluation of effectiveness. Results: Tigecycline exhibits excellent in vitro antimicrobial activity, however the standard tigecycline dosing regimen fails to achieve the best outcome in vivo for the common drug-resistant strains, including Acinetobacter baumannii, Enterobacter spp, and Klebsiella pneumoniae. This may result in a lack of response to tigecycline therapy or to a further increase in the resistance rate. Conclusions: In the absence of new drugs on the horizon, rather than using a single fixed dosing regimen, tigecycline dosing needs to be optimized in order to achieve the desired successful clinical response and to prevent an escalation in drug resistance. [ABSTRACT FROM AUTHOR]

Abstract: The aim of the present study was to investigate the therapeutic effect and mechanism of 3,4-oxo-isopropylidene-shikimic acid (ISA) on 2,4,6-trinitrobenzenesulfonic acid (TNBS)-induced colitis in rats. (50, 100, 200mg/kg) was administered for 14days, 1day after the induction of colitis by TNBS. The colonic injury and inflammation were assessed by macroscopic damage scores and myeloperoxidase (MPO) activity. Malondialdehyde (MDA) and nitric oxide (NO) levels, and superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities in plasma were measured with biochemical methods. Prostaglandin E2 (PGE2) level in colon was determined by radioimmunoassay. Expressions of inducible nitric oxide synthase (iNOS), cyclo-oxygenase-2 (COX-2), inhibitor kappa B-alpha (IκBα) and nuclear factor kappa B (NF-κB) p65 proteins in the colonic tissue were detected with immunohistochemistry. Enhanced colonic mucosal injury, inflammatory response and oxidative stress were observed in the animals clystered with TNBS, which was manifested as the significant increase in colon mucosal damage index, MPO activity, levels of MDA, NO and PGE2, as well as the expressions of iNOS, COX-2 and NF-κB p65 proteins in the colonic mucosa, and the significant decrease in expressions of IκBα proteins in the colonic mucosa. However, these parameters were found to be significantly ameliorated in rats treated with ISA at given doses, especially at 100mg/kg and 200mg/kg. Administration of ISA may have significant therapeutic effects on experimental colitis in rats, probably due to its mechanism of antioxidation, its inhibition of arachidonic acid metabolism and its modulation of the IκBα/NF-κB p65 expression. [Copyright &y& Elsevier]