Pharmaco-Epidemiological Study and Correlation Between Antibiotic Resistance and Antibiotic Consumption in a Tunisian Teaching Hospital from 2010 to 2022

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Abstract
The exponential rise of bacterial resistance poses a threat to antibiotic efficacy, with a great impact on public health. This study aims to analyze the correlation between antibiotic consumption and the emergence of bacterial resistance. Conducted retrospectively at Charles Nicolle Hospital in Tunis, Tunisia, from 2010 to 2022, this study was based on STKMED® software for antibiotic consumption data, hospital administrative records for the number of hospitalization days, and SIRSCAN® software for bacteriological data. Data processing was performed using Excel® software version 2019, and analysis was conducted using SPSS23®. In 2022, consumption was almost evenly split between the two major “AWaRe” groups, with 49.33% for “Access” and 46.89% for “Watch”, and the consumption of the “Reserve” group also increased, accounting for 3.77% of the total. Bacterial resistances, notably carbapenem-resistant Klebsiella pneumoniae, increased. Seventy-four significant correlations were identified, including those between carbapenem consumption and resistance in Escherichia coli and Klebsiella pneumoniae strains. However, no significant correlation was observed with imipenem-resistant Pseudomonas aeruginosa strains. The significant correlations between the emergence of bacterial resistance and antibiotic use, particularly with antibiotics in the “Watch” and “Reserve” groups, underscore the urgent need to continue efforts to combat this threat through rational antibiotic use.

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