Antibiotics use and its association with Multi-Drug Resistance in a Tertiary Care Geriatrics Hospital in Egypt

Abstract

Introduction: Multi-Drug Resistance (MDR) is common in hospitalized geriatric patients. The study aims to investigate the pattern of antibiotic use and determine its association with MDR in hospitalized geriatric patients. Methodology: A retrospective cohort study including 193 geriatric patients admitted to a Geriatric Intensive Care Unit (GICU) in a tertiary care Geriatrics hospital in Egypt, throughout a consecutive 6 months duration. A review of medical records was done to extract clinical, socio-demographic, and prescribing data on antibiotics throughout admission. The presence of MDR organisms (MDROs) was determined by reviewing culture and sensitivity reports. Descriptive statistics and logistic regression analysis were performed. Results: 181 (93.8%) patients received at least 1 antibiotic. Cephalosporins were the most commonly consumed antibiotics (24%). MDROs were significantly associated with receiving ≥ 3 antibiotics. Longer hospital stay was a predictor of multiple antibiotics use (Odds Ratio of 1.075). MDROs were prevalent in 110 (57.0 %) patients. Klebsiella species were the most frequent MDROs (26%) with the highest susceptibility to amikacin. Conclusions: The study provides a detailed description of both antibiotics use and MDR among hospitalized geriatric patients in Egypt. It gives a novel insight into the ongoing drug-pathogen combinations in acute healthcare settings of the aged. This data has a potential role in applying antimicrobial stewardship programs for hospitalized geriatric patients to mitigate antimicrobial resistance in similar settings.