Attached
Introduction
The World Health Organization recommends
establishing surveillance programmes to
monitor antibiotic resistance.
Objectives
This study aims to describe the resistance and
utilization pattern of antibiotics in two private
sector outpatient department (OPD) in
Colombo district.
Method
A cross-sectional descriptive study was carried
out at the OPD of two private hospitals in the
Colombo District. E s c h e r ic h ia c o li (E. c o li)
obtained from the urine specimens of
patients who were suspected to have urinary
tract infections was the indicator bacteria.
The resistance pattern tested using disc
diffusion method was extracted from
laboratory records. Details of antibiotics
dispensed in the same year at the OPD
pharmacies of the said hospitals were
extracted from pharmacy records and
quantified using Defined Daily Doses (DDD).
Results
Of the 5969 urine samples, pathogenic E. c o li
was isolated in 969 (16.2%) and 267 (28%) of
them were Extended Spectrum Beta
Lactamase producers. E. c o li was most
resistant to ampicillin (80%), followed by
nalidixic acid (67.8%), ciprofloxacin (59.5%)
norfloxacin (59%)
trimethoprim/sulphamethoxazole (52.5%),
amoxicillin /clavulanic acid (43.8%),
cephalothin (40.4%) and nitrofurantoin (9%).
Multi-drug resistance was seen in 53%.
Resistance to second level antibiotics such as
cefotaxime, cefixime, aztreonam and
cefepime was above 60%. Co-amoxiclav was
the most frequently dispensed antibiotic
(34181.8 DDDs) followed by ciprofloxacin
(22153 DDDs) and amoxicillin (15738.3 DDDs)
Conclusions
Resistance rate > 20% was observed for all
except nitrofurantoin. High use of coamoxiclav and ciprofloxacin for outpatients
would have contributed to this high rate of
resistance in the community.
