The Effect Of The Antibiotics Management On The Bacterial Resistance And The Role Of Procalcitonin And C-reactive Protein In The Lower Respiratory Tract Infections

Objective: To evaluate the effect of the antibiotic control and management onbacterial resistance and explore the role of procalcitonin (PCT) and C-reactive protein(CRP) in lower respiratory tract bacterial infections, which could be helpful for the properuse of antibiotics.Methods: The data of antibiotic use, the biological assay rate, the gram negative (G-)and gram positive (G+) bacterium resistance in Lianyungang First People’s Hospital in theyear2010,2011and2012were retrospectively analyzed.According to the clinical manifestations, radiology and bacterial cultures,135caseshospitalized in Lianyungang First People’s Hospital were diagnosed to be lowerrespiratory tract bacterial infections (37with G+and98with G-bacterial infections).31healthy persons were the control. The data of PCT, CRPin both groups were analyzed. Thedifferences of PCT, CRP, white blood cells（WBC）, neutrophils (N) and lymphocytes (L)between the G-and G+groups were analyzed. The relationship between the PCT and CRPwere calculated.Results:1. The clinical data of antibiotic use in Lianyungang First People’s Hospital decreasedyear by year after the antibiotic control and management. Compared the antibiotic use inin-hospital patients and out-hospital patients in2010, that in2012significantly reduced(P<0.05).2. The clindamycin, moxicillin, linezolid and vancocin resistant G+bacteriumreduced from2010to2012, and that in2012was greatly lower compared to that in2010(P<0.05). The piperacillin/tazobactama, ceftazidime, aztreonam and imipenem resistant G-bacterium reduced from2010to2012, and that in2012was greatly lower compared to thatin2010(P<0.05). However, the levofloxacin, cepoperazon and amikacin resistant G- bacterium increased during the past three years.3. The PCT levels in lower respiratory tract bacterial infections were greatly higherthan that in the control (P<0.05). There were no significant differences about the WBC, Nand L between the G+and G-infections (P>0.05).4. The PCT and CRP were direct correlations in lower respiratory tract bacterialinfections (r=0.642,P=0.033).Conclusions:1. The antibiotic control and management got a considerable effect on antibiotic use.2. The antibiotic control and management reduced bacterial resistance. Thepiperacillin/tazobactama, ceftazidime, aztreonam and imipenem resistant G-bacteriumreduced year by year. The clindamycin, moxicillin, linezolid and vancocin resistant G+bacterium also reduced year by year.3. PCT levels were significantly increased in lower respiratory tract bacterialinfections, which indicates PCT is a useful biomarker in bacterial infections.4. The PCT and CRP were direct correlations in lower respiratory tract bacterialinfections. That both PCT and CRP increase is helpful for diagnosing the bacterialinfections.