# P-1308. Assessing the Drug Resistance Index of E. coli and K. pneumoniae in Two Public Hospitals in uMgungundlovu District, KwaZulu-Natal

## TL;DR

This study measured antibiotic resistance in E. coli and K. pneumoniae from two hospitals in South Africa, finding high resistance levels that suggest current treatments are becoming less effective.

## Contribution

The study provides a localized drug resistance index for E. coli and K. pneumoniae using hospital-specific antibiotic consumption and resistance data.

## Key findings

- The drug resistance index for E. coli ranged from 55 to 58, and for K. pneumoniae from 68 to 88.
- Current empiric treatments for these bacteria are less effective, requiring updated hospital guidelines.
- Improved national surveillance of antibiotic resistance and consumption is needed for better policy decisions.

## Abstract

Antibiotic resistance (ABR) is a growing global health concern, with inappropriate prescribing practises playing a significant role. The drug resistance index (DRI) is a composite metric used by policymakers to assess the effectiveness of antibiotic therapy, where a score of 0 indicates complete susceptibility and 100 indicating complete resistance.

This study evaluated the DRI for Escherichia coli and Klebsiella pneumoniae using antibiotic consumption and resistance data from two public sector hospitals in the uMgungundlovu District in KwaZulu-Natal, between 2017 and 2019. Antibiotic consumption (ABC) data were sourced from the Provincial Department of Health for one district and one tertiary hospital, while antibiotic resistance data were obtained from a surveillance study of urinary tract and bloodstream infections. ABC was calculated using the WHO GLASS methodology, incorporating Defined Daily Dose (DDD) and bed-occupancy.

The DRI ranged from 55-58 for E. coli and and 68-88 for K. pneumoniae, across the study period, indicating reduced effectiveness of current empiric treatments .

These findings highlight the urgent need to revise standard treatment guidelines at the hospital level. Strengthening national surveillance of ABR and ABC is essential to inform evidence-based policy and optimize antimicrobial stewardship.

Sabiha Essack, B. Pharm, M. Pharm, PhD, CARB-X: Board Member|GSK: Honoraria|Reckitt (Pty.) Ltd.: Honoraria