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Antimicrobial resistance pattern of gram negative bacteria to 3rd and 4th generation cephalosporins

Introduction / objectives

Antimicrobial resistance (AMR) is increasing & the status in rural areas is less known. To find out the AMR pattern of clinical isolates of selected gram negative bacilli (GNB) to 3rd and 4thgeneration cephalosporins (GCPs) at a rural and urban tertiary care hospital.


A total 2366(Rural= 1016; Urban=1350) isolates (various clinical samples) of GNB collected over 3 consecutive months were studied for AMR pattern of selected 3rd and 4th GCPs. The data were entered in WHONET & analysed& compared with each other.


In rural & urban isolates the AMR pattern for 3rd / 4thGCPs varied from 60-100 /32-100 &34-50/21-58 respectively to selected GNB, & it was significantly more among rural isolates. Among GNB, AMR was low with E.Coli & Klebsiella but high among Pseudomonas.


A heterogeneous AMR pattern observed in the study was comparable with published reports. The probable reasons for wide variations were due to overuse, misuse& dysregulated availability of antimicrobials; promotional incentives & high profit margins; & demands of the community. These push the rural practitioners to use newer generation of antimicrobials frequently. Also lack of adherence to medication, suboptimal regulatory system (Antibiotic policy, Monitoring), lack of prescribing policies and to some extent technical aspects of GNB, might have contributed to increased AMR in rural areas. Hence there is an urgent need to design & implement antimicrobial policy & surveillance system at regional & institutional level under national guidelines.

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This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Revathi, P., Senthinath, T.J. & Vigneswari, R. Antimicrobial resistance pattern of gram negative bacteria to 3rd and 4th generation cephalosporins. BMC Proc 5 (Suppl 6), P146 (2011).

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  • Cephalosporin
  • Antimicrobial Resistance
  • Profit Margin
  • Tertiary Care Hospital
  • Gram Negative Bacillus