{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T05:52:41Z","timestamp":1789710761939,"version":"4.0.1"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002383","name":"King Saud University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002383","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"\n Introduction<\/jats:title>\n Multidrug-resistant (MDR) microorganisms have increased all over the world, which is considered a public health threat. The emergence of MDR bacterial pathogens correlates with the increased antibiotic usage. This study aimed to determine the correlation between antibiotic usage and antibiotic resistance within 3 years.<\/jats:p>\n <\/jats:sec>\n \n Method<\/jats:title>\n This was a retrospective cross-sectional study reviewing the positive bacterial culture results and the total antibiotic usage in six hospitals in Penang for 3 years from January 2021 to December 2023 through a convenient sampling method.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Every sample type has experienced a significant shift over the years. Most microorganisms from all samples significantly changed in distribution over time, except for\n Streptococcus pneumoniae<\/jats:italic>\n , carbapenem-resistant Enterobacterales (CRE)\n Escherichia coli<\/jats:italic>\n , and CRE\n Klebsiella pneumoniae<\/jats:italic>\n . However, methicillin-resistant\n Staphylococcus aureus<\/jats:italic>\n (MRSA),\n K. pneumoniae<\/jats:italic>\n , and\n Pseudomonas aeruginosa<\/jats:italic>\n showed significant changes in the number of total isolates from blood cultures only in the 3 years. In terms of prevalence, statistically significant differences were observed for most microorganisms from all samples except for\n S. pneumoniae<\/jats:italic>\n , CRE\n E. coli<\/jats:italic>\n , and CRE\n K. pneumoniae<\/jats:italic>\n across the years.\n P. aeruginosa<\/jats:italic>\n showed significant prevalence in blood culture over time. Cefoperazone\/sulbactam, amoxicillin\/clavulanic acid, ceftriaxone, and ceftazidime showed significant changes in susceptibility for\n K. pneumoniae<\/jats:italic>\n over time. A statistically significant difference in total antibiotic usage across the 3 years was observed. Regarding the correlation between antibiotic usage and antibiotic resistance, Pearson\u2019s correlation was 0.777 (p = 0.433), which is suggestive of a strong positive correlation between third-generation cephalosporin usage and extended-spectrum beta-lactamase (ESBL), whereas Pearson\u2019s correlation was 0.762 (p = 0.448), which also suggests strong positive correlation between carbapenem usage and CREs.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The correlation between the use of third-generation cephalosporins and ESBL rate, as well as the use of carbapenems and CRE rate, further suggests that controlling certain antibiotic usage could help mitigate the rise in MDR microorganisms.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fcimb.2025.1608921","type":"journal-article","created":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T04:10:40Z","timestamp":1754021440000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["The correlation between antibiotic usage and antibiotic resistance: a 3-year retrospective study"],"prefix":"10.3389","volume":"15","author":[{"given":"Ann Lisa","family":"Arulappen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amer Hayat","family":"Khan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed Shahzad","family":"Hasan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabariah Noor","family":"Harun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting Soo","family":"Chow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmood Basil A.","family":"Al-Rawi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wajid","family":"Syed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,8,1]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/j.jhin.2023.05.006","article-title":"Impact of antimicrobial stewardship programs on antibiotic consumption and resistance in hospitals: a multicenter study","volume":"135","author":"Abdul Aziz","year":"2023","journal-title":"J. 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