The geographic relationship between the use of antimicrobial drugs and the pattern of resistance for Streptococcus pneumoniae in Italy

被引:29
作者
Boccia, D [1 ]
Alegiani, SS [1 ]
Pantosti, A [1 ]
Moro, ML [1 ]
Traversa, G [1 ]
机构
[1] Hlth Protect Agcy CDSC, Ctr Communicable Dis Surveillance, London NW9 5EQ, England
关键词
ecological study; penicillin; macrolides;
D O I
10.1007/s00228-003-0724-x
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Objectives. A temporal relationship between the increasing use of antibiotics and the increasing levels of antibiotic resistance has been established for Streptococcus pneumoniae. There are also data that support the presence of a geographic correlation between the level of resistance and the pattern of use among different countries and even within the same country. The aim of this study was to evaluate the potential geographic correlation between the use of beta-lactams and erythromycin in different Italian regions and the resistance of these antibiotics to invasive strains of S. pneumoniae during the period 1999-2000. Methods. Ecological study Results. In Italy the mean level of resistance for penicillin and erythromycin was 11.4% and 28.9%, respectively. The highest level of resistance for both antibiotics was observed in central and southern regions (i.e. Campania, Lazio and the combined regions of Calabria, Puglia and Sicilia). These regions were also those with the highest consumption of antibiotics. A strong correlation was found between the prevalence of resistance to erythromycin and the regional use of macrolides (r=0.93, P=0.001) and beta-lactams (r=0.84, P=0.002). With regard to penicillin resistance, the greatest correlation was observed for oral penicillin (r=0.85, P=0.002). Conclusion. Our study provides further evidence of the association between regional level of antibiotic use and prevalence of antibiotic resistance.
引用
收藏
页码:115 / 119
页数:5
相关论文
共 15 条
[1]   The relationship between trends in macrolide use and resistance to macrolides of common respiratory pathogens [J].
Cizman, M ;
Pokorn, M ;
Seme, K ;
Orazem, A ;
Paragi, M .
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 2001, 47 (04) :475-477
[2]   Antimicrobial-drug use and changes in resistance in Streptococcus pneumoniae [J].
Diekema, DJ ;
Brueggemann, AB ;
Doern, GV .
EMERGING INFECTIOUS DISEASES, 2000, 6 (05) :552-556
[3]  
*DRUG UT MON CTR, 2000, DRUG UT IT NAT REP Y
[4]  
*EUR ANT RES SURV, 2001, ANN REP 2001
[5]   The Alexander Project 1996-1997:: latest susceptibility data from this international study of bacterial pathogens from community-acquired lower respiratory tract infections [J].
Felmingham, D ;
Grüneberg, RN .
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 2000, 45 (02) :191-203
[6]   Importance of local variations in antibiotic consumption and geographical differences of erythromycin and penicillin resistance in Streptococcus pneumoniae [J].
García-Rey, C ;
Aguilar, L ;
Baquero, F ;
Casal, J ;
Dal-Ré, R .
JOURNAL OF CLINICAL MICROBIOLOGY, 2002, 40 (01) :159-164
[7]   A review of the role of antibiotic policies in the control of antibiotic resistance [J].
Gould, IM .
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 1999, 43 (04) :459-465
[8]   Streptococcus pneunoniae resistance to erythromycin and penicillin in relation to macrolide and β-lactam consumption in Spain (1979-1997) [J].
Granizo, JJ ;
Aguilar, L ;
Casal, J ;
García-Rey, C ;
Dal-Ré, R ;
Baquero, F .
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 2000, 46 (05) :767-773
[9]   Antimicrobial use and antimicrobial resistance: A population perspective [J].
Lipsitch, M ;
Samore, MH .
EMERGING INFECTIOUS DISEASES, 2002, 8 (04) :347-354
[10]   Antibiotic prescription rates vary markedly between 13 European countries [J].
Mölstad, S ;
Lundborg, CS ;
Karlsson, AK ;
Cars, O .
SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES, 2002, 34 (05) :366-371