Journal of Antimicrobial Chemotherapy (2000) 46, 307-309
© 2000 The British Society for Antimicrobial Chemotherapy
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Community antibiotic therapy, hospitalization and subsequent respiratory tract isolation of Haemophilus influenzae resistant to amoxycillin: a nested case–control study
a Infection and Immunodeficiency Unit, Tayside University Hospitals NHS Trust, Kings Cross Hospital; b Medical Medicines Monitoring Unit, Department of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Dundee; c Department of Microbiology, Tayside University Hospitals NHS Trust, Ninewells Hospital, Scotland, UK
The study objective was to determine whether recent community antibiotic prescribing and hospitalization are associated with ß-lactam resistance in respiratory isolates of Haemophilus influenzae. Data obtained for hospitalization and community prescribing (in the previous 3 months) from 412 adults (>15 years) in whom an episode of respiratory tract infection had been described, during which H. influenzae was isolated, were analysed. Seventy-three (17.7%) isolates of H. influenzae were resistant to amoxycillin. Resistance was associated with recent hospitalization [odds ratio (OR) 3.2, 1.8–5.6] and antibiotic exposure in the community (2.1, 1.2–3.6). These variables were independently associated with amoxycillin resistance [hospitalization (OR 4.5, 1.7–12.5) and community ß-lactam antibiotic exposure (3.9, 1.6–9.8)]. Hospitalized patients probably received antibiotics during their admission although aquisition of the organism or the ß-lactamase via plasmids from other Gram-negative organisms in the hospital could also be a factor. Control measures to reduce the inappropriate use of antimicrobials in the community and in hospital need to be reinforced.
* Correspondence address. Infection and Tropical Medicine Service, Brownlee Centre, North Glasgow University Hospitals NHS Trust, Gartnavel General Hospital, 1053 Great Western Road, Glasgow G12 0YN, UK. Tel: +44-141-211-0292; Fax: +44-141-211-0294.
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