JAC Advance Access published online on November 12, 2003
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkg488
© 2003 by The British Society for Antimicrobial Chemotherapy
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Original article
1 Department of Clinical
Microbiology, Central Hospital, SE-351 85 Växjö;
* Corresponding author. E-mail: gunnar.kahlmeter{at}ltkronoberg.se.
Received 2 June 2003
; revised 24 September 2003
; accepted 27 September 2003
Objectives: To investigate the correlation
between non-hospital antimicrobial consumption and resistance. Methods: Information on the non-hospital sales
of antimicrobials from 14 European countries in 1997 and 2000 was
compared with the antimicrobial resistance profiles of Escherichia
coli isolated from women with community-acquired urinary tract
infection in the same countries in 1999/2000. Results: There was no statistically significant
correlation between the consumption of and resistance
to co-amoxiclav, cefadroxil, fosfomycin, mecillinam, sulfamethoxazole,
trimethoprim or trimethoprim-sulfamethoxazole. On the other
hand, there were statistically significant correlations between
consumption of broad-spectrum penicillins and quinolones in 1997
and 2000 and resistance to ciprofloxacin
(P range 0.0005-0.0045)
and nalidixic acid (P range 0.0013-0.0049).
Total antimicrobial consumption in 1997 was significantly correlated
to ciprofloxacin (P = 0.0009) and nalidixic
acid (P = 0.0018) resistance, and there were
significant relationships between quinolone consumption in both
years and resistance to gentamicin (P range 0.0029-0.0043)
and nitrofurantoin (P range 0.0003-0.0007). E. coli with multiple antimicrobial resistance
were significantly more common in countries with high total antimicrobial
consumption. Conclusions: Owing to the frequent presence
of many possible confounding factors, antimicrobial resistance to
one drug does not always correlate well to the consumption of the
same drug or closely related drugs. This study showed that the degree
of antimicrobial consumption was significantly correlated to the incidence
of multidrug-resistant E. coli.
Keywords: Non-hospital antimicrobial usage and resistance
in
community-acquired Escherichia coli urinary tract
infection
2 LEO Pharma, Ballerup, Denmark
3 Swedish Institute for
Infectious Disease Control, Stockholm, Sweden;
-lactams, quinolones,
multiple resistance, Europe
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