Limits...
Community prescribing and resistant Streptococcus pneumoniae.

Barkai G, Greenberg D, Givon-Lavi N, Dreifuss E, Vardy D, Dagan R - Emerging Infect. Dis. (2005)

Bottom Line: In both populations, antimicrobial prescriptions were markedly reduced over time, especially for penicillins and erythromycin.In contrast, azithromycin prescriptions increased from 1998 to 2001 with a parallel increase in macrolide and multidrug resistance.Penicillin resistance was associated with macrolide resistance.

View Article: PubMed Central - PubMed

Affiliation: Soroka University Medical Center and Ben-Gurion University of the Negev, Beer-Sheva, Israel.

ABSTRACT
We investigated the association between prescribing antimicrobial agents and antimicrobial resistance of Streptococcus pneumoniae among children with acute otitis media in southern Israel. During a 6-year period, all prescriptions of a sample of approximately 20% of Jewish and Bedouin children <5 years of age were recorded and all pneumococcal isolates from middle ear fluid were collected. Although antimicrobial drug use was significantly higher in Bedouin children, the proportion of S. pneumoniae isolates with penicillin MIC = or > 1.0 microg/mL was significantly higher in Jewish children. In both populations, antimicrobial prescriptions were markedly reduced over time, especially for penicillins and erythromycin. In contrast, azithromycin prescriptions increased from 1998 to 2001 with a parallel increase in macrolide and multidrug resistance. Penicillin resistance was associated with macrolide resistance. These findings strongly suggest that azithromycin affects increased antimicrobial resistance, including multidrug resistance, in S. pneumoniae.

Show MeSH

Related in: MedlinePlus

Antimicrobial drug prescription rates for Bedouin and Jewish children <5 years of age in southern Israel from 1998 through 2003. Amoxi, amoxicillin; Amoxi-clav, amoxicillin-clavulanate; Pen, phenoxymethyl penicillin; Azithro, azithromycin; Ceph, cephalosporins (cefazolin, cefaclor, cephalexin monohydrate, and cefuroxime-axetil); Ery, erythromycin.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3367585&req=5

Figure 1: Antimicrobial drug prescription rates for Bedouin and Jewish children <5 years of age in southern Israel from 1998 through 2003. Amoxi, amoxicillin; Amoxi-clav, amoxicillin-clavulanate; Pen, phenoxymethyl penicillin; Azithro, azithromycin; Ceph, cephalosporins (cefazolin, cefaclor, cephalexin monohydrate, and cefuroxime-axetil); Ery, erythromycin.

Mentions: As a group, penicillins were the most frequently prescribed agents and accounted for 80.6% (120,514/149,589) of prescriptions for Bedouin and 80.4% (69,872/86,877) for Jewish children (Table and Figure 1). The cephalosporin group ranked second in Bedouin children (12.5% of all prescriptions), and azithromycin ranked second in Jewish children (10.4% of all prescriptions). Significantly more amoxicillin (1.53-fold), amoxicillin-clavulanate (2.10-fold), cephalosporins (3.04-fold), and erythromycin (1.44-fold) were prescribed for Bedouin than for Jewish children. Jewish children received more prescriptions for phenoxymethyl penicillin (1.20-fold) and azithromycin (1.41-fold) than Bedouin children. All differences between prescription rates of Bedouin and Jewish children were significant (Table).


Community prescribing and resistant Streptococcus pneumoniae.

Barkai G, Greenberg D, Givon-Lavi N, Dreifuss E, Vardy D, Dagan R - Emerging Infect. Dis. (2005)

Antimicrobial drug prescription rates for Bedouin and Jewish children <5 years of age in southern Israel from 1998 through 2003. Amoxi, amoxicillin; Amoxi-clav, amoxicillin-clavulanate; Pen, phenoxymethyl penicillin; Azithro, azithromycin; Ceph, cephalosporins (cefazolin, cefaclor, cephalexin monohydrate, and cefuroxime-axetil); Ery, erythromycin.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3367585&req=5

Figure 1: Antimicrobial drug prescription rates for Bedouin and Jewish children <5 years of age in southern Israel from 1998 through 2003. Amoxi, amoxicillin; Amoxi-clav, amoxicillin-clavulanate; Pen, phenoxymethyl penicillin; Azithro, azithromycin; Ceph, cephalosporins (cefazolin, cefaclor, cephalexin monohydrate, and cefuroxime-axetil); Ery, erythromycin.
Mentions: As a group, penicillins were the most frequently prescribed agents and accounted for 80.6% (120,514/149,589) of prescriptions for Bedouin and 80.4% (69,872/86,877) for Jewish children (Table and Figure 1). The cephalosporin group ranked second in Bedouin children (12.5% of all prescriptions), and azithromycin ranked second in Jewish children (10.4% of all prescriptions). Significantly more amoxicillin (1.53-fold), amoxicillin-clavulanate (2.10-fold), cephalosporins (3.04-fold), and erythromycin (1.44-fold) were prescribed for Bedouin than for Jewish children. Jewish children received more prescriptions for phenoxymethyl penicillin (1.20-fold) and azithromycin (1.41-fold) than Bedouin children. All differences between prescription rates of Bedouin and Jewish children were significant (Table).

Bottom Line: In both populations, antimicrobial prescriptions were markedly reduced over time, especially for penicillins and erythromycin.In contrast, azithromycin prescriptions increased from 1998 to 2001 with a parallel increase in macrolide and multidrug resistance.Penicillin resistance was associated with macrolide resistance.

View Article: PubMed Central - PubMed

Affiliation: Soroka University Medical Center and Ben-Gurion University of the Negev, Beer-Sheva, Israel.

ABSTRACT
We investigated the association between prescribing antimicrobial agents and antimicrobial resistance of Streptococcus pneumoniae among children with acute otitis media in southern Israel. During a 6-year period, all prescriptions of a sample of approximately 20% of Jewish and Bedouin children <5 years of age were recorded and all pneumococcal isolates from middle ear fluid were collected. Although antimicrobial drug use was significantly higher in Bedouin children, the proportion of S. pneumoniae isolates with penicillin MIC = or > 1.0 microg/mL was significantly higher in Jewish children. In both populations, antimicrobial prescriptions were markedly reduced over time, especially for penicillins and erythromycin. In contrast, azithromycin prescriptions increased from 1998 to 2001 with a parallel increase in macrolide and multidrug resistance. Penicillin resistance was associated with macrolide resistance. These findings strongly suggest that azithromycin affects increased antimicrobial resistance, including multidrug resistance, in S. pneumoniae.

Show MeSH
Related in: MedlinePlus