Comparison of antibiotic prescribing and antimicrobial resistance in urinary tract infections at the municipal level among women in two Nordic regions.

Autor:	Nygaard Jensen J; Department of Clinical Microbiology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark.; Task Force for Reducing Hospital Infections, Capital Region of Denmark, Copenhagen, Denmark., Melander E; Regional Center of Communicable Disease Control, Skaane Region, Malmö, Sweden., Hedin K; Futurum - Academy for Health and Care, Region Jönköping County, Jönköping, Sweden.; Department of Clinical Sciences, Family Medicine, Lund University, Malmö, Sweden., Bjerrum L; Section of General Practice and Research Unit for General Practice Department of Public Health, University of Copenhagen, Copenhagen, Denmark., Kornfält Isberg H; Family Medicine and Community Medicine, Lund University, Malmö, Sweden., Holm A; Section of General Practice and Research Unit for General Practice Department of Public Health, University of Copenhagen, Copenhagen, Denmark., Neel Jacobsen H; Department of Clinical Pharmacology, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark., Skovby A; Department of Clinical Microbiology, Division of Laboratory Medicine, Lund, Sweden., Córdoba Currea GC; Section of General Practice and Research Unit for General Practice Department of Public Health, University of Copenhagen, Copenhagen, Denmark., Hyllebusk L; Department of Clinical Microbiology, Division of Laboratory Medicine, Lund, Sweden., Brogaard E; Department of Medicines Resource, Skaane Region, Malmö, Sweden., Arpi M; Department of Clinical Microbiology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark.; Task Force for Reducing Hospital Infections, Capital Region of Denmark, Copenhagen, Denmark.
Jazyk:	angličtina
Zdroj:	The Journal of antimicrobial chemotherapy [J Antimicrob Chemother] 2018 Aug 01; Vol. 73 (8), pp. 2207-2214.
DOI:	10.1093/jac/dky177
Abstrakt:	Objectives: To describe and compare the prescribing of antibiotics used for urinary tract infections and its correlation with resistance in Escherichia coli in urinary samples across two adjacent regions-the Capital Region and the Skaane Region-and their municipalities in Denmark and Sweden. Methods: The Capital Region consists of 29 municipalities and 725 960 female inhabitants aged ≥18 years and the Skaane Region consists of 33 municipalities and 515 668 female inhabitants aged ≥18 years. Aggregated data from outpatient care on the prescribing of pivmecillinam, trimethoprim and nitrofurantoin from both regions were analysed. The Department of Clinical Microbiology in both regions provided data on E. coli resistance in urinary samples from women aged ≥18 years. Data were measured as the number of prescriptions/1000 women/year, number of DDDs/1000 women/year and DDDs/prescription. Correlation analyses between antibiotic prescribing and antibiotic resistance rates were performed. Results: Antibiotic prescribing and resistance rates were significantly higher in the Capital Region compared with the Skaane Region. Large variations in prescription and resistance rates were found at the municipal level, but there were no correlations between the antibiotic prescription and resistance rates when each region was analysed separately. Conclusions: Although closely related, there are large differences in antibiotic prescribing and antibiotic resistance. It is suggested that the regional guidelines are an important driver and explanatory factor for the variations; however, further research is needed in this new field and factors such as the influence of cultural aspects should be the target of further research.
Databáze:	MEDLINE
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