Streptococcus pyogenes resistance to erythromycin in relation to macrolide consumption in Spain (1986-1997)
Streptococcus pyogenes resistance to erythromycin in relation to macrolide consumption in Spain (1986-1997)
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DOI：
10.1093/jac/46.6.959
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发表时间：
2000-12-01
影响因子：
5.2
通讯作者：
Baquero, F
中科院分区：
文献类型：
--
作者：
Granizo, JJ;Aguilar, L;Baquero, F
研究了西班牙化脓性链球菌对红霉素的耐药性与大环内酯类抗生素使用的关系。红霉素耐药性与总大环内酯类药物用量高度相关(r=0.88，P<；0.01)。根据大环内酯类药物的药代动力学和药效学性质将其分成不同的亚组分别进行分析，发现红霉素耐药性主要与每日两次(r=0.86，P<；0.01)和每日一次(r=0.87，P<；0.01)有关，而与每日四次(Qds)或三次(Tds)无关(r=-0.04，P=0.90)。在连续使用BD和OD大环内酯类药物后，红霉素耐药曲线逐渐增加，导致大环内酯类药物的总用量增加，取代了TDS大环内酯类药物处方。虽然这一生态分析不能在抗生素消耗和化脓性链球菌耐药性之间建立明确的因果关系，但数据与大环内酯类抗生素的广泛使用，主要是BD和OD大环内酯类化合物的广泛使用，导致西班牙对红霉素耐药的化脓性葡萄球菌S的流行的假设是一致的。
The relationship between Streptococcus pyogenes resistance to erythromycin and macrolide consumption in Spain was studied. Erythromycin resistance was highly correlated with the consumption of total macrolides (r = 0.88, P < 0.01). When macrolides were grouped into posological subgroups according to their pharmacokinetic and pharmacodynamic properties and analysed separately, erythromycin resistance appeared to be related mainly to those macrolides taken twice daily (bd) (r = 0.86, P < 0.01) and those taken once daily (od) (r = 0.87, P< 0.01), but not to those taken four (qds) or three times a day (tds) (r = -0.04, P = 0.90). A progressive increase in the erythromycin resistance curve was seen after the consecutive introduction of both bd and od macrolides, which contributed to the increase in the total macrolide consumption, replacing tds macrolide prescription. Although this ecological analysis cannot establish an unequivocal causal relationship between antibiotic consumption and S. pyogenes resistance, the data are consistent with the hypothesis that widespread use of macrolides, mainly of bd and od macrolides, resulted in an increased prevalence of S, pyogenes resistant to erythromycin in Spain.