Antibiotic use and resistance of Streptococcus pneumoniae in The Netherlands during the period 1994-1999
Antibiotic use and resistance of Streptococcus pneumoniae in The Netherlands during the period 1994-1999
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DOI：
10.1093/jac/48.3.441
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发表时间：
2001-09-01
影响因子：
5.2
通讯作者：
Goettsch, WG
中科院分区：
文献类型：
--
作者：
de Neeling, AJ;Overbeek, BP;Goettsch, WG
描述了1994-1999年期间荷兰抗生素的使用与肺炎链球菌常规分离株耐药性的关系。研究期间抗生素的平均使用量为3.4限定日剂量/1000人/天（DDD/1000/天），青霉素、除青霉素外的β-内酰胺类药物为0.066 DDD/1000/天，四环素为2.3 DDD/1000/天，甲氧苄啶和磺胺类药物为0.71 DDD/1000/天，无明显上升或下降。相比之下，大环内酯类药物的使用量翻了一番，从1994年的0.51 DDD/1000/天增加到1997年的1.0 DDD/1000/天，1998年和1999年保持在1.07 DDD/1000/天。1994年，从患者中分离出的第一批肺炎球菌显示出0.7%的青霉素耐药（中间加完全耐药），2.5%的红霉素耐药，4.2%的复方新诺明耐药，4.7%的四环素耐药。1999年，第一批分离株对青霉素耐药率为1.5%，对红霉素耐药率为3.8%，对复方新诺明耐药率为4.4%，对四环素耐药率为6.6%。红霉素耐药性的适度但显著的上升可能是由1994-1997年大环内酯类药物使用的增加引起的。青霉素耐药性的增加似乎与β-内酰胺类药物的使用增加无关.
Antibiotic use in The Netherlands during the period 1994-1999 is described in relation to the resistance of routine isolates of Streptococcus pneumoniae. The average antibiotic use in the study period was 3.4 defined daily doses per 1000 persons per day (DDD/1000/day) pencillins, 0.066 DDD/1000/day beta -lactams other than penicillins, 2.3 DDD/1000/day tetracyclines and 0.71 DDD/1000/day trimethoprim and sulphonamides, without apparent rise or decline. In contrast, the use of macrolides doubled from 0.51 DDD/1000/day in 1994 to 1.0 DDD/1000/day in 1997 and stayed at 1.07 DDD/1000/day in 1998 and 1999. In 1994 the first pneumococci isolated from patients showed 0.7% resistance to penicillin (intermediate plus full resistance), 2.5% to erythromycin, 4.2% to co-trimoxazole and 4.7% to tetracycline. In 1999 first isolates showed 1.5% resistance to penicillin, 3.8% to erythromycin, 4.4% to co-trimoxazole and 6.6% to tetracycline. The modest but significant rise in the resistance to erythromycin may have been caused by the increased use of macrolides in the years 1994-1997. The rise in resistance to penicillin seemed not to be related to increased beta -lactam use.