Outpatient antibiotic use in Europe and association with resistance: a cross-national database study.
Outpatient antibiotic use in Europe and association with resistance: a cross-national database study.
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DOI：
10.1016/s0140-6736(05)17907-0
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发表时间：
2005-02-12
期刊：
影响因子：
168.9
通讯作者：
Elseviers, M
中科院分区：
文献类型：
--
作者：
Goossens, H;Ferech, M;Elseviers, M
背景 对抗生素的耐药性是一个主要的公共卫生问题，并且抗生素的使用越来越被认为是驱动这种耐药性的主要选择压力。我们的目的是评估门诊抗生素的使用情况及其与耐药性的关系。方法我们调查了欧洲 26 个国家的门诊抗生素使用情况。 1997年1月1日至2002年12月31日之间的国际可比分配或报销数据；根据世界卫生组织解剖治疗化学物质 M 分类和 DDD 测量方法，计算每 1000 名居民每天的规定日剂量 (DDD) 数量 R。我们使用 Spearman 相关系数评估了抗生素使用与抗生素耐药率之间的生态关联。结果 欧洲初级保健中的抗生素处方差异很大；比率最高的是法国（每 1000 名居民每天 32.2 DDD），最低的是荷兰（每 1000 名居民每天 10.0 DDD）。我们注意到从旧的窄谱抗生素到新的广谱抗生素的转变。我们还记录到，在每年抗生素使用量较高的国家，冬季峰值加剧，出现了显着的季节性波动。我们发现高消费国家的抗生素耐药率较高，这可能与南欧和东欧的消费高于北欧有关。解释这些数据可能为评估旨在减少抗生素使用和耐药水平的公共卫生策略提供有用的方法。
Background Resistance to antibiotics is a major public-health problem and antibiotic use is being increasingly recognised as the main selective pressure driving this resistance. Our aim was to assess outpatient use of antibiotics and the association with resistance.Methods We, investigated outpatient antibiotic use in 26 countries in Europe that provided. internationally M comparable distribution or reimbursement data, between Jan 1, 1997, and Dec 31, 2002; by calculating the number R of defined daily doses (DDD) per 1000 inhabitants per day, according to WHO anatomic therapeutic chemical M classification and DDD measurement methodology. We assessed the ecological association between antibiotic use and antibiotic resistance rates using Spearman's correlation coefficients.Findings Prescription of antibiotics in primary care in Europe varied greatly; the highest rate was in France (32.2 DDD per 1000 inhabitants daily) and the lowest was in the Netherlands (10.0 DDD per 1000 inhabitants daily). We noted a shift from the old narrow-spectrum antibiotics to the new broad-spectrum antibiotics. We also recorded striking seasonal fluctuations with heightened winter peaks in countries with high yearly use of antibiotics. We showed higher rates of antibiotic resistance in high consuming countries, probably related, to the higher consumption in southern and eastern Europe than in northern Europe.Interpretation These data might provide a useful method for assessing public-health strategies that aim to reduce antibiotic use and resistance levels.