Rev Esp Quimioter 2014:27(1):28-35
Antibiotic prescribing and changes in antimicrobial resistances in the health area of Segovia (Spain) during the period between 2007 and 2011
SONIA MIGUÉLEZ-FERREIRO, ELENA MORENO-SÁNCHEZ, MARÍA GUTIÉRREZ-DE ANTONIO, SUSANA HERNANDO-REAL
Introduction. We analyzed the antibiotic prescribing and resistances of respiratory and urinary pathogens more common in the Health Area of Segovia in the period 2007-2011. The aim of the study was to investigate variability, time trends of antibiotic prescribing and correlation with changes in the antimicrobial resistance patterns.
Material and methods. Retrospective cross-sectional study. Antibiotic consumption was expressed in defined daily doses (DDD) per 1000 inhabitants per day (DHD). The antimicrobial resistance was expressed in percentages. Trend analysis was performed testing Spearman and Pearson correlation coefficients.
Results. The average antibiotic prescribing was 14.17 DHD, the coefficient and low ratio was 38.93% and 17.94. Penicillins was the most prescribed group (73%). Rural localization, lack of training MIR, distance to hospital and percentage of patients >65 years; showed significant association with increased antibiotic prescribing. Resistance of E. coli to cotrimoxazole and resistance of H. influenzae to amoxicillin decreased both by 8%. Resistance of S. pyogenes to erythromycin decreased by 5%. Resistances of S. pneumoniae to penicillin and E.coli to cephalosporins were both increased by 12%. Correlation between antibiotic prescription and resistances did not show singnificative results.
Conclusions. Prescribing of antibiotics decreased by 3.2% during the period. The use of broad-spectrum antibiotics was increased. Geographic wide variation in antibiotic prescribing was detected, also between physicians. There were not obtained conclusive data from the correlation between antibiotic prescribing and antimicrobial resistance.
Rev Esp Quimioter 2014:27(1):28-35 [pdf]