Over 1 year, a quarter of the total population used antibacterials. Patterns of use and types of drugs used differed markedly between genders and between different age groups.
We examined the relation between various drugs used for treating high blood pressure and the incidence of acute myocardial infarction with a case-control design. Four hospitals taking care of all patients in Oslo with acute myocardial infarction participated with a total of 95 hypertensive men and women under 75 years of age who had had an acute myocardial infarction. A total of 329 age and sex matched controls were hypertensive citizens in Oslo without myocardial infarction. Frequency of treatment with drugs and odds ratio of risks with these drugs were calculated. The risk (odds ratio) of myocardial infarction for drug treatment during the last five years versus non drug treatment was 0.70 (95% confidence interval 0.42-1.18). The risk for diuretics and beta-blockers tested against no treatment was 0.91 (0.52-1.61). The corresponding risk for vasodilating drugs was 0.43 (0.20-0.91). Four weeks of exposure to alpha-blockers, on the other hand, tested against other drug treatments, indicated an odds ratio of 4.62 (1.01-24.0) for individuals with a history of angina. These data confirm that treatment with diuretics and beta-blockers has only little effect on the incidence of myocardial infarction. As a whole, vasodilators are associated with a significant reduction in this incidence, but alpha-blockers enhance the risk in patients with angina.
Background
Antiviral resistance in Norwegian influenza viruses is rare. Only one A(H1N1)pdm09 virus from May 2015 had been found resistant to oseltamivir since the introduction of these viruses in 2009.
Objectives
Surveillance of antiviral resistance is part of the Norwegian surveillance system, to rapidly detect the development of antiviral‐resistant viruses and spread in the community. We describe the spread of oseltamivir‐resistant A(H1N1)pdm09 viruses in Norway in the 2016‐17 season, found as part of the routine surveillance.
Methods
Influenza H1N1 viruses were analysed for antiviral resistance by pyrosequencing, neuraminidase susceptibility assay and by Sanger sequencing of the HA and NA genes.
Results
During the 2015‐16 influenza season, 3% of all A(H1N1)pdm09 viruses screened for resistance in Norway were resistant to oseltamivir, possessing the H275Y substitution in the neuraminidase protein. In comparison, the overall frequency in Europe was 0.87%. Out of these, 37% (n = 10) were reported from Norway. Most cases in Norway were not related to antiviral treatment, and the cases were from several different locations of southern Norway. Genetic analysis revealed that resistant virus emerged independently on several occasions and that there was some spread of oseltamivir‐resistant influenza A(H1N1)6B.1 viruses in the community, characterised by a N370S substitution in the haemagglutinin and T48I in the neuraminidase.
Conclusions
Our findings emphasise the importance of antiviral resistance surveillance in the community, not only in immunocompromised patients or other patients undergoing antiviral treatment.
Smoking habits influenced the usage of antibacterials years later with a dose-response relationship. Prescribers seem to acknowledge smoking as a risk factor for resistant bacteria since broad-spectrum antibacterials are more frequently prescribed to smokers than never smokers.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.