Do antimicrobials increase the carriage rate of penicillin resistant pneumococci in children? Cross sectional prevalence study

Arason, Vilhjalmur A.; Kristinsson, Karl G.; Sigurdsson, Jóhann Á.; Stefansdottir, Gudrun; Mölstad, Sigvard; Guðmundsson, Sigurður

doi:10.1136/bmj.313.7054.387

Cited by 426 publications

(283 citation statements)

References 21 publications

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“…Extrapolating from the prevalence data in 2010 across the United States suggests that the average child may be receiving nearly 3 courses of antibiotics by the time they are 2, 11 courses by the time they are 10, and 17 courses by the time they are 20 years old. Such data are consistent with more limited studies in other developed countries (63)(64)(65).…”

Section: State Of the Art S24supporting

confidence: 80%

A Brave New World: The Lung Microbiota in an Era of Change

Segal

Blaser

2014

Annals ATS

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Section: State Of the Art S24supporting

confidence: 80%

A Brave New World: The Lung Microbiota in an Era of Change

Segal

Blaser

2014

Annals ATS

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“…Many bacterial species, such as Escherichia coli, Haemophilus in£uenzae, Neisseria meningitidis, Moraxella catarrhalis, Streptococcus pneumoniae and Staphylococcus aureus, exist as commensals in their human hosts with asymptomatic colonization. Arason et al (1996) considered how the rates of carriage and resistance of S. pneumoniae in children in day-care centres were linked to antimicrobial consumption. Reductions in selection pressure will lead to reductions in resistance, although the time-scales may be considerable.…”

Section: Antibiotic Resistance In the Communitymentioning

confidence: 99%

“…As already demonstrated, the primary selection pressure driving changes in the frequency of resistance is the volume of drug use. Establishing a precise quantitative relationship between antibiotic consumption and the frequency of resistance in community settings has been di¤cult due to the lack of longitudinal studies that record both resistance and consumption patterns (Nissinen et al 1995;Arason et al 1996;Seppa« la« et al 1997). In a study by Nissinen et al (1995) in Finland following the rapid emergence of -lactamase resistance in Moraxella catarrhalis, increasing -lactam consumption led to further increases in the frequency of -lactamase producing clinical isolates.…”

Section: Antibiotic Resistance In the Communitymentioning

confidence: 99%

Studies of antibiotic resistance within the patient, hospitals and the community using simple mathematical models

Austin

Anderson

1999

Phil. Trans. R. Soc. Lond. B

172

127

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The emergence of antibiotic resistance in a wide variety of important pathogens of humans presents a worldwide threat to public health. This paper describes recent work on the use of mathematical models of the emergence and spread of resistance bacteria, on scales ranging from within the patient, in hospitals and within communities of people. Model development starts within the treated patient, and pharmacokinetic and pharmacodynamic principles are melded within a framework that mirrors the interaction between bacterial population growth, drug treatment and the immunological responses targeted at the pathogen. The model helps identify areas in which more precise information is needed, particularly in the context of how drugs in£uence pathogen birth and death rates (pharmacodynamics). The next area addressed is the spread of multiply drug-resistant bacteria in hospital settings. Models of the transmission dynamics of the pathogen provide a framework for assessing the relative merits of di¡erent forms of intervention, and provide criteria for control or eradication. The model is applied to the spread of vancomycin-resistant enterococci in an intensive care setting. This model framework is generalized to consider the spread of resistant organisms between hospitals. The model framework allows for heterogeneity in hospital size and highlights the importance of large hospitals in the maintenance of resistant organisms within a de¢ned country. The spread of methicillin resistant Staphylococcus aureus (MRSA) in England and Wales provides a template for model construction and analysis. The ¢nal section addresses the emergence and spread of resistant organisms in communities of people and the dependence on the intensity of selection as measured by the volume or rate of drug use. Model output is ¢tted to data for Finland and Iceland and conclusions drawn concerning the key factors determining the rate of spread and decay once drug pressure is relaxed.

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“…Mas já há preocupação em relação à emergência crescente de resistência às penicilinas demonstrada pelo aparecimento de cepas de pneumococo penicilino-resistentes em todo o mundo, o que poderá suprimir essa opção de tratamento no futuro. 1 Quando mais de uma infecção respiratória concomitante foi referida, 75% das pessoas utilizaram antimicrobianos, devido provavelmente à maior morbidade associada a esses casos.…”

Section: Infecçõesunclassified

“…7,13 O emprego crescente e indiscriminado dessas drogas está associado à emergência de cepas microbianas resistentes em todo o mundo. 1 O fenômeno tem suscitado preocupação em virtude da possibilidade de, em um curto espaço de tempo, nos depararmos com dificuldades no tratamento de doenças infecciosas comuns, que remontam à era pré-antibiótica. O uso abusivo de antimicrobianos deve-se a uma série de fatores.…”

Section: Introductionunclassified

Utilização de medicamentos para tratamento de infecções respiratórias na comunidade

et al. 2004

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DescritoresInfecções respiratórias, quimioterapia. Infecções respiratórias, epidemiologia. Uso de medicamentos. Antibióticos, uso terapêutico. Estudos transversais. Prevalência. Resultados A prevalência global de infecções respiratórias tratadas foi de 6,3%. Ela foi maior nas crianças de até quatro anos de idade (18%) e menor nos idosos (60 anos ou mais) (3%; p<0,001). As faringoamigdalites foram as infecções mais freqüentemente tratadas (41%). Cinqüenta e nove por cento dos entrevistados usaram antimicrobianos no tratamento de infecções respiratórias. O antimicrobiano mais utilizado foi a amoxicilina (38%). Entre as drogas sintomáticas utilizadas, os antiinflamatórios não esteróides foram os mais citados (27%). Conclusões A maioria das infecções respiratórias para as quais se utilizou algum medicamento são tratadas com antimicrobianos, apesar de a etiologia viral ser a mais prevalente nessas doenças. O uso excessivo dessas drogas, além de aumentar os custos dos tratamentos, pode levar à emergência de resistência bacteriana aos antimicrobianos mais freqüentemente utilizados. Keywords Abstract ObjectiveThis study describes the utilization of drugs to treat respiratory tract infections in a community setting. The description of antimicrobial and non-antimicrobial drugs use is important to design interventions aimed at improving treatment strategies for these common illnesses.

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Do antimicrobials increase the carriage rate of penicillin resistant pneumococci in children? Cross sectional prevalence study

Cited by 426 publications

References 21 publications

A Brave New World: The Lung Microbiota in an Era of Change

A Brave New World: The Lung Microbiota in an Era of Change

Studies of antibiotic resistance within the patient, hospitals and the community using simple mathematical models

Utilização de medicamentos para tratamento de infecções respiratórias na comunidade

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