Socioeconomic determinants of regional differences in outpatient antibiotic consumption: Evidence from Switzerland

Filippini, Massimo; Masiero, Giuliano; Moschetti, Karine

doi:10.1016/j.healthpol.2005.09.009

Cited by 137 publications

(151 citation statements)

References 45 publications

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“…The increase in ciprofloxacin resistance correlates closely with increased ciprofloxacin consumption in Switzerland, as previously shown in the ECO-SENS study for other countries [25]. Although antibiotic use in Switzerland is generally low in comparison with other European nations, Switzerland is one of the leading nations in fluoroquinolone consumption (1.8 defined daily doses/day per 1,000 inhabitants) [26,27], which may explain the rather high resistance rates for ciprofloxacin that we found in our study.…”

Section: Secular Trends Of Antimicrobial Resistancesupporting

confidence: 89%

Secular Trend and Risk Factors for Antimicrobial Resistance in Escherichia coli Isolates in Switzerland 1997–2007

et al. 2009

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Background: Antibacterial resistance in Escherichia coli isolates of urinary infections, mainly to fluoroquinolones, is emerging. The aim of our study was to identify the secular trend of resistant E. coli isolates and to characterize the population at risk for colonization or infections with these organisms. Patients and Methods: Retrospective analysis of 3,430 E.coli first isolates of urine specimens from patients admitted to the University Hospital Basel in 1997Basel in , 2000Basel in , 2003Basel in , and 2007. Results: Resistance to ciprofloxacin, trimethoprim/sulfamethoxazole, and amoxicillin/clavulanate has increased over the 10-year study period (from 1.8% to 15.9%, 17.4% to 21.3%, and 9.5% to 14.5%, respectively). A detailed analysis of the 2007 data revealed that independent risk factors for ciprofloxacin resistance were age (5.3% < 35 years of age to 21.9% in patients > 75 years; odds ratio [OR] 1.29 per 10 years, 95% confidence interval [CI] 1.15-1.45, p < 0.001) and male gender (OR 1.59, 95% CI 1.05-2.41, p = 0.04). In contrast, nosocomial E. coli isolates were associated with lower odds of ciprofloxacin resistance (OR 0.51, 95% CI 0.28-0.67, p < 0.001). The frequency of resistant isolate rates was not influenced by the clinical significance (i.e., colonization vs urinary tract infection, UTI) or by whether the urine was taken from a urinary catheter. Importantly, the increase in ciprofloxacin resistance paralleled the increase in ciprofloxacin consumption in Switzerland (Pearson's correlation test R 2 = 0.998, p = 0.002). Of note, resistance was less frequent in isolates sent in by general practitioners. However, after adjustment for age and gender, only resistance against amoxicillin/clavulanate was found to be less frequent (OR 0.34, p = 0.03). Conclusion: Our study reveals that resistance rates have been increasing during the last decade. Published resistance rates may lack information due to important differences regarding age, gender, and probable origin of the isolates. Empirical therapy for UTI should be guided more on individual risk profile and local resistance data than on resistance data banks.

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Section: Secular Trends Of Antimicrobial Resistancesupporting

confidence: 89%

Secular Trend and Risk Factors for Antimicrobial Resistance in Escherichia coli Isolates in Switzerland 1997–2007

et al. 2009

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“…However, this rate is lower than that reported in The Netherlands (7.8% [19]). Variable prevalence rates of ESBL producers may be related in part to differences in antibiotic policy (more quinolone used than ␤-lactams for treating community patients in Switzerland [10]) but also to differences in urban sizes (Paris area or Amsterdam versus Lausanne, for example). The bla CTX-M genes were widespread among ESBL producers, 79%, which was a slightly higher value than that reported at Bicêtre Hospital (65%) (personal data), in Amsterdam (64%) (1), and in Austria (58%) (9).…”

Section: Discussionmentioning

confidence: 99%

“…Since those CTX-Ms are reported increasingly in France (8,15,17,26), Italy (4,20), and recently Austria (9), it was interesting to search for those enzymes in Switzerland, a country known to have a strict policy of antibiotic prescription and to have an overall low level of multidrug resistance in bacteria (10).…”

mentioning

confidence: 99%

Extended-Spectrum β-Lactamases of the CTX-M Type Now in Switzerland

Lartigue

Zinsius

Wenger

et al. 2007

Antimicrob Agents Chemother

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The epidemiology of clavulanic acid-inhibited extended-spectrum ␤-lactamases (ESBLs) was investigated among infection-associated enterobacterial isolates at the University Hospital in Lausanne, Switzerland, from January 2004 to June 2005. Out of 57 nonrepetitive ESBL producers (prevalence rate of 0.7%), 45 produced CTX-M-like ESBLs. CTX-M enzymes were mostly from clonally nonrelated Escherichia coli isolates, from urinary infections and community-acquired infections. Pediatric patients (20 out of 57) accounted for a large number of CTX-M producers. CTX-M-15 was the most frequent CTX-M-type enzyme. The plasmid-located bla CTX-M genes were associated with either ISEcp1 or ISCR1 insertion sequences. This study is the first published report of CTX-M-type ␤-lactamases in Switzerland.Plasmid-mediated extended-spectrum ␤-lactamases (ESBLs) were first identified in a Klebsiella pneumoniae isolate in Germany in 1983 (14). Since then, ESBL-positive Enterobacteriaceae have been isolated worldwide mostly from hospitalized patients (18). These enzymes hydrolyze significantly expandedspectrum cephalosporins such as cefotaxime and ceftazidime and the monobactam aztreonam, sparing carbapenems. Their activity is inhibited in vitro by clavulanic acid. Until the 2000s, most of the ESBLs were structurally related to the narrowspectrum TEM-and SHV-type ␤-lactamases, with one to several amino acid substitutions surrounding their active site (18). Beginning in the late 1990s, novel types of ESBLs, the CTX-M enzymes, emerged worldwide, mostly from Escherichia coli. The CTX-Ms are mostly from community-acquired isolates (2,22). The over 50 CTX-M enzymes so far reported may be grouped into five main subgroups according to amino acid sequence identity (CTX-M-1, -M-2, -M-8, -M-9, and -M-25) (2). Most of the CTX-Ms hydrolyze cefotaxime better than ceftazidime. However, several CTX-Ms including CTX-M-15 (2, 12, 25), which is now the most widespread CTX-M enzyme worldwide (6), hydrolyze ceftazidime efficiently (25).Since those CTX-Ms are reported increasingly in France (8,15,17,26), Italy (4,20), and recently Austria (9), it was interesting to search for those enzymes in Switzerland, a country known to have a strict policy of antibiotic prescription and to have an overall low level of multidrug resistance in bacteria (10).The aim of the present study was to estimate the prevalence and the type of the ESBLs produced by enterobacterial isolates among nonrepetitive clinical isolates over an 18-month period from January 2004 to June 2005 at the University Hospital of Lausanne, Switzerland. MATERIALS AND METHODSBacterial isolates. ESBL-producing enterobacterial isolates resulted from the screening of 8,259 enterobacterial isolates obtained from infection samples that were sent to the Department of Microbiology of the Lausanne University Hospital, Switzerland, from January 2004 to June 2005. Isolates were first identified by using the Vitek2 system (bioMérieux SA, Marcy-l'Etoile, France). Electrocompetent E. coli TOP10 (Invitrogen, Cergy Pontoise, ...

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“…The cantons in the French western part of Switzerland such as Geneva, Valais, Neuchatel and Vaud have a higher usage of antibiotics than the northeastern cantons like Thurgau, Sankt Gallen and Zurich [8]. Sulphonamides followed by Tetracycline and Penicillin are the most used antibiotics in Switzerland [5].…”

Section: Discussionmentioning

confidence: 99%

Herd Level Antimicrobial Resistance in Beef Calves in Switzerland 1986 through 2011

Hässig¹,

Eugster²,

Lewis³

2014

OJVM

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The increasing emergence of antimicrobial resistance in food animals is a growing global concern and is closely linked to animal husbandry practices. In this study we describe the changement of antimicrobial resistance in beef calf production in Switzerland from 1986 through 2011. Data were collected from farms with known calf herd problems, such as diarrhoea or pneumonia, along with antimicrobial resistance from those herds. The Herd Health Section of the University of Zurich visited each farm. Samples were analysed for bacterial growth and resistance test commonly indicated in diseases such as calf pneumonia and diarrhoea. Each resistance test comprised of samples from at least three diseased animals. For diarrhoea, a faeces sample was used, for pneumonia a deep nasal swab was taken. In nasal swabs, only batches yielding considerable bacterial growth in three individual animal samples were included for diagnosis. Other growth of bacteria was considered as contamination. The results consisted of bacterial resistance to antibiotics against defined diseases such as calf diarrhoea and calf pneumonia at herd level. This approach is reflecting the situation as found in practice when a calf has to be treated without delay and without results from further laboratory diagnostics. In diarrhoea cases, four antibiotics showed no bacterial resistance. Bacterial resistance of below 10% was observed to three antibiotics. Up to 20% bacterial resistance was found to two antibiotics. Eighty per cent and over was found to be six antibiotics. Bacterial resistance to two antibiotics was found in over 90% of samples and all samples were resistant to one antibiotic. In pneumonia three antibiotics showed no resistance; one was below 10%; four antibiotics were below 20%. Over 80% of samples were resistant to four antibiotics. One resistance was over 90% and all bacterial samples were resistant to two antibiotics. Differences in bacterial resistance between pneumonia and diarrhoea in two study periods with equal cases, i.e.

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Socioeconomic determinants of regional differences in outpatient antibiotic consumption: Evidence from Switzerland

Cited by 137 publications

References 45 publications

Secular Trend and Risk Factors for Antimicrobial Resistance in Escherichia coli Isolates in Switzerland 1997–2007

Secular Trend and Risk Factors for Antimicrobial Resistance in Escherichia coli Isolates in Switzerland 1997–2007

Extended-Spectrum β-Lactamases of the CTX-M Type Now in Switzerland

Herd Level Antimicrobial Resistance in Beef Calves in Switzerland 1986 through 2011

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