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首页> 外文期刊>Journal of Clinical Microbiology >Importance of Local Variations in Antibiotic Consumption and Geographical Differences of Erythromycin and Penicillin Resistance in Streptococcus pneumoniae
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Importance of Local Variations in Antibiotic Consumption and Geographical Differences of Erythromycin and Penicillin Resistance in Streptococcus pneumoniae

机译：肺炎链球菌抗生素消费的局部变化和红霉素和青霉素耐药性的地理差异的重要性

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A geographical analysis of how commonly prescribed oral antibiotics are quantitatively and qualitatively responsible for the different local rates of erythromycin and penicillin resistance in Streptococcus pneumoniae in Spain is presented. From 1998 to 1999 a multicenter surveillance study yielded 1,684 consecutive S. pneumoniae isolates from community-acquired respiratory infections. Data on antibiotic sales in the retail market for the same period were gathered, and the corresponding defined doses per 1,000 inhabitants per day were calculated. Macrolides and β-lactams were considered separately. Macrolides were subdivided into thrice-, twice-, and once-a-day macrolides, and β-lactams were split into aminopenicillins and cephalosporins. Univariate Spearman nonparametric coefficients (R) were calculated, and variables proving to be significantly associated (P < 0.1) were entered into several multiple lineal regression models. Ample variation in both resistance rates and antibiotic consumption was seen. Multivariate analyses showed that integrated consumption of both macrolides and β-lactams accounted well for erythromycin (R2 = 0.722; P = 0.002) and penicillin (R2 = 0.706; P = 0.002) resistance. Macrolides were more important drivers for local differences in both erythromycin and penicillin resistance than β-lactams were. Consumption of once-a-day macrolides was key for local erythromycin resistance variations. Cephalosporins were slightly more important penicillin resistance drivers than aminopenicillins were.
机译：地理分析了在西班牙肺炎链球菌中常用处方口服抗生素在数量和质量上对红霉素和青霉素耐药的不同局部发生率的作用。从1998年到1999年，一项多中心监视研究得出了1,684个连续的 S。肺炎来自社区获得性呼吸道感染。收集了同期零售市场上抗生素销售的数据，并计算出每千名居民每天相应的确定剂量。大环内酯类和β-内酰胺类分别考虑。将大环内酯类药物细分为一日三次，两次和一次大环内酯类药物，将β-内酰胺类药物分为氨基青霉素和头孢菌素。计算单变量Spearman非参数系数（ R ），并将证明具有显着相关性的变量（ P <0.1）输入几个多元线性回归模型。观察到耐药率和抗生素消耗量都有很大变化。多因素分析表明，大环内酯类和β-内酰胺类药物的综合消耗占红霉素（ R 2 = 0.722; P = 0.002）和青霉素的好关系（ R 2 = 0.706; P = 0.002）电阻。与β-内酰胺类相比，大环内酯类药物是引起红霉素和青霉素耐药性局部差异的重要驱动力。每天服用一次大环内酯类药物是局部红霉素耐药性变化的关键。与氨基青霉素相比，头孢菌素是更重要的青霉素耐药性驱动因素。

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