Outpatient Antibiotic Prescribing and Nonsusceptible Streptococcus pneumoniae in the United States, 1996-2003

Hicks, Lauri A.; Chien, Yu Wen; Taylor, Thomas H.; Haber, Michael; Klugman, Keith P.

doi:10.1093/cid/cir443

Cited by 156 publications

(118 citation statements)

References 36 publications

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“…Antibiotic use, including the use of classes such as macrolides, penicillins, and cephalosporins, is higher in children under 5 than in older children or adults in the United States (87,104). Young age is a risk factor for resistance to multiple drugs in common colonizing bacteria such as S. pneumoniae (109).…”

Section: Explanations For the Proliferation Of Mdr Strainsmentioning

confidence: 99%

Origin and Proliferation of Multiple-Drug Resistance in Bacterial Pathogens

Chang

Cohen

Grad

et al. 2015

Microbiol Mol Biol Rev

204

143

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SUMMARY Many studies report the high prevalence of multiply drug-resistant (MDR) strains. Because MDR infections are often significantly harder and more expensive to treat, they represent a growing public health threat. However, for different pathogens, different underlying mechanisms are traditionally used to explain these observations, and it is unclear whether each bacterial taxon has its own mechanism(s) for multidrug resistance or whether there are common mechanisms between distantly related pathogens. In this review, we provide a systematic overview of the causes of the excess of MDR infections and define testable predictions made by each hypothetical mechanism, including experimental, epidemiological, population genomic, and other tests of these hypotheses. Better understanding the cause(s) of the excess of MDR is the first step to rational design of more effective interventions to prevent the origin and/or proliferation of MDR.

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Section: Explanations For the Proliferation Of Mdr Strainsmentioning

confidence: 99%

Origin and Proliferation of Multiple-Drug Resistance in Bacterial Pathogens

Chang

Cohen

Grad

et al. 2015

Microbiol Mol Biol Rev

204

143

View full text Add to dashboard Cite

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“…7,8 Because of limited therapeutic options, antibiotic-resistant infections are difficult to treat and, in some cases, are associated with poor clinical outcomes. 54 Application of stringent diagnostic criteria and use of therapy only when the diagnosis and potential benefits are well established is essential to minimizing the impact of antibiotic overuse on resistance in individuals and within communities.…”

Section: Harms Of Antibiotic Therapymentioning

confidence: 99%

“…1 Recent evidence shows that broad-spectrum antibiotic prescribing has increased and frequently occurs when either no therapy is necessary or when narrower-spectrum alternatives are appropriate. 1,2 Such overuse of antibiotics causes avoidable drugrelated adverse events, [4][5][6] contributes to antibiotic resistance, 7,8 and adds unnecessary medical costs. This is compounded by the fact that few new antibiotics to treat antibiotic-resistant infections are under development.…”

Section: Introductionmentioning

confidence: 99%

Principles of Judicious Antibiotic Prescribing for Upper Respiratory Tract Infections in Pediatrics

Hersh¹,

Jackson²,

Hicks³

et al. 2013

Pediatrics

232

199

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Most upper respiratory tract infections are caused by viruses and require no antibiotics. This clinical report focuses on antibiotic prescribing strategies for bacterial upper respiratory tract infections, including acute otitis media, acute bacterial sinusitis, and streptococcal pharyngitis. The principles for judicious antibiotic prescribing that are outlined focus on applying stringent diagnostic criteria, weighing the benefits and harms of antibiotic therapy, and understanding situations when antibiotics may not be indicated. The principles can be used to amplify messages from recent clinical guidelines for local guideline development and for patient communication; they are broadly applicable to antibiotic prescribing in general.

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“…8 Patients prescribed antibiotics in primary care are more likely to develop antibiotic-resistant infections, 9 and higher outpatient antimicrobial use has been associated with increased resistance, in both community and health care settings. [10][11][12][13][14] Overuse is also associated with greater health care costs and more adverse events. [15][16][17] Furthermore, the correlation between in-hospital antimicrobial use and resistance has been found to be poor, which suggests that outpatient prescribing drives much of inpatient resistance.…”

mentioning

confidence: 99%

A decade of outpatient antimicrobial use in older adults in Ontario: a descriptive study

Tan

Graves

et al. 2017

CMAJ Open

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Background: Antimicrobials are frequently prescribed to community-dwelling older adults. Our aim was to examine the prevalence, quantity and indications of antimicrobial prescriptions to older residents of Ontario. Methods:We conducted a population-based analysis of outpatient antimicrobial prescriptions to residents of Ontario aged 65 years or more from 2006 to 2015. Antimicrobial prescriptions, infectious disease diagnoses and prescriber information were determined from linked health care databases. Our analyses were primarily focused on antibiotics, which account for most antimicrobial use. Results:We identified 2 879 779 unique Ontario residents aged 65 years or more over our study period. On average, 40.7% (range 40.1%-41.5%) of older adult outpatients in any given year received 1 or more antibiotic prescriptions. Antibiotic use remained stable over the study period, averaging 25.1 (range 24.1-25.6) defined daily doses per 1000 person-days per year. Selection of antibiotics evolved, with increasing use of penicillins and decreasing use of fluoroquinolones and macrolides. For 65.7% of prescriptions, no infectious disease diagnoses were identified within 7 days of the prescription. Among prescriptions with an associated diagnosis, upper respiratory tract infection was most common (18.9%), followed by urinary tract infection (6.2%), skin/soft-tissue infection (4.3%), lower respiratory tract infection (4.2%) and other infection (1.2%). Most antibiotics were prescribed by family physicians. MethodsWe conducted a province-wide analysis of antimicrobial prescriptions to older adults (aged ≥ 65 yr) in Ontario from Jan. 1, 20061, , to Dec. 31, 2015. Data sourcesThis study used population-based administrative databases housed at the Institute for Clinical Evaluative Sciences. These databases are well validated and have been used in studies on antimicrobial prescribing. [34][35][36][37][38] The Ontario Drug Benefit Program database, which contains all publicly funded medications prescribed to Ontario residents aged 65 years or more, was used for information on antimicrobial prescribing. This database exhibits greater than 99% accuracy when compared against pharmacy dispensing data. 34 To identify older adults and determine infectious disease diagnoses, the following databases were linked to the Ontario Drug Benefit Program database at the patient level: the Registered Persons Database, which contains demographic information for Ontario residents with publicly funded health insurance (> 95% of residents); the Ontario Health Insurance Plan database, which contains all billing claims made by health care providers for services performed in Ontario; the Discharge Abstracts Database, which contains information on all admissions, discharges and same-day surgical procedures in Ontario hospitals; and the National Ambulatory Care Reporting System, which contains information on all emergency department visits in Ontario hospitals. Antimicrobial prescriptionsWe used the Registered Persons Database to identify all Ontario reside...

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Outpatient Antibiotic Prescribing and Nonsusceptible Streptococcus pneumoniae in the United States, 1996-2003

Cited by 156 publications

References 36 publications

Origin and Proliferation of Multiple-Drug Resistance in Bacterial Pathogens

Origin and Proliferation of Multiple-Drug Resistance in Bacterial Pathogens

Principles of Judicious Antibiotic Prescribing for Upper Respiratory Tract Infections in Pediatrics

A decade of outpatient antimicrobial use in older adults in Ontario: a descriptive study

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