Trends and Seasonal Variation in Outpatient Antibiotic Prescription Rates in the United States, 2006 to 2010

Suda, Katie J.; Hicks, Lauri A.; Roberts, Rebecca M.; Hunkler, Robert J.; Taylor, Thomas H.

doi:10.1128/aac.02239-13

Cited by 137 publications

(139 citation statements)

References 27 publications

(40 reference statements)

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“…7,26,31,54,57 The b-lactams, predominantly penicillins, cephalosporins, and carbapenems, as well as their derivatives, share a four-membered ring that irreversibly inhibits the transpeptidases involved in bacterial peptidoglycan cross-linking, leading to cell lysis. The most common mechanism of b-lactam resistance is found in the b-lactamase enzymes, 21 which hydrolyze the b-lactam ring, rendering the drug inactive.…”

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confidence: 99%

High Diversity of CTX-M Extended-Spectrum β-Lactamases in Municipal Wastewater and Urban Wetlands

Borgogna

Mielke

et al. 2016

Microbial Drug Resistance

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confidence: 99%

High Diversity of CTX-M Extended-Spectrum β-Lactamases in Municipal Wastewater and Urban Wetlands

Borgogna

Mielke

et al. 2016

Microbial Drug Resistance

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“…Approximately 12 × 10 6 kg of antimicrobial drugs are administered to food animals annually in the United States; roughly 61% of these are medically relevant. Higher resistance frequencies in winter/spring (12.2%) than summer/ fall (7.5%) could be attributed to variation in prescription rates by season (10).…”

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confidence: 99%

Antimicrobial Drug–Resistant Shiga Toxin–Producing Escherichia coli Infections, Michigan, USA

Mukherjee¹,

Mosci²,

Anderson³

et al. 2017

Emerg. Infect. Dis.

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High frequencies of antimicrobial drug resistance were observed in O157 and non-O157 Shiga toxin-producing E. coli strains recovered from patients in Michigan during 2010-2014. Resistance was more common in non-O157 strains and independently associated with hospitalization, indicating that resistance could contribute to more severe disease outcomes. Shiga toxin-producing Escherichia coli (STEC) contributes to 265,000 cases of foodborne illness annually in the United States (1). Most infections are caused by O157 strains; however, non-O157 STEC infections have increased (2). Antimicrobial drug resistance among STEC has been reported (3-5) but is probably underestimated. Given the importance of resistance in E. coli pathotypes, we sought to determine the prevalence of resistant STEC infections and assess the effects of resistance on disease.We obtained 358 STEC isolates from the Michigan Department of Health and Human Services (MDHHS) Reference Laboratory (Lansing, MI, USA), collected during 2010-2014. Of these, 14 were outbreak associated. We examined 1 strain per outbreak using protocols approved by Michigan State University (MSU; Lansing, MI, USA; IRB #10-736SM) and MDHHS (842-PHALAB). Overall, 31 (8.8%) strains (23 non-O157, 8 O157) were resistant to antimicrobial drugs (Table). Resistance to ampicillin (7.4%) was most common, followed by trimethoprim/sulfamethoxazole (SXT) (4.0%) and ciprofloxacin (0.3%). Compared with national rates, resistance to ampicillin and SXT was higher, but not significantly different, for O157 isolates from Michigan (online Technical Appendix Figure 1, https://wwwnc. cdc.gov/EID/article/23/9/17-0523-Techapp1.pdf) (6). One strain was resistant to all drugs, and all resistant strains had high MICs (ampicillin, >64 μg/mL; ciprofloxacin, >32 μg/ mL; SXT, in 1:19 ratio, >32/608 μg/mL). Notably, resistance was twice as common for non-O157 (11.1%) than for O157 (5.5%) strains. O111 strains (n = 7) had significantly higher resistance frequencies (24.1%) than other non-O157 serogroups (p = 0.03). We found variation by year and season; resistance frequencies were highest in 2012 (online Technical Appendix, Figure 2) and during winter/spring (online Technical Appendix Table 1), but neither trend was significant. We also observed a strong but nonsignificant association between resistance and hospitalization but no association for urban versus rural residence (7) or county after stratifying by prescription rates (8) in the univariate analyses.We conducted a multivariate analysis using logistic regression, with hospitalization as the dependent variable; we included variables with significant (p<0.05) and strong (p<0.20) associations from the univariate analysis as independent variables. Forward selection indicated that hospitalized patients were more likely to have resistant infections (odds ratio [OR] 2.4, 95% CI 1.00-5.82) and less likely to have non-O157 infections (OR 0.4, 95% CI 0.21-0.61) (online Technical Appendix Table 2), suggesting that resistant infections or O157 infections may cause ...

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“…Seasonal variation in antibiotic use has been associated with short-term lowering of resistance rates in the United States (7) and Israel (8); moreover, low seasonal variation has been related to appropriate-use profiles in Europe (9,10). Furthermore, it has been suggested that a better understanding of seasonal variation of antibiotic prescribing can be useful in the design of interventions to reduce inappropriate use of antibiotics (11).…”

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confidence: 99%

Seasonal Variation in Penicillin Use in Mexico and Brazil: Analysis of the Impact of Over-the-Counter Restrictions

Santa‐Ana‐Téllez

Mantel‐Teeuwisse

Leufkens

et al. 2015

Antimicrob Agents Chemother

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c During 2010, Mexico and Brazil implemented policies to enforce existing laws of restricting over-the-counter sales of antibiotics. We determined if the enforcement led to more appropriate antibiotic use by measuring changes in seasonal variation of penicillin use. We used retail quarterly sales data in defined daily doses per 1,000 inhabitant-days (DDD/TID) from IMS Health from the private sector in Mexico and Brazil from the first quarter of 2007 to the first quarter of 2013. This database contains information on volume of antibiotics sold in retail pharmacies using information from wholesalers. We used interrupted time-series models controlling for external factors with the use of antihypertensives with interaction terms to assess changes in trend, level, and variation in use between quarters for total penicillin use and by active substance. The most used penicillin was amoxicillin, followed by amoxicillin-clavulanic acid and ampicillin (minimal use in Brazil). Before the restrictions, the seasonal variation in penicillin use was 1.1 DDD/TID in Mexico and 0.8 DDD/TID in Brazil. In Mexico, we estimated a significant decrease in the seasonal variation of 0.4 DDD/TID after the restriction, mainly due to changes in seasonal variation of amoxicillin and ampicillin. In Brazil, the seasonal variation did not change significantly, overall and in the breakdown by individual active substances. For Mexico, inappropriate penicillin use may have diminished after the restrictions were enforced. For Brazil, increasing use and no change in seasonal variation suggest that further efforts are needed to reduce inappropriate penicillin use.

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Trends and Seasonal Variation in Outpatient Antibiotic Prescription Rates in the United States, 2006 to 2010

Cited by 137 publications

References 27 publications

High Diversity of CTX-M Extended-Spectrum β-Lactamases in Municipal Wastewater and Urban Wetlands

High Diversity of CTX-M Extended-Spectrum β-Lactamases in Municipal Wastewater and Urban Wetlands

Antimicrobial Drug–Resistant Shiga Toxin–Producing Escherichia coli Infections, Michigan, USA

Seasonal Variation in Penicillin Use in Mexico and Brazil: Analysis of the Impact of Over-the-Counter Restrictions

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