Oct 30, 2018

Outpatient prescribing of four major antibiotic classes and prevalence of antimicrobial resistance in US adults

BioRxiv : the Preprint Server for Biology
Edward GoldsteinMarc Lipsitch

Abstract

Background: There is limited information on the relation between antibiotic use and antibiotic resistance in the US. Methods: We used multivariable logistic regression to relate state-specific rates of outpatient prescribing overall for fluoroquinolones, penicillins, macrolides, and cephalosporins between 2011-2014 to state-specific prevalence of resistance for select combinations of antibiotics/bacteria among catheter-associated urinary tract infections (CAUTIs) in the CDC Patient Safety Atlas data between 2011-2014 for adults aged 65+y and 19-64y, adjusting for potential confounders. Results: Rates of fluoroquinolone prescribing were positively associated with prevalence of fluoroquinolone resistance in Escherichia coli and Pseudomonas aeruginosa (both age groups), resistance to extended-spectrum (ES) cephalosporins in E. coli (aged 19-64y), and resistance to methicillin in Staphylococcus aureus (aged 19-64y). Rates of penicillin prescribing were positively associated with prevalence of resistance to fluoroquinolones in E. coli (aged 65+) and P. aeruginosa (both age groups), and resistance to ES cephalosporins in Klebsiella spp. (both age groups). Rates of cephalosporin prescribing were negatively associated with prevalence o...Continue Reading

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Mentioned in this Paper

Fluoroquinolone antiinfectives, ophthalmologic
Pseudomonas aeruginosa (antigen)
Fluoroquinolones
Fluoroquinolone antibacterials, systemic
Methicillin resistant Staphylococcus aureus (organism)
Antibiotic throat preparations
Macrolide Antibiotics
Antifungal Antibiotics, Topical
Urinary Tract Infection
Mrsa - Methicillin Resistant Staphylococcus Aureus Infection

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