抗生素处方强度和社区尿路感染耐药性:一个横截面的生态研究
Lucy McDonnell1, Mark Ashworth2, Peter Schofield2
1Department of Population Health, King's College London, London, UK lmcdonnell@doctors.net.uk.
BJGP open
|October 1, 2024
概括
在社区中,高抗生素处方强度与增加的尿路感染 (UTI) 耐药性无关. 个体患者过度使用抗生素可能不是社区级抗菌素耐药性 (AMR) 的主要驱动因素.
科学领域:
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 过度使用抗生素是已知的抗菌素耐药性 (AMR) 的贡献者.
- 社区AMR的具体驱动因素,无论是一般使用还是强烈的个人处方,仍然不清楚.
研究的目的:
- 调查在小社区中高抗生素处方强度和尿路感染 (UTI) 耐药率之间的关联.
- 为了区分整体抗生素使用与强烈,重复的个人处方对社区尿路感染耐药性的影响.
主要方法:
- 在2012-2015年间,对地理区域 (平均人口1500人) 的匿名初级保健数据和尿液培养进行了生态分析.
- 强化抗生素处方率 (≥5处方/3年或≥4/1年) 和平均每日量 (ADQ) 与同时发生的和之前发生的尿路感染耐药率的比较.
- 使用混合效应物流回归,调整区域级别的共变量.
主要成果:
- 在196513名患者中,16%的患者接受了强化抗生素处方,占所有处方的近30%.
- 在12308个尿路感染样本中,有65%对至少一种常见的抗生素产生了耐药性.
- 在高强度或整体抗生素处方和尿路感染耐药率之间没有发现显著的关联.
结论:
- 在小城市社区处方高强度抗生素与COVID-19之前增加的尿路感染耐药率没有相关性.
- 强烈的个人抗生素使用可能不是社区水平尿路感染耐药性的独立风险因素.
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