The nature of the temporal relationship between antibacterial consumption and Streptococcus pneumoniae penicillin resistance is investigated using population level data across time. IMS Health Global Services provided national outpatient antibiotic prescription data for the years 1996-2003 from France, Spain, Italy, Germany, the United Kingdom, and the United States. Surveillance data consist of S. pneumoniae isolates obtained from a surveillance database in the same geographic regions from 1996 to 2003. A linear mixed model for repeated measures was used to analyze the association between resistance and several antibacterial classes through time. Changes in penicillin resistance through time in any country are better explained by the weighted cumulative antibacterial consumption with a 2-year lag. Narrow-spectrum penicillins are associated with lower resistance rates. Large reductions in consumption at the population level are needed to affect resistance. There is a peak level of penicillin resistance associated with cumulative exposure to a combination of antibiotic classes that is unique for every country.

译文

使用跨时间的人群水平数据研究了抗菌药物消耗与肺炎链球菌青霉素耐药性之间的时间关系的性质。IMS Health Global Services提供了来自法国,西班牙,意大利,德国,英国和美国的1996-2003年全国门诊抗生素处方数据。监视数据由从2003年1996年相同地理区域的监视数据库中获得的肺炎链球菌分离株组成。使用用于重复测量的线性混合模型来分析耐药性与几种抗菌剂之间的关系。在任何国家,青霉素耐药性随时间的变化都可以通过滞后2年的加权累积抗菌药物消耗量来更好地解释。窄谱青霉素与较低的耐药率相关。为了影响抵抗力,需要大量减少人口消费。青霉素耐药性的峰值水平与累积暴露于抗生素类别的组合有关,这在每个国家都是独一无二的。

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