The Relative Impact of Community and Hospital Antibiotic Use on the Selection of Extended-spectrum Beta-lactamase-producing Escherichia coli.
Clin Infect Dis
; 69(1): 182-188, 2019 06 18.
Article
em En
| MEDLINE
| ID: mdl-30462185
ABSTRACT
Antibiotic stewardship programs have traditionally focused on reducing hospital antibiotic use. However, reducing community antibiotic prescribing could have substantial impacts in both hospital and community settings. We developed a deterministic model of transmission of extended-spectrum beta-lactamase-producing Escherichia coli in both the community and hospitals. We fit the model to existing, national-level antibiotic use and resistance prevalence data from Sweden. Across a range of conditions, a given relative change in antibiotic use in the community had a greater impact on resistance prevalence in both the community and hospitals than an equivalent relative change in hospital use. However, on a per prescription basis, changes in antibiotic use in hospitals had the greatest impact. The magnitude of changes in prevalence were modest, even with large changes in antimicrobial use. These data support the expansion of stewardship programs/interventions beyond the walls of hospitals, but also suggest that such efforts would benefit hospitals themselves.
Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Infecção Hospitalar
/
Escherichia coli
/
Infecções por Escherichia coli
/
Gestão de Antimicrobianos
/
Antibacterianos
Tipo de estudo:
Risk_factors_studies
Limite:
Humans
País como assunto:
Europa
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article