RESUMO
The level of resistance to fusidic acid among community methicillin-susceptible Staphylococcus aureus (MSSA) isolates in the UK and prescriptions for fusidic acid have both doubled over the past 6 years. It is hypothesized that selective pressure arising from topical use of fusidic acid in the community accounts for this increase. A significant correlation was found between prescribing of fusidic acid and resistance at the practice level (Spearman's rho = 0.46, 95% confidence interval 0.11-0.71, P = 0.01). Further controlled studies are required to determine whether this association is causal.
Assuntos
Antibacterianos/farmacologia , Infecções Comunitárias Adquiridas/microbiologia , Ácido Fusídico/farmacologia , Meticilina/farmacologia , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/efeitos dos fármacos , Infecções Comunitárias Adquiridas/epidemiologia , Prescrições de Medicamentos , Farmacorresistência Bacteriana , Uso de Medicamentos , Humanos , Infecções Estafilocócicas/epidemiologia , Reino Unido/epidemiologiaRESUMO
The prevalence of antibiotic resistance in community-acquired infections is rising but in contrast to popular perception there has been little published work on its epidemiology. This systematic review evaluates the published evidence on the relationship between antibiotic prescribing and antibiotic resistance of organisms causing community-acquired urinary tract infection. Fourteen papers met the inclusion criteria and these reported on five ecological studies and ten studies of individuals. Only one ecological study provided good evidence of a link with prescribing rates. The remaining studies had no control for population differences in demographics and/or no comparison population. Studies at the individual level lacked clear case definitions and statistical power. Until the epidemiology of antibiotic resistance is better defined the design of effective interventions will not be possible.