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The Relative Impact of Community and Hospital Antibiotic Use on the Selection of Extended-spectrum Beta-lactamase-producing Escherichia coli.
MacFadden, Derek R; Fisman, David N; Hanage, William P; Lipsitch, Marc.
Afiliação
  • MacFadden DR; Harvard TH Chan School of Public Health, Boston, Massachusetts.
  • Fisman DN; Division of Infectious Diseases, Department of Medicine, University of Toronto, Ontario, Canada.
  • Hanage WP; Division of Infectious Diseases, Department of Medicine, University of Toronto, Ontario, Canada.
  • Lipsitch M; Harvard TH Chan School of Public Health, Boston, Massachusetts.
Clin Infect Dis ; 69(1): 182-188, 2019 06 18.
Article em En | MEDLINE | ID: mdl-30462185
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.
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Texto completo: 1 Coleções: 01-internacional 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/Região como assunto: Europa Idioma: En Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional 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/Região como assunto: Europa Idioma: En Ano de publicação: 2019 Tipo de documento: Article