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Comparison of antibiotic prescribing and antimicrobial resistance in urinary tract infections at the municipal level among women in two Nordic regions

Jensen, Jette Nygaard; Melander, Eva LU ; Hedin, Katarina LU ; Bjerrum, Lars; Isberg, Helena Kornfält LU ; Holm, Anne; Jacobsen, Helle Neel; Skovby, Annette; Currea, Gloria Cristina Córdoba and Hyllebusk, Lena, et al. (2018) In Journal of Antimicrobial Chemotherapy 73(8). p.2207-2214
Abstract

Objectives: To describe and compare the prescribing of antibiotics used for urinary tract infections and its correlation with resistance in Escherichia coli in urinary samples across two adjacent regions - the Capital Region and the Skaane Region - and their municipalities in Denmark and Sweden. Methods: The Capital Region consists of 29 municipalities and 725 960 female inhabitants aged ≥18 years and the Skaane Region consists of 33 municipalities and 515 668 female inhabitants aged ≥18 years. Aggregated data from outpatient care on the prescribing of pivmecillinam, trimethoprim and nitrofurantoin from both regions were analysed. The Department of Clinical Microbiology in both regions provided data on E. coli resistance in urinary... (More)

Objectives: To describe and compare the prescribing of antibiotics used for urinary tract infections and its correlation with resistance in Escherichia coli in urinary samples across two adjacent regions - the Capital Region and the Skaane Region - and their municipalities in Denmark and Sweden. Methods: The Capital Region consists of 29 municipalities and 725 960 female inhabitants aged ≥18 years and the Skaane Region consists of 33 municipalities and 515 668 female inhabitants aged ≥18 years. Aggregated data from outpatient care on the prescribing of pivmecillinam, trimethoprim and nitrofurantoin from both regions were analysed. The Department of Clinical Microbiology in both regions provided data on E. coli resistance in urinary samples from women aged ≥18 years. Data were measured as the number of prescriptions/1000 women/year, number of DDDs/1000 women/year and DDDs/prescription. Correlation analyses between antibiotic prescribing and antibiotic resistance rates were performed. Results: Antibiotic prescribing and resistance rates were significantly higher in the Capital Region compared with the Skaane Region. Large variations in prescription and resistance rates were found at the municipal level, but there were no correlations between the antibiotic prescription and resistance rates when each region was analysed separately. Conclusions: Although closely related, there are large differences in antibiotic prescribing and antibiotic resistance. It is suggested that the regional guidelines are an important driver and explanatory factor for the variations; however, further research is needed in this new field and factors such as the influence of cultural aspects should be the target of further research.

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Journal of Antimicrobial Chemotherapy
volume
73
issue
8
pages
8 pages
publisher
Oxford University Press
external identifiers
  • scopus:85055340779
ISSN
0305-7453
DOI
10.1093/jac/dky177
language
English
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yes
id
5f36b679-ec2b-47a4-afcb-c94e6fbf90f8
date added to LUP
2018-11-20 11:55:35
date last changed
2019-04-23 04:42:34
@article{5f36b679-ec2b-47a4-afcb-c94e6fbf90f8,
  abstract     = {<p>Objectives: To describe and compare the prescribing of antibiotics used for urinary tract infections and its correlation with resistance in Escherichia coli in urinary samples across two adjacent regions - the Capital Region and the Skaane Region - and their municipalities in Denmark and Sweden. Methods: The Capital Region consists of 29 municipalities and 725 960 female inhabitants aged ≥18 years and the Skaane Region consists of 33 municipalities and 515 668 female inhabitants aged ≥18 years. Aggregated data from outpatient care on the prescribing of pivmecillinam, trimethoprim and nitrofurantoin from both regions were analysed. The Department of Clinical Microbiology in both regions provided data on E. coli resistance in urinary samples from women aged ≥18 years. Data were measured as the number of prescriptions/1000 women/year, number of DDDs/1000 women/year and DDDs/prescription. Correlation analyses between antibiotic prescribing and antibiotic resistance rates were performed. Results: Antibiotic prescribing and resistance rates were significantly higher in the Capital Region compared with the Skaane Region. Large variations in prescription and resistance rates were found at the municipal level, but there were no correlations between the antibiotic prescription and resistance rates when each region was analysed separately. Conclusions: Although closely related, there are large differences in antibiotic prescribing and antibiotic resistance. It is suggested that the regional guidelines are an important driver and explanatory factor for the variations; however, further research is needed in this new field and factors such as the influence of cultural aspects should be the target of further research.</p>},
  author       = {Jensen, Jette Nygaard and Melander, Eva and Hedin, Katarina and Bjerrum, Lars and Isberg, Helena Kornfält and Holm, Anne and Jacobsen, Helle Neel and Skovby, Annette and Currea, Gloria Cristina Córdoba and Hyllebusk, Lena and Brogaard, Emma and Arpi, Magnus},
  issn         = {0305-7453},
  language     = {eng},
  number       = {8},
  pages        = {2207--2214},
  publisher    = {Oxford University Press},
  series       = {Journal of Antimicrobial Chemotherapy},
  title        = {Comparison of antibiotic prescribing and antimicrobial resistance in urinary tract infections at the municipal level among women in two Nordic regions},
  url          = {http://dx.doi.org/10.1093/jac/dky177},
  volume       = {73},
  year         = {2018},
}