Study examines role of seasonal prescribing changes in antibiotic resistance

July 2, 2012

A new study published in Clinical Infectious Diseases and available online shows how seasonal changes in outpatient antibiotic use – retail sales of antibiotics typically get a boost during the winter – can significantly alter seasonal patterns of drug resistance. The findings suggest that hospital campaigns to reduce inappropriate antibiotic use should be coordinated with efforts in the broader community if they are to be most effective.

In the study, Dr. Ramanan Laxminarayan, director of the Center for Disease Dynamics, Economics and Policy in Washington, D.C., and research scholar at Princeton University, and Eili Klein and Lova Sun at Princeton University show a link between changing rates of antibiotic consumption and resistance. They also suggest that restrictions imposed by hospitals may be undermined if usage at the community level is not addressed. "Considering that approximately 260 million antibiotic prescriptions are filled each year," they noted, "individual hospitals' efforts to restrict antibiotic usage are unlikely to have a large effect on certain pathogens unless complemented by and coordinated with campaigns at the community level."

Dr. Laxminarayan and his colleagues demonstrate that highly seasonal temporal relationships exist between some combinations of prescriptions among five classes of (representing almost three-quarters of yearly antibiotic prescriptions) and resistance levels of two bacteria, Escherichia coli and methicillin-resistant Staphylococcus aureus (MRSA). Specifically, resistant E. coli and MRSA were significantly correlated with lagged for drugs that were highly prescribed, but uncorrelated with antibiotics that were not used as often.

To analyze prescribing patterns, the researchers relied on data collected from U.S. retail pharmacies from 1999 to 2007. Information about resistance came from a repository of test results collected from more than 300 laboratories spread throughout the country. In nearly all cases analyzed, a one-month lag was found between high antibiotic prescription levels and the prevalence of resistant E. coli and S. aureus.

Because the sheer quantity of antibiotic consumption is still the main driver of resistance, Dr. Laxminarayan said, "decreasing inappropriate use through flu vaccinations and better education of both patients and physicians on when to use antibiotics will have an immediate impact." The United States still uses more antibiotics per capita than most comparable countries, and "there is room to lower prescribing without compromising on outcomes." The researchers plan future studies to examine other combinations of antibiotics and resistant bacteria, and to specify subpopulations of the U.S.

Related Stories

Antibiotics often the wrong prescription for pediatric asthma

June 1, 2011

(Medical Xpress) -- At nearly one in six pediatric asthma visits, antibiotics are prescribed as a remedy, despite national guidelines against the practice. Ian Paul, departments of pediatrics and public health sciences, Penn ...

Roads pave the way for the spread of superbugs

September 29, 2011

Antibiotic resistant E. coli was much more prevalent in villages situated along roads than in rural villages located away from roads, which suggests that roads play a major role in the spread or containment of antibiotic ...

Recommended for you

Can social isolation fuel epidemics?

July 21, 2015

Conventional wisdom has it that the more people stay within their own social groups and avoid others, the less likely it is small disease outbreaks turn into full-blown epidemics. But the conventional wisdom is wrong, according ...

Lack of knowledge on animal disease leaves humans at risk

July 20, 2015

Researchers from the University of Sydney have painted the most detailed picture to date of major infectious diseases shared between wildlife and livestock, and found a huge gap in knowledge about diseases which could spread ...

IBD genetically similar in Europeans and non-Europeans

July 20, 2015

The first genetic study of inflammatory bowel disease (IBD) to include individuals from diverse populations has shown that the regions of the genome underlying the disease are consistent around the world. This study, conducted ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.