Department of General Practice and Family Medicine, Center for Public Health, Medical University of Vienna, Waehringer Str, 13a/3rd floor, 1090 Vienna, Austria.
BMC Infect Dis. 2011 Nov 28;11:330. doi: 10.1186/1471-2334-11-330.
Antibiotic resistance is an increasing challenge for health care services worldwide. While up to 90% of antibiotics are being prescribed in the outpatient sector recommendations for the treatment of community-acquired infections are usually based on resistance findings from hospitalized patients. In context of the EU-project called "APRES - the appropriateness of prescribing antibiotic in primary health care in Europe with respect to antibiotic resistance" it was our aim to gain detailed information about the resistance data from Austria in both the scientific and the grey literature.
A systematic review was performed including scientific and grey literature published between 2000 and 2010. Inclusion and exclusion criteria were defined and the review process followed published recommendations.
Seventeen scientific articles and 23 grey literature documents could be found. In contrast to the grey literature, the scientific publications describe only a small part of the resistance situation in the primary health care sector in Austria. Merely half of these publications contain data from the ambulatory sector exclusively but these data are older than ten years, are very heterogeneous concerning the observed time period, the number and origin of the isolates and the kind of bacteria analysed. The grey literature yields more comprehensive and up-to-date information of the content of interest. These sources are available in German only and are not easily accessible. The resistance situation described in the grey literature can be summarized as rather stable over the last two years. For Escherichia coli e.g. the highest antibiotic resistance rates can be seen with fluorochiniolones (19%) and trimethoprim/sulfamethoxazole (27%).
Comprehensive and up-to-date antibiotic resistance data of different pathogens isolated from the community level in Austria are presented. They could be found mainly in the grey literature, only few are published in peer-reviewed journals. The grey literature, therefore, is a very valuable source of relevant information. It could be speculated that the situation of published literature is similar in other countries as well.
抗生素耐药性是全球医疗保健服务面临的日益严峻的挑战。尽管高达 90%的抗生素用于门诊治疗，但社区获得性感染的治疗建议通常基于住院患者的耐药性研究结果。在欧盟名为“APRES-欧洲初级保健中抗生素使用的适当性与抗生素耐药性”的项目中，我们的目标是在科学文献和灰色文献中详细了解奥地利的耐药数据。
我们进行了一项系统评价，包括 2000 年至 2010 年期间发表的科学文献和灰色文献。定义了纳入和排除标准，并遵循已发表的建议进行了评价过程。
我们找到了 17 篇科学文章和 23 篇灰色文献。与灰色文献相比，科学出版物仅描述了奥地利初级保健部门抗生素耐药情况的一小部分。只有一半的出版物仅包含来自门诊部门的数据，但这些数据的年份超过十年，观察期、分离株数量和来源以及分析的细菌种类都非常不同。灰色文献提供了更全面和最新的相关信息。这些来源仅为德文，且不易获取。灰色文献中描述的耐药情况在过去两年中相对稳定。例如，对大肠杆菌而言，氟喹诺酮类（19%）和复方磺胺甲噁唑（27%）的抗生素耐药率最高。
我们呈现了来自奥地利社区层面不同病原体的综合且最新的抗生素耐药数据。这些数据主要来自灰色文献，只有少数发表在同行评议的期刊上。因此，灰色文献是相关信息的非常有价值的来源。可以推测，其他国家的发表文献情况也类似。
