Division of Epidemiology and Preventive Medicine, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel.
Clin Microbiol Rev. 2013 Apr;26(2):289-307. doi: 10.1128/CMR.00001-13.
Bacterial resistance to antibiotics is a growing clinical problem and public health threat. Antibiotic use is a known risk factor for the emergence of antibiotic resistance, but demonstrating the causal link between antibiotic use and resistance is challenging. This review describes different study designs for assessing the association between antibiotic use and resistance and discusses strengths and limitations of each. Approaches to measuring antibiotic use and antibiotic resistance are presented. Important methodological issues such as confounding, establishing temporality, and control group selection are examined.
细菌对抗生素的耐药性是一个日益严重的临床问题和公共卫生威胁。抗生素的使用是抗生素耐药性出现的已知危险因素，但要证明抗生素使用与耐药性之间的因果关系具有挑战性。本综述描述了评估抗生素使用与耐药性之间关联的不同研究设计，并讨论了每种设计的优缺点。还介绍了抗生素使用和抗生素耐药性的测量方法。此外，还研究了重要的方法学问题，如混杂、确定时间关系和对照组选择。
