Miguélez-Ferreiro S, Moreno-Sánchez E, Gutiérrez-de Antonio M, Hernando-Real S
Sonia Miguélez Ferreiro,Centro de Salud Segovia I, Calle Santo Tomás 9, 40002- SEGOVIA, Spain.
Rev Esp Quimioter. 2014 Mar;27(1):28-35.
We analyzed the antibiotic prescribing and resistances of respiratory and urinary pathogens more common in the Health Area of Segovia in the period 2007-2011. The aim of the study was to investigate variability, time trends of antibiotic prescribing and correlation with changes in the antimicrobial resistance patterns.
Retrospective cross-sectional study. Antibiotic consumption was expressed in defined daily doses (DDD) per 1000 inhabitants per day (DHD). The antimicrobial resistance was expressed in percentages. Trend analysis was performed testing Spearman and Pearson correlation coefficients.
The average antibiotic prescribing was 14.17 DHD, the coefficient and low ratio was 38.93% and 17.94. Penicillins was the most prescribed group (73%). Rural localization, lack of training MIR, distance to hospital and percentage of patients >65 years; showed significant association with increased antibiotic prescribing. Resistance of E. coli to cotrimoxazole and resistance of H. influenzae to amoxicillin decreased both by 8%. Resistance of S. pyogenes to erythromycin decreased by 5%. Resistances of S. pneumoniae to penicillin and E.coli to cephalosporins were both increased by 12%. Correlation between antibiotic prescription and resistances did not show singnificative results.
Prescribing of antibiotics decreased by 3.2% during the period. The use of broad-spectrum antibiotics was increased. Geographic wide variation in antibiotic prescribing was detected, also between physicians. There were not obtained conclusive data from the correlation between antibiotic prescribing and antimicrobial resistance.
我们分析了2007 - 2011年期间塞哥维亚健康区较为常见的呼吸道和泌尿道病原体的抗生素处方及耐药情况。本研究的目的是调查抗生素处方的变异性、时间趋势以及与抗菌药物耐药模式变化的相关性。
回顾性横断面研究。抗生素消耗量以每1000居民每天的限定日剂量（DDD）表示（DHD）。抗菌药物耐药性以百分比表示。采用Spearman和Pearson相关系数进行趋势分析。
抗生素平均处方量为14.17 DHD，系数和低比率分别为38.93%和17.94。青霉素是处方量最大的类别（73%）。农村地区、缺乏微生物学检验培训、距离医院的远近以及65岁以上患者的比例；与抗生素处方量增加显著相关。大肠杆菌对复方新诺明的耐药性以及流感嗜血杆菌对阿莫西林的耐药性均下降了8%。化脓性链球菌对红霉素的耐药性下降了5%。肺炎链球菌对青霉素的耐药性以及大肠杆菌对头孢菌素的耐药性均增加了12%。抗生素处方与耐药性之间的相关性未显示出显著结果。
在此期间抗生素处方量下降了3.2%。广谱抗生素的使用有所增加。在抗生素处方方面发现了地域广泛的差异，医生之间也存在差异。未从抗生素处方与抗菌药物耐药性之间的相关性中获得确凿数据。
