title: Frequency of penicillin-resistant pneumococci in children is correlated to community utilization of antibiotics.
abstract: OBJECTIVE
  To study the impact of the utilization of antibiotics in children at the population level on the frequency of penicillin-nonsusceptible pneumococci (PNSP).
  
  
  METHODS
  Children ages 0 to 6 years with a nasopharyngeal culture of PNSP were registered on place of residency in the 20 municipalities of the former Malmöhus County (since 1998 a part of Skåne County). Where possible the total number of nasopharyngeal cultures with growth of pneumococci was registered as well. All antibiotic prescriptions for 0- to 6-year-old children were analyzed in the 20 municipalities.
  
  
  METHODS
  Correlation between the utilization of antibiotics and the frequency of PNSP in children at the municipality level.
  
  
  RESULTS
  The proportion of PNSP among all isolates of pneumococci from nasopharyngeal cultures varied between 0 and 49.5%. The antibiotic utilization in children varied among the 20 neighboring municipalities from 8.5 to 19.7 defined daily doses per 1000 children per day. The municipalities with high total utilization also had more frequent use of macrolides and broad spectrum antibiotics. The was a significant correlation between antibiotic use and the proportion of PNSP (correlation coefficient, 0.96; P = 0.002), and the correlation coefficients for trimethoprim-sulfamethoxazole, amoxicillins, macrolides and cephalosporins were significant at the 0.001 level. There was no significant correlation between the use of penicillin V and the frequency of PNSP. CONCLUSIONS. There was a significant correlation between the frequency of PNSP and the utilization of antibiotics in children at the population level.
authors.affiliation: Clinical Microbiology Laboratory, Lund University Hospital, Sweden. eva.z.melander@skane.se
authors.forename: E
authors.initials: E
authors.lastname: Melander
authors.forename: K
authors.initials: K
authors.lastname: Ekdahl
authors.forename: G
authors.initials: G
authors.lastname: Jönsson
authors.forename: S
authors.initials: S
authors.lastname: Mölstad
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004363:Drug Utilization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010045:Outpatients; D010403:Penicillin Resistance; D011008:Pneumococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000302:isolation & purification; D013548:Sweden / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents