title: Antibiotic use and the prevalence of antibiotic resistance in bacteria from healthy volunteers in the dutch community.
abstract: BACKGROUND
  Although most antibiotics are consumed in the community (80%), the relation of antibiotic consumption and resistance in the community has not been thoroughly studied.
  
  
  METHODS
  In the present study, antibiotic use was related to the prevalence of antibiotic resistance of Escherichia coli and enterococci isolated from healthy volunteers living in the southern part of the Netherlands in 1996 and 1999.
  
  
  RESULTS
  No change in the total antibiotic use in the Dutch community was observed between 1996 and 1999 (3542 and 3598 defined daily doses [DDD] per 1000 inhabitants/year). However, the increased fluoroquinolone use (+ 18%) and the increased prevalence of ciprofloxacin resistance from 0 to 2% is a point of concern, especially since this was accompanied by a significant shift towards higher minimum inhibitory concentration (MIC) values (p < 0.05). A significant decrease in the prevalence of vancomycin-resistant enterococci (p < 0.05) was found in addition to a significant shift towards lower MIC valued for avoparcin, a glycopeptide previously used as growth promoter in animal husbandry (p < 0.05). This was very likely due to the banning of avoparcin for this purpose from April 1997 onwards.
  
  
  CONCLUSIONS
  In order to maintain the low level of antibiotic use and resistance in The Netherlands, surveillance of antibiotic resistance in nonclinical isolates in relation to antibiotic use is very important.
authors.affiliation: Dept of Medical Microbiology, University Hospital Maastricht, P O Box 5800, NL-6202 AZ Maastricht, The Netherlands.
authors.forename: N
authors.initials: N
authors.lastname: Bruinsma
authors.forename: E
authors.initials: E
authors.lastname: Stobberingh
authors.forename: P
authors.initials: P
authors.lastname: de Smet
authors.forename: A
authors.initials: A
authors.lastname: van den Bogaard
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D024881:Drug Resistance, Bacterial; D016983:Enterococcus / Q000187:drug effects; D004926:Escherichia coli / Q000187:drug effects; D005243:Feces / Q000382:microbiology; D006801:Humans; D008826:Microbial Sensitivity Tests; D009426:Netherlands
chemical_list: D000900:Anti-Bacterial Agents