Antimicrobial drugs and community-acquired methicillin-resistant Staphylococcus aureus, United Kingdom.
We report results of a case-control study of the association between receipt of antimicrobial agents and diagnosis of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) in the United Kingdom. Eligible adults, selected from the General Practice Research Database, had no previous diagnosis of MRSA, no hospitalization in the past 2 years, and > or = 2 years of follow-up recorded in the database. For 2000-2004, we identified 1,981 MRSA case-patients and 19,779 matched control-patients. The odds ratios (ORs) and 95% confidence intervals (CIs) of MRSA diagnosis for patients who were prescribed 1, 2-3, or > or = 4 antimicrobial drugs were 1.57 (CI 1.36-1.80), 2.46 (CI 2.15-2.83), and 6.24 (CI 5.43-7.17), respectively. Risk for community-acquired MRSA increased with number of antimicrobial drug prescriptions, appeared to vary according to antimicrobial drug classes prescribed the previous year, and was highest for quinolones (OR 3.37, CI 2.80-4.09) and macrolides (OR 2.50, CI 2.14-2.91).
Schneider-Lindner
Verena
V
McGill University Health Center, Montreal, Quebec, Canada.
Delaney
J A
JA
Dial
Sandra
S
Dascal
Andre
A
Suissa
Samy
S
D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D016022:Case-Control Studies; D015169:Colony Count, Microbial; D017714:Community-Acquired Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D016001:Confidence Intervals; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D008297:Male; D008712:Methicillin / Q000494:pharmacology; D016106:Methicillin Resistance; D008826:Microbial Sensitivity Tests; D016017:Odds Ratio; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects*; D006113:United Kingdom / Q000453:epidemiology
D000900:Anti-Bacterial Agents; D008712:Methicillin