title: Antimicrobial drug use and resistance in Europe.
abstract: Our study confronts the use of antimicrobial agents in ambulatory care with the resistance trends of 2 major pathogens, Streptococcus pneumoniae and Escherichia coli, in 21 European countries in 2000-2005 and explores whether the notion that antimicrobial drug use determines resistance can be supported by surveillance data at national aggregation levels. The data obtained from the European Surveillance of Antimicrobial Consumption and the European Antimicrobial Resistance Surveillance System suggest that variation of consumption coincides with the occurrence of resistance at the country level. Linear regression analysis showed that the association between antimicrobial drug use and resistance was specific and robust for 2 of 3 compound pathogen combinations, stable over time, but not sensitive enough to explain all of the observed variations. Ecologic studies based on routine surveillance data indicate a relation between use and resistance and support interventions designed to reduce antimicrobial drug consumption at a national level in Europe.
authors.affiliation: National Institute of Public Health and the Environment, Bilthoven, the Netherlands.
authors.forename: Nienke
authors.initials: N
authors.lastname: van de Sande-Bruinsma
authors.forename: Hajo
authors.initials: H
authors.lastname: Grundmann
authors.forename: Didier
authors.initials: D
authors.lastname: Verloo
authors.forename: Edine
authors.initials: E
authors.lastname: Tiemersma
authors.forename: Jos
authors.initials: J
authors.lastname: Monen
authors.forename: Herman
authors.initials: H
authors.lastname: Goossens
authors.forename: Matus
authors.initials: M
authors.lastname: Ferech
mesh_terms: D000553:Ambulatory Care; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D024881:Drug Resistance, Bacterial; D004363:Drug Utilization / Q000706:statistics & numerical data; D004926:Escherichia coli / Q000187:drug effects* / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000188:drug therapy* / Q000453:epidemiology; D005060:Europe / Q000453:epidemiology; D006761:Hospitals; D006801:Humans; D016014:Linear Models; D011008:Pneumococcal Infections / Q000188:drug therapy* / Q000453:epidemiology; D011358:Product Surveillance, Postmarketing; D012189:Retrospective Studies; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents