title: Relationship between hospital antibiotic use and quinolone resistance in Escherichia coli.
abstract: BACKGROUND
  The relationship between the hospital use of various classes of antibiotics and resistance of Escherichia coli to quinolones remains debated. Our aim was to study the relationship between the hospital use of 16 classes of antibacterial agents and the incidence of quinolone-resistant E. coli isolates.
  
  
  METHODS
  Antibiotic use and resistance data were collected from 36 hospitals. Incident rate ratios (IRR) were assessed using negative binomial regression.
  
  
  RESULTS
  The incidence of quinolone-resistant isolates was independently associated with the consumption of tetracyclines (IRR 1.139, 95% CI 1.030-1.259), first- and second-generation cephalosporins (IRR 1.007, 95% CI 1.002-1.013), third-generation cephalosporins (IRR 1.029, 95% CI 1.010-1.048), and quinolones (IRR 1.007, 95% CI 1.000-1.014). These associations were independent from the type of patient served.
  
  
  CONCLUSIONS
  The level of hospital use of quinolones influences the incidence of quinolone resistance in E. coli hospital isolates. The consumption of two other classes of antibiotics, cephalosporins and tetracyclines, is also associated with quinolone resistance.
authors.affiliation: EA3826 Thérapeutiques Cliniques et Expérimentales des Infections, Faculté de Medecine, Université de Nantes, 1 rue Gaston-Veil, Nantes, F-44000, Nantes, France. eric.batard@chu-nantes.fr
authors.forename: Eric
authors.initials: E
authors.lastname: Batard
authors.forename: Florence
authors.initials: F
authors.lastname: Ollivier
authors.forename: David
authors.initials: D
authors.lastname: Boutoille
authors.forename: Jean-Benoît
authors.initials: JB
authors.lastname: Hardouin
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Montassier
authors.forename: Jocelyne
authors.initials: J
authors.lastname: Caillon
authors.forename: Françoise
authors.initials: F
authors.lastname: Ballereau
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002511:Cephalosporins / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial; D004363:Drug Utilization / Q000706:statistics & numerical data*; D004926:Escherichia coli / Q000187:drug effects*; D004927:Escherichia coli Infections / Q000188:drug therapy*; D005602:France; D006760:Hospitalization; D006761:Hospitals; D006801:Humans; D015363:Quinolones / Q000627:therapeutic use*; D012044:Regression Analysis; D013754:Tetracyclines / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D015363:Quinolones; D013754:Tetracyclines