title: Epidemiological interpretation of studies examining the effect of antibiotic usage on resistance.
abstract: Bacterial resistance to antibiotics is a growing clinical problem and public health threat. Antibiotic use is a known risk factor for the emergence of antibiotic resistance, but demonstrating the causal link between antibiotic use and resistance is challenging. This review describes different study designs for assessing the association between antibiotic use and resistance and discusses strengths and limitations of each. Approaches to measuring antibiotic use and antibiotic resistance are presented. Important methodological issues such as confounding, establishing temporality, and control group selection are examined.
authors.affiliation: Division of Epidemiology and Preventive Medicine, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel.
authors.forename: Vered
authors.initials: V
authors.lastname: Schechner
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Temkin
authors.forename: Stephan
authors.initials: S
authors.lastname: Harbarth
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Carmeli
authors.forename: Mitchell J
authors.initials: MJ
authors.lastname: Schwaber
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D004363:Drug Utilization; D004812:Epidemiologic Methods; D006801:Humans; D015995:Prevalence
chemical_list: D000900:Anti-Bacterial Agents
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