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dc.contributor.authorArason, V A
dc.contributor.authorKristinsson, K G
dc.contributor.authorSigurdsson, J A
dc.contributor.authorStefansdottir, G
dc.contributor.authorMölstad, S
dc.contributor.authorGudmundsson, S
dc.date.accessioned2010-09-29T11:42:10Z
dc.date.available2010-09-29T11:42:10Z
dc.date.issued1996-08-17
dc.date.submitted2010-09-29
dc.identifier.citationBMJ. 1996, 313(7054):387-91en
dc.identifier.issn0959-8138
dc.identifier.pmid8761224
dc.identifier.urihttp://hdl.handle.net/2336/112022
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links fielden
dc.description.abstractOBJECTIVE: To study the correlation of antimicrobial consumption with the carriage rate of penicillin resistant and multiresistant pneumococci in children. DESIGN: Cross sectional and analytical prevalence study. SETTING: Five different communities in Iceland. MAIN OUTCOME MEASURE: Prevalence of nasopharyngeal carriage of penicillin resistant pneumococci in children aged under 7 years in relation to antibiotic use as determined by information from parents, patient's records, and total sales of antimicrobials from local pharmacies in four study areas. RESULTS: Total antimicrobial sales for children (6223 prescriptions) among the four areas for which data were available ranged from 9.6 to 23.2 defined daily doses per 1000 children daily (1.1 to 2.6 courses yearly per child). Children under 2 consumed twice as much as 2-6 year olds (20.5 v 10.9 defined daily doses per 1000 children daily). Nasopharyngeal specimens were obtained from 919 children, representing 15-38% of the peer population groups in the different areas. Pneumococci were carried by 484 (52.7%) of the children, 47 (9.7%) of the isolates being resistant to penicillin or multiresistant. By multivariate analysis age (< 2 years), area (highest antimicrobial consumption), and individual use of antimicrobials significantly influenced the odds of carrying penicillin resistant pneumococci. By univariate analysis, recent antimicrobial use (two to seven weeks) and use of co-trimoxazole were also significantly associated with carriage of penicillin resistant pneumococci. CONCLUSIONS: Antimicrobial use, with regard to both individual use and total antimicrobial consumption in the community, is strongly associated with nasopharyngeal carriage of penicillin resistant pneumococci in children. Control measures to reduce the prevalence of penicillin resistant pneumococci should include reducing the use of antimicrobials in community health care.
dc.language.isoenen
dc.publisherBritish Medical Associationen
dc.relation.urlhttp://www.bmj.com/content/313/7054/387.abstracten
dc.subject.meshAge Factorsen
dc.subject.meshAnti-Bacterial Agentsen
dc.subject.meshCarrier Stateen
dc.subject.meshChilden
dc.subject.meshChild, Preschoolen
dc.subject.meshCross-Sectional Studiesen
dc.subject.meshFemaleen
dc.subject.meshHumansen
dc.subject.meshIcelanden
dc.subject.meshInfanten
dc.subject.meshInfant, Newbornen
dc.subject.meshMaleen
dc.subject.meshMultivariate Analysisen
dc.subject.meshNasopharyngeal Diseasesen
dc.subject.meshNasopharynxen
dc.subject.meshPenicillin Resistanceen
dc.subject.meshPneumococcal Infectionsen
dc.subject.meshPrevalenceen
dc.subject.meshResidence Characteristicsen
dc.subject.meshStreptococcus pneumoniaeen
dc.subject.meshTrimethoprim-Sulfamethoxazole Combinationen
dc.titleDo antimicrobials increase the carriage rate of penicillin resistant pneumococci in children? Cross sectional prevalence studyen
dc.typeArticleen
dc.contributor.departmentDepartment of Family Medicine, Sólvangur Health Centre, University of Iceland, Hafnarfjördur, Iceland.en
dc.identifier.journalBMJ (Clinical research ed.)en
html.description.abstractOBJECTIVE: To study the correlation of antimicrobial consumption with the carriage rate of penicillin resistant and multiresistant pneumococci in children. DESIGN: Cross sectional and analytical prevalence study. SETTING: Five different communities in Iceland. MAIN OUTCOME MEASURE: Prevalence of nasopharyngeal carriage of penicillin resistant pneumococci in children aged under 7 years in relation to antibiotic use as determined by information from parents, patient's records, and total sales of antimicrobials from local pharmacies in four study areas. RESULTS: Total antimicrobial sales for children (6223 prescriptions) among the four areas for which data were available ranged from 9.6 to 23.2 defined daily doses per 1000 children daily (1.1 to 2.6 courses yearly per child). Children under 2 consumed twice as much as 2-6 year olds (20.5 v 10.9 defined daily doses per 1000 children daily). Nasopharyngeal specimens were obtained from 919 children, representing 15-38% of the peer population groups in the different areas. Pneumococci were carried by 484 (52.7%) of the children, 47 (9.7%) of the isolates being resistant to penicillin or multiresistant. By multivariate analysis age (< 2 years), area (highest antimicrobial consumption), and individual use of antimicrobials significantly influenced the odds of carrying penicillin resistant pneumococci. By univariate analysis, recent antimicrobial use (two to seven weeks) and use of co-trimoxazole were also significantly associated with carriage of penicillin resistant pneumococci. CONCLUSIONS: Antimicrobial use, with regard to both individual use and total antimicrobial consumption in the community, is strongly associated with nasopharyngeal carriage of penicillin resistant pneumococci in children. Control measures to reduce the prevalence of penicillin resistant pneumococci should include reducing the use of antimicrobials in community health care.


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