Outpatient Use of Erythromycin: Link to Increased Erythromycin Resistance in Group A Streptococci

Resistance to erythromycin in group A streptococci has become an important problem among outpatients in Finland. The prevention of such problems requires information about the relationship between antimicrobial consumption and antimicrobial resistance. Having found considerable variation among healt...

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Bibliographic Details
Published in:Clinical infectious diseases 1995-12, Vol.21 (6), p.1378-1385
Main Authors: Seppälä, Helena, Klaukka, Timo, Lehtonen, Risto, Nenonen, Erkki, Huovinen, Pentti
Format: Article
Language:English
Subjects:
Ambulatory Care
Anti-Bacterial Agents - therapeutic use
Antibacterial agents
Antibiotic resistance
Antibiotics
Antibiotics. Antiinfectious agents. Antiparasitic agents
Antimicrobials
Bacteria
Biological and medical sciences
Clinical Articles
Correlations
Dose-Response Relationship, Drug
Drug Resistance, Microbial
Drug Utilization
Erythromycin - therapeutic use
Humans
Logistic regression
Medical sciences
Modeling
Pharmacology. Drug treatments
Public health
Research and development laboratories
Statistical significance
Streptococcus pyogenes
Streptococcus pyogenes - drug effects
Streptococcus pyogenes - isolation & purification
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Summary:Resistance to erythromycin in group A streptococci has become an important problem among outpatients in Finland. The prevention of such problems requires information about the relationship between antimicrobial consumption and antimicrobial resistance. Having found considerable variation among health authority areas in the proportions of group A streptococci resistant to erythromycin, we investigated the potential impact of local differences in the consumption of this agent on the development of resistance. In 1992, 10,162 group A streptococcal isolates (nearly 100% were from outpatients) collected from 206 health authority areas were tested for erythromycin resistance; 1,647isolates (16%) were resistant. Logistic regression analysis showed that the proportion of isolates resistant to erythromycin clearly increased with increasing local erythromycin consumption by outpatients in 1991 (P = .006). This positive association indicates that a prudent policy for the treatment of outpatients is essential to maintenance of the effectiveness of antimicrobial agents.
ISSN:1058-4838
1537-6591
DOI:10.1093/clinids/21.6.1378