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Resistance needed for antibiotic misuse

4 December 2012

Do prescribing habits really have an effect on the rise of antibiotic resistance? A HRB-funded study in the west of Ireland shows that many antibiotics are prescribed inappropriately, and highlights a link between the prescription of antibiotics and an increased risk of antibiotic resistance.

'By using antibiotics we make them gradually less useful,' explains Dr Akke Vellinga, a senior lecturer in primary care and lecturer in bacteriology at NUI Galway. 'The antibiotics end up in the environment and the bacterial community adapts by developing resistance.'

The study looked at databases on prescribing practices and antibiotic resistance.

'We found there was a very direct link ? the more antibiotics a practice prescribed the higher the chance that an individual patient will be diagnosed with a resistant E. coli,' says Dr Vellinga.

The study also analysed urine samples from all patients who had suspected urinary tract infections at a selection of practices and examined what, if anything, had been prescribed for them. 'We saw that only 20 per cent of the urine samples had an organism identified, but 56 per cent of them had an antibiotic prescribed,' says Dr Vellinga. 'And of those 56 per cent, only 37 per cent were prescribed according to the recommended treatment.'

In addition, the risks of being diagnosed with an antibiotic-resistant bacterial infection shot up if a patient had more than one course of antibiotics: having two or more rounds of the medication could increase the risk of resistance by more than six-fold.

The analysis also pointed to an area risk of antibiotic resistance, suggesting the possible spread of resistant bacteria in the community.

Outcomes

  • Quantified the increased risk of antibiotic resistance due to inappropriate prescribing in general practice.
  • Findings are informing an education and awareness campaign about antibiotic prescription and use.

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