Abstract
There is growing evidence that primary care prescribed antibiotics lead to antibiotic resistance in bacteria causing minor infections or being carried by asymptomatic adults, but little research to date has investigated links between primary care prescribed antibiotics and resistance among more serious infections requiring hospital care. Knowledge of these effects is likely to have a major influence on public expectations for, and primary care use of, antibiotics. This study aimed to assess the feasibility of recruiting symptomatic adult patients admitted to hospital with urinary infections and to link primary and secondary data information to investigate the relationship between primary care prescribed antibiotics and antimicrobial resistance in these patients. A microbiology database search of in patients who had submitted a urine sample identified 740 patients who were potentially eligible to take part in the study. Of these, 262 patients did not meet the eligibility criteria, mainly due to use of a urinary catheter (40%). Two-hundred and forty three patients could not be recruited as the nurse was unable to visit the patients prior to discharge, as they were too unwell. Eighty patients provided complete information. Results indicate that there is evidence that prior antibiotic use is associated with resistant infections in hospital patients. A fully powered study, conducted using routinely collected data is proposed to fully clarify the precision of the association.
Highlights
Resistance to antibiotics is a major threat to public health, and in the European Union, about25,000 patients die in hospital each year from infections caused by selected multidrug-resistant bacteria and the associated costs are estimated at about 1.5 billion Euros per year [1]
The remaining 740 samples were from patients who were potentially available to be screened for study eligibility
Complete primary care data were available for 80 participants
Summary
Resistance to antibiotics is a major threat to public health, and in the European Union, about25,000 patients die in hospital each year from infections caused by selected multidrug-resistant bacteria and the associated costs are estimated at about 1.5 billion Euros per year [1]. Resistance to antibiotics is a major threat to public health, and in the European Union, about. Of significant concern, is the rate at which bacteria are becoming resistant, which is outstripping the rate at which new antibiotics are being developed [2]. Patient expectations for antibiotics are a powerful determinant of prescribing [4] and for some GPs and patients, antibiotic resistance is seen only as a theoretical [4] or minimal [5] risk. The relationship between primary care antibiotic prescribing and resistance is complex and incompletely understood. Previous studies have established the relationship between the use of antibiotics in primary care and the asymptomatic carriage of resistant bacteria in adults [6,7,8]
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