Author/Editor		Čižman, Milan; Oražem, Andreja; Križan-Hergouth, Veronika
Title		Poraba antibiotikov in odpornost bakterij v splošni populaciji
Translated title		Use of antibiotics in the community and resistance
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 39, št. Suppl 1
Publication year		2000
Volume		str. 12-21
Language		slo
Abstract		The frequency of resistance among community-acquired pathogens and the number of drugs to which they are resistant are increasing worldwide. Resistance to certain antimicrobials is clearly linked to their consumption in outpatient settings. Antimicrobial consumption and the resistance of most common community-acquired pathogens in Slovenia are within European ranges. In the period between 1995 and 1998, the total number of prescriptions for systemic antibiotics increased in Slovenia by 4% and DDD/1000 inhabitants/day increased by 18.5% (from 16.4 to 19.4). The number of prescripcions increased for clindamycin (130%), quinolones (73%), macrolides (37%) and combinations of aminopenicillins and beta-lactamase inhibitors (19%). A decreased number of prescriptions was observed for tetracyclines (30%), trimethoprim/sulphamethoxazole (22.7%) and penicillin V (11.4%). The resistance of Streptococcus pneumoniae (penicillin nonsensitive 14-20%), Haemophilus infIuenzae (beta-lactamase positive 13%), Neisseria meningiadis (less sensitive to penicillin 7.1%) is stable. A small increase in the resistance of Streptococcus pyogenes (6.8%) and Streptococcus pneumoniae (up to 6.6%) to macrolides was found. In the future, the total consumption of antibiotics for systemic use in outpatient facilities should be decreased, as well as the consumption of broad-spectrum antibiotics, especially for the treatment of respiratory tract infections. The consumption of antibiotics and surveillance pathogen resistance should continue to be performed throughout Slovenia.
Summary		Odpornost bakterij, pridobljenih v domačem okolju, na antibiotike raste po vsem svetu. Odpornost na nekatere antibiotike je jasno povezana z ambulantno porabo antibiotikov. Ambulantna poraba antibiotikov in odpornost pogostih bakterij, ki povzročajo okužbe v domačem okolju, sta v Sloveniji v evropskem povprečju. V Sloveniji je narastlo celokupno število predpisanih receptov za antibiotike v letih 1995 do 1998 za 4%, število definiranih dnevnih doz (DDD) na 1000 prebivalcev na dan se je istočasno povečalo za 18,5 % od 16,40 na 19,44, kar kaže, da so zdravniki predpisovali višje odmerke antibiotikov. V Sloveniji je v tem obdobju narastlo število predpisanih receptov za klindamicin (130 %), kinolone (73 %), makrolide (37 %) in kombinacije aminopenicilinov z zaviralci betalaktamaz (19 %). Padlo je število predpisanih receptov za tetracikline (30 %), trimetoprim/sulfametoksazol (22,7 %) in penicilin V (11,4 %). Odpornosti pnevmokoka na penicilin (14-20% manj občutljivih izolatov na penicilin), Haemophilus influenzae na ampicilin (betalaktamaza pozitiven 13 %) in meningokoka na penicilin (manj občutljivih sevov na penicilin 7,1 %) so stabilne. Opažamo rahel porast odpornosti betahemolitičnega streptokoka skupine A (6;8 %) in pnevmokokov na makrolide (do 6,6 %). V prihodnosti moramo zmanjšati celokupno ambulantno porabo antibiotikov, znižati porabo širokospektralnih antibiotikov, posebno v zdravljenju okužb dihalnih poti, in še nadaljnje skrbno spremljati porabo in odpornost bakterij v vsej Sloveniji.
Descriptors		PRESCRIPTIONS, DRUG MICROBIAL SENSITIVITY TESTS DRUG UTILIZATION ANTIBIOTICS DRUG RESISTANCE, MICROBIAL STREPTOCOCCUS PNEUMONIAE AMBULATORY CARE PENICILLIN RESISTANCE STREPTOCOCCUS PYOGENES HAEMOPHILUS INFLUENZAE MORAXELLA (BRANHAMELLA) CATARRHALIS NEISSERIA MENINGITIDIS STAPHYLOCOCCUS AUREUS ESCHERICHIA COLI SALMONELLA CAMPYLOBACTER