Author/Editor		Čižman, M
Title		Poraba antibiotikov v splošni populaciji in vpliv porabe antibiotikov na odpornost bakterij
Translated title		The use of antibiotics in the general population and the influence of antibiotic usage on bacterial resistance
Type		članek
Source		Slov Pediatr
Vol. and No.		Letnik 9, št. 2-3
Publication year		2002
Volume		str. 151-4
Language		slo
Abstract		The frequency of resistance to antibiotics among common community-acquired pathogens, and the number of drugs to which they are resistant have increased worldwide. The relationship between antibiotic usage and resistance is strongly supported by data from several studies. Countries with the highest per capita antibiotic consumption have the highest resistance. The emergence of penicillin- resistant Streptococcus pneumoniae is related to the high consumption of antibiotics in general, as well as to the increased use of aminopenicillins and/or probably to the wider use of oral cephalosporins. The increased consumption of macrolides, especially the long-acting ones, correlates significantly with the level of macrolide resistance of group A streptococci and Streptococcus pneumoniae, while the increased use of oral cephalosporins might be associated with the increase in beta-lactamase producing strains of Moraxella catarrhalis. Trimethoprim/sulfamethoxazole resistance is strongly associated with resistance to penicillin. A rise in the consumption of fluoroquinolones is consonant with a higher rate of resistance of Streptococcus pneumoniae, Escherichia coli and other Gram-negative bacteria to quinolones. Paediatric bacterial isolates are more often resistant to various antimicrobial agents than isolates from adult patients; this higher resistance rate may be due to more frequent antimicrobial treatments in children, and extensive child-to- child transmission. Reliable data on antimicrobial consumption and resistance should form a basis for national policies devised to reduce the resistance of microorganisms to antibiotics.
Summary		V svetu narašča odpornost bakterij na antibiotike, ki povzročajo okužbe v domačem okolju. Številne študije kažejo, da obstaja povezava med porabo antibiotikov in odpornostjo bakterij. Največ odpornih bakterij osamimo v državah, kjer je največja poraba antibiotikov na prebivalca. Pojav na penicilin odpornih pnevmokokov je v povezavi z visoko celokupno porabo antibiotikov in tudi z zvečano porabo aminopenicilinov in/ali morda s širšo porabo oralnih cefalosporinov. Povečana potrošnja makrolidov, posebno tistih z dolgo razpolovno dobo, je v povezavi z odpornostjo sevov Streptococcus pyogenes in Streptococcus pneumoniae na makrolide. Zvečana poraba oralnih cefalosporinov je morda v povezavi s povečanim številom sevov Moraxelle catarrhalis, ki izločajo betalaktamaze. Obstaja tudi povezava med odpornostjo pnevmokokov na trimetoprim/sulfametoksazol in penicilin. Povečano potrošnjo fluorokinolonov spremlja višja odpornost sevov Streptococcus pneumoniae, E coli in drugih po Gramu negativnih bakterij na kinolone. Bakterije, osamljene pri otrocih, so pogosteje odporne na različne antibiotike kot pri odraslih. Višji odstotek odpornosti je morda v povezavi s pogostejšim protimikrobnim zdravljenjem pri otrocih in s pogostejšim prenosom okužb z otroka na otroka. Potrebujemo zanesljive podatke o porabi antibiotikov in odpornosti bakterij, kar nam služi za osnovo pri izdelavi priporočil za znižanje odpornosti mikroorganizmov na antibiotike.
Descriptors		AMBULATORY CARE ANTIBIOTICS DRUG UTILIZATION DRUG RESISTANCE, MICROBIAL SLOVENIA