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Addressing antibiotic resistance at prescription

Antibiotic resistance is a growing public health concern as effective therapy is hampered, leading to higher health care expenses, morbidity and sometimes mortality. Studies worldwide have shown that higher antibiotic consumption is linked to increased antibiotic resistance.

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Funded by the EU, the APRES project will assess antibiotic prescription policies in Europe for outpatients and the emerging resistance patterns to prepare evidence-based primary care treatment recommendations. Studies revealed that 90 % of antibiotic drugs are prescribed by a primary care general practitioner (GP), and prescription rates vary across Europe. Thus, APRES researchers will study prescription and resistance patterns between countries and if possible within countries. The relationship between antibiotics' consumption and antibiotic resistance patterns were analysed through a systematic literature search after standardising search terms in each participating country. In addition, existing databases were searched for information on outpatient antibiotic consumption or resistance. Antibiotic resistance of Staphylococcus aureus (S.aureus) and Streptococcus pneumonia (S. pneumonia) was studied in 9 European countries after collecting 32 770 nasal mucous swabs through GPs. The S. aureus strains were assessed for susceptibility to 13 antibiotics at a central laboratory. Susceptibility testing of S. pneumonia is ongoing. Seven participating countries have delivered a database with adequate information on antibiotic prescription patterns and treatment policies, with data validation an ongoing process. Database development in remaining participating countries is in progress. The available data was analysed and compared to start formulating evidence-based treatment guidelines. Results have been submitted for publication in a peer-reviewed journal. Research results showed positive correlation between antibiotic use and antibiotic resistance, with highest S. aureus prevalence in Sweden. Penicillin resistance cases were higher and the highest incidence of antibiotic resistance was found to be in France. Current research outcomes show country-wise variability in antibiotic consumption and treatment practices. Continued research could also shed further light on variability within a country and produce a standardised treatment protocol that will minimise antibiotic resistance build up.

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