The APRES project aims at providing information and recommendations on the appropriateness of prescribing antibiotics in primary care. The appropriateness of prescribing antibiotics is the extent to which the pattern of prescribed antibiotics is congruent with the antibiotic resistance pattern of bacteria. More than 90% of antibiotics in Europe is prescribed to non-hospitalized patients, but existing information on the antibiotic resistance pattern is exclusively based on samples from hospitalized patients. Guidelines for prescribing antibiotics to outpatients cannot be based on empirical evidence about antibiotic resistance of bacteria circulating in the community because this evidence is lacking. The APRES project contains 4 work packages. WP1 includes a) a systematic review on the relationship between outpatient consumption of antibiotics and patterns of antibiotic resistance of pathogens circulating in the community; b) the establishment of a database of information sources and databases in nine European countries on outpatient consumption of antibiotics and antibiotic resistance patterns of pathogens circulating in the community. In WP2 the antibiotic resistance pattern of S. aureus and S. pneumoniae will be established in nine European countries, based on samples from healthy persons consulting in primary care practices participating in nationally representative networks. In WP3 we will establish the 5-year pattern of prescribed antibiotics the same practices and its variation between nine European countries. The data will be retrieved from electronic medical records in the same primary care practices. WP4 includes the integrative analyses by linking the antibiotic prescribing data with the antibiotic resistance patterns obtained in the same practices to establish the appropriateness of prescribing antibiotics. On the basis of these results, country specific guidelines will be formulated for appropriate prescribing of antibiotics.
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