RESUMEN
The correlation between increased macrolide consumption and the resistance of Streptococcus pyogenes, Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis to macrolides in Slovenia from 1994 to 1999 was evaluated. The outpatient consumption of macrolides increased from 1.89 to 3.84 defined daily doses (DDD)/1000 inhabitants/day during the observation period. This increase in macrolide consumption was paralleled by a steady increase in macrolide resistance in S. pyogenes (from 0 to 7.4%, r = 0.90, P = 0.014) and upper respiratory S. pneumoniae isolates (from 0 to 9%, r = 0.82, P = 0.044). In other pathogens studied, no significant increase was detected.
Asunto(s)
Antibacterianos/administración & dosificación , Antibacterianos/farmacología , Bacterias/efectos de los fármacos , Farmacorresistencia Microbiana , Atención Ambulatoria , Antibacterianos/uso terapéutico , Haemophilus influenzae/efectos de los fármacos , Humanos , Modelos Lineales , Macrólidos , Pruebas de Sensibilidad Microbiana , Moraxella catarrhalis/efectos de los fármacos , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Eslovenia/epidemiología , Streptococcus pneumoniae/efectos de los fármacos , Streptococcus pyogenes/efectos de los fármacos , Factores de TiempoAsunto(s)
Antiinfecciosos/administración & dosificación , Antiinfecciosos/farmacología , Farmacorresistencia Microbiana , Escherichia coli/efectos de los fármacos , Infecciones Urinarias/microbiología , Adolescente , Atención Ambulatoria , Niño , Fluoroquinolonas , Humanos , Eslovenia/epidemiología , Infecciones Urinarias/tratamiento farmacológico , Infecciones Urinarias/orinaRESUMEN
The impact of increased macrolide consumption on the resistance of common respiratory pathogens to erythromycin and azithromycin was evaluated. The study focused mainly on azithromycin. During the period from 1991 to 1996, a 3.5-fold increase in macrolide prescriptions for outpatients was observed in Slovenia. Compared to 1994, when no macrolide resistance was evident in Streptococcus pyogenes and noninvasive Streptococcus pneumoniae, a significant increase in macrolide resistance was observed in these two pathogens in 1997. Moraxella catarrhalis remained uniformly susceptible to macrolides. Close monitoring of macrolide resistance of common respiratory pathogens is thus necessary.
Asunto(s)
Antibacterianos/farmacología , Infecciones del Sistema Respiratorio/microbiología , Antibacterianos/uso terapéutico , Azitromicina/farmacología , Azitromicina/uso terapéutico , Prescripciones de Medicamentos , Farmacorresistencia Microbiana , Utilización de Medicamentos , Eritromicina/farmacología , Eritromicina/uso terapéutico , Humanos , Moraxella/efectos de los fármacos , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Streptococcus/efectos de los fármacosRESUMEN
By means of a visual tristimulus colorimeter according to Guild-Bechstein, the following items were determined for a male deuteranopic observer on a foveal, i.e. 2 degrees diameter visual field: (1) the deuteranopic missing color, by means of the perceptual criterion "indistinguishably equal", (2) the neutral zone, by means of the perceptual criterion "neither blue nor yellow," (3) the alychne trace, by means of the perceptual criterion "heterochromatically equally bright." The evaluation in the chromaticity chart resulted in two straight lines forming a dichromatic pencil, the deuteranopic missing color providing the carrier point (vertex). These two straight lines represent the referential chromaticities of a deuteranopic opponent color system.
Asunto(s)
Pruebas de Percepción de Colores/métodos , Percepción de Color/fisiología , Defectos de la Visión Cromática/diagnóstico , Fóvea Central/fisiopatología , Adulto , Defectos de la Visión Cromática/fisiopatología , Humanos , Masculino , Psicometría , Valores de Referencia , Campos Visuales/fisiologíaRESUMEN
The susceptibility of 108 Streptococcus pneumoniae strains isolated from normally sterile body sites during 1993-1995 in Slovenia has been studied. Overall resistance to penicillin, erythromycin, trimethoprim-sulfamethoxazole, cefuroxime, cefaclor and chloramphenicol was 16.6, 0.9, 26.8, 0, 4.5 and 4.6%, respectively. All penicillin-resistant isolates (intermediate resistance) were susceptible to cefotaxime, ceftriaxone and vancomycin. Isolates less susceptible to penicillin were also significantly less sensitive to chloramphenicol, cefaclor and trimethoprim-sulfamethoxazole than penicillin-sensitive strains. Pneumococci isolated in children were significantly (p < 0.05) more resistant to trimethoprim-sulfamethoxazole than those isolated in adults. The study demonstrated moderate resistance rate of S. pneumoniae to penicillin and trimethoprim-sulfamethoxazole and a low-level resistance rate to erythromycin, cefaclor and chloramphenicol. No straightforward correlation between overall consumption of antibiotics and antimicrobial resistance was found.
Asunto(s)
Farmacorresistencia Microbiana , Resistencia a las Penicilinas , Infecciones Neumocócicas/microbiología , Streptococcus pneumoniae/efectos de los fármacos , Adolescente , Adulto , Antibacterianos/farmacología , Cefalosporinas/farmacología , Niño , Cloranfenicol/farmacología , Resistencia a Múltiples Medicamentos , Femenino , Humanos , Masculino , Pruebas de Sensibilidad Microbiana , Serotipificación , Eslovenia , Streptococcus pneumoniae/clasificación , Streptococcus pneumoniae/aislamiento & purificación , Combinación Trimetoprim y Sulfametoxazol/farmacologíaRESUMEN
Use of systemic antibacterial drugs in the countries of central and eastern Europe (CCEE) has been studied using the defined daily doses (DDD) methodology. For the comparison, national wholesale data from Bulgaria, the Czech Republic, Estonia, Hungary, Lithuania, Slovakia, Slovenia and Romania for the years 1989 and 1992 were used, i.e. for the years before and after the rapid sociopolitical changes in these countries. Substantial differences in the patterns of antibacterial drug use between countries as geographically and economically similar as the CCEE were observed. The general sales of antibiotics varied almost twofold among the CCEE and had decreased in most of the CCEE during the study period. The proportion of tetracyclines in the sales of 1992 ranged from 10% in Slovenia to 49% in Estonia, and that of broad-spectrum penicillins from 6% in Estonia to 40% in Slovenia. The use of narrow-spectrum penicillins varied within the range of 4% in Bulgaria to 38% in Slovakia, and had decreased during the study years in all countries. Aminoglycosides accounted for 5-12% of all antibacterials in Bulgaria, Estonia, Lithuania, Romania and Slovakia in the study period, and these countries, with the exception of Slovakia, also had a high consumption of chloramphenicol. In 1992, by far the most popular antiinfectives in the CCEE were doxycycline, ampicillin and co-trimoxazole, which ranked among the top ten drugs in all countries studied.(ABSTRACT TRUNCATED AT 250 WORDS)