OBJECTIVES: The aim of the study was to evaluate the relationship between the development of the resistance of Streptococcus pyogenes strains to erythromycin and the utilisation of macrolides in the Olomouc region, Czech Republic. METHOD: During the period 1997-2001, data for utilisation of macrolides was obtained from the database of the regional General Health Insurance Company and expressed indefined daily doses per 1,000 patients per day. S. pyogenes strains were isolated from community patients suffering from acute bacterial tonsillitis. Their susceptibility to antibiotics was assessed by the disk diffusion method. RESULTS: Utilisation of macrolides increased by 13% in the period 1997-2001; their utilisation represented 11.40% of total antibiotic prescription in 1997 and 15.48% in 2001. Occurrence of erythromycin-resistant S. pyogenes strains increased significantly from 14% in 1997 to 32% in the year 2001 (P < 0.01). In 2000, macrolides consumption decreased non-significantly, but with no concomitant decrease in erythromycin-resistant S. pyogenes strains occurrence. Absolute susceptibility of S. pyogenes, the most important bacterial pathogen in community-acquired bacterial tonsillitis, to penicillin contrasts with increasing macrolide resistance. CONCLUSIONS: The study documents the influence of increased utilisation of macrolides on bacterial resistance. Penicillin should be a first-choice antibiotic in acute bacterial tornsillitis; macrolides should only be reserved for patients allergic to penicillins.
- MeSH
- antibakteriální látky farmakologie terapeutické užití MeSH
- bakteriální léková rezistence * MeSH
- časové faktory MeSH
- erythromycin farmakologie terapeutické užití MeSH
- hodnocení spotřeby léčiv statistika a číselné údaje trendy MeSH
- lidé MeSH
- mikrobiální testy citlivosti metody MeSH
- Streptococcus pyogenes účinky léků izolace a purifikace MeSH
- streptokokové infekce farmakoterapie mikrobiologie MeSH
- tonzilitida farmakoterapie mikrobiologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
- Geografické názvy
- Česká republika MeSH
- Názvy látek
- antibakteriální látky MeSH
- erythromycin MeSH
PURPOSE: The objective was to analyse the exposure to lipid lowering agents (LLA) using the databases of health insurance companies and to appraise its concordance with the findings of evidence based medicine. METHODS: Three health insurance companies' prescription based databases were analysed in the years 1997-2000. All inhabitants in the Czech Republic (CR) have to be insured. The insured person with a recorded prescription for LLA in the year of interest was defined as a patient, the insured person with a recorded prescription for LLA in the years bordering the year of interest was defined as a chronically treated patient. In the year of interest the percentage of chronically treated patients without LLA medication, with 'very low' (<122 defined daily doses (DDD)/year), 'low' (122-243 DDD/year) and 'adequate' (>243 DDD/year) consumption was determined. RESULTS: During the observed period the total consumption of LLA increased among 450 000 inhabitants twice (by 109.6%) to 24.8 DDD/1000 inhabitants/day. In 2000 the rate of the consumption of statins and fibrates represented 34.2 and 65.6% respectively. In 1998 33.5% and in 1999 41.0% of the chronically treated patients occurred in the 'adequate' consumption group. CONCLUSIONS: The signals of inappropriate drug treatment such as the preferred use of fibrates and low doses of LLA prescribed to the Czech population were identified. Conversely, the increasing proportion of the chronically treated patients belonging to the group with the 'adequate' consumption could be considered as a positive signal.
- MeSH
- časové faktory MeSH
- farmakoepidemiologie metody statistika a číselné údaje trendy MeSH
- hodnocení spotřeby léčiv metody statistika a číselné údaje MeSH
- hypolipidemika klasifikace farmakologie terapeutické užití MeSH
- lidé středního věku MeSH
- lidé MeSH
- medicína založená na důkazech metody MeSH
- rozvrh dávkování léků * MeSH
- sběr dat metody MeSH
- sexuální faktory MeSH
- věkové faktory MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
- Názvy látek
- hypolipidemika MeSH
