New Antibiotic Prescribing Policies Needed to Curb Resistance

Source: Effect of B lactam antibiotic use in children on pneumococcal resistance to penicillin: prospective cohort study BMJ Volume 324, pp 28-30

The likelihood of children carrying a resistant bug is related to the amount of antibiotics they take, finds a study in this week’s BMJ. If these drugs are to retain their clinical usefulness, new prescribing policies are needed, argue the authors.

The research team identified 461 children, aged under 4 years, living in Canberra, Australia to take part in the study. Parents were asked to keep a daily diary of the children’s respiratory symptoms, visits to the doctor, and use of drugs, for two years. Nasal swabs were collected from the children every six months, and pneumococci bacteria were identified and tested for antibiotic resistance.

A total of 631 pneumococcal isolates were found, of which 14% were resistant to penicillin. The likelihood of carrying penicillin resistant bacteria was doubled in children who had taken a B lactam antibiotic in the two months before each swab collection. The odds of carrying penicillin resistant bacteria was 4% higher for each additional day of B lactam use in the six months before swab collection.

Our results suggest that a substantial reduction of B lactam use in preschool children could quickly reduce the carriage rates of penicillin resistant bacteria, say the authors. In view of the propensity of these organisms to be spread among children in the community, the prevalence of penicillin resistant organisms may fall as a consequence, they conclude.

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