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Volume 10, Number 8—August 2004

Research

Antimicrobial Drug Use and Methicillin-resistant Staphylococcus aureus, Aberdeen, 1996–2000

Dominique L. Monnet*, Fiona M. MacKenzie†Comments to Author , José María López-Lozano‡, Arielle Beyaert§, Máximo Camacho§, Rachel Wilson†, David Stuart†, and Ian M. Gould†
Author affiliations: *Statens Serum Institut, Copenhagen, Denmark; †Aberdeen Royal Infirmary, Aberdeen, Scotland; ‡Hospital Vega Baja, Orihuela (Alicante), Spain; §University of Murcia, Murcia, Spain

Main Article

Table 3

Summary of transfer function models explaining the monthly %MRSA by use of each antimicrobial drug classa

Antimicrobial classb Average delay (months) Direction of effectc p value R2d
Combinations of penicillins with β-lactamase inhibitors
2
4
Positive
Positive
0.04
0.01
0.92
β-lactamase-resistant penicillins
0
6
Negative
Positive
0.02
0.002
0.90
Macrolides
1
Positive
0.0001
0.93
Penicillins with extended spectrum
1
Positive
0.03
0.91
Third-generation cephalosporins
1
Positive
0.04
0.90
β−lactamase sensitive penicillins
6
Positive
0.04
0.89
Combinations of sulfonamides and trimethoprim, including derivatives
4
Positive
0.02
0.90
Fluoroquinolones
4
Positive
0.0004
0.92
Second-generation cephalosporins
No relationship
Other antibacterialsd
0
Positive
0.002
0.91
Tetracyclines
4
7
Positive
Negative
0.03
0.0007
0.91
Aminoglycosides
No relationship
Lincosamides
7
Positive
0.02
0.89
First-generation cephalosporins
No relationship
Carbapenems 3 Positive 0.03 0.90

aMRSA, methicillin-resistant Staphylococcus aureus.
bGlycopeptide use is not presented in this table because it showed an inverse relationship with %MRSA. In other words, %MRSA explained the monthly variations of glycopeptide use and not the reverse (Discussion).
cPositive direction of effect: increase in antimicrobial use results in increase in %MRSA and inversely. Negative direction of effect: increase in antimicrobial use results in decrease in %MRSA and inversely.
dAll models include the variable %MRSA with a 1-month delay with a p value < 0.0001.
dAmphenicols, monobactams, other quinolones, imidazoles, fusidic acid, and nitrofurantoin derivatives.

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