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Volume 14, Number 11—November 2008

CME ACTIVITY

Antimicrobial Drug Use and Resistance in Europe

Nienke van de Sande-Bruinsma, Hajo GrundmannComments to Author , Didier Verloo, Edine Tiemersma, Jos Monen, Herman Goossens, Matus Ferech, and the European Antimicrobial Resistance Surveillance System and European Surveillance of Antimicrobial Consumption Project Groups 1
Author affiliations: National Institute of Public Health and the Environment, Bilthoven, the Netherlands (N. van de Sande-Bruinsma, H. Grundmann, E. Tiemersma, J. Monen); University Medical Centre, Groningen, Groningen, the Netherlands (H. Grundmann); Veterinary and Agrochemical Research Centre, Ukkel, Belgium (D. Verloo); University of Antwerp, Antwerp, Belgium (H. Goossens, M. Ferech);

Main Article

Table 3

Range and median correlation between the occurrence (logodds) of PNSP, ENSP, and FQRE in 2002–2005 and antimicrobial drug consumption, Europe, 2000–2004*

E consumption O-resistance phenotype No. E–O intervals with significant association† Correlation coefficients (r)
Median
Minimum
Maximum
r (CI) E–O year r (CI) E–O year r (CI) E–O year
Total use (J01)
PNSP 11 0.68 
(0.30–0.87) 2003–2003 0.61 
(0.17–0.84) 2001–2003 0.73 
(0.39–0.90) 2002–2002
ENSP
9
0.55 
(0.07–0.82)
2001–2003

0.37 
(–0.11 to 0.75)
2004–2005

0.71 
(0.33–0.89)
2003–2003
Penicillins (J01C)
PNSP 11 0.78 
(0.48–0.92) 2003–2004 0.69 
(0.28–0.87) 2003–2005 0.82 
(0.55–0.93) 2004–2004
ENSP
3
0.37 
(–0.15 to 0.74)
2003–2005

0.26 
(–0.29 to 0.66)
2001–2002

0.60 
(0.15–0.84)
2003–2003
Cephalosporins, monobactams, carbapenems (J01D)
PNSP 8 0.57 
(0.13–0.83) 2002–2003 0.41 
(–0.07 to 0.74) 2002–2004 0.64 
(0.23–0.86) 2000–2002
ENSP
11
0.69 
(0.30–0.88)
2001–2002

0.50 
(0.00–0.79)
2003–2005

0.79 
(0.48–0.92)
2004–2004
Macrolides, lincosamides, streptogramins (MLS class J01F)
PNSP 4 0.42 
(–0.08 to 0.75) 2004–2004 0.26 
(–0.22 to 0.67) 2004–2005 0.53 
(0.07–0.81) 2002–2002
ENSP
9
0.56 
(0.08–0.82)
2001–2002

0.35 
(–0.19 to 0.71)
2004–2004

0.67 
(0.27–0.88)
2003–2004
Fluoroquinolones (JO1MA) PNSP 9 0.51 
(0.04–0.80) 2004–2004 0.36 
(–0.10 to 0.74) 2003–2005 0.57 
(0.12–0.82) 2002–2002
ENSP 10 0.62 
(0.18–0.85) 2001–2002 0.48 
(–0.04 to 0.78) 2004–2005 0.69 
(0.29–0.89) 2004–2004
FQRE‡ 9 0.60 
(0.17–0.84) 2004–2004 0.44 
(–0.05 to 0.76) 2003–2005 0.70 
(0.33–0.88) 2001–2002

*PNSP, penicillin-nonsusceptible Streptococcus pneumoniae; ENSP, erythromycin-nonsusceptible S. pneumoniae; FQRE, fluoroquinolone-resistant Escherichia coli; E, exposure; O, outcome; CI, 95% confidence interval; MLS, macrolides, lincosamines, and streptogramins.
†Exposure outcome intervals include all 11 possible time windows, considering the data for consumption (exposure) and resistance (outcome) for the same year as well as for intervals of 1 to 2 y between exposure and outcome. p<0.05 was significant.
‡Significant correlations of fluoroquinolone consumption were found only with FQRE. Other correlations were therefore not shown.

Main Article

1National representatives of these 2 project groups in 2005 were as follows: Austria: H. Mittermayer, S. Metz, W. Koller (European Antimicrobial Resistance Surveillance System [EARSS]); Belgium: E. Hendrickx (EARSS), H. Goossens; Bulgaria: B. Markova; Croatia: A. Tambic-Andrasevic, Igor Francetic (European Surveillance of Antimicrobial Consumption [ESAC]), S. Kalenic (EARSS); Cyprus: D. Bagatzouni (EARSS); Czech Republic: P. Dvorak (ESAC), P. Urbaskova (EARSS); Denmark: D. Monnet, A. Anker Nielsen (ESAC); Estonia: P. Naaber (EARSS); Finland: P. Huovinen (ESAC), P. Paakkari (ESAC), O. Lyytikainen (EARSS), A. Nissinen (EARSS); France: P. Maugendre (ESAC), D. Guillemot (ESAC), B. Coignard, (EARSS), V. Jarlier (EARSS); Germany: W. Kern (ESAC), H. Schroeder (ESAC), W. Witte (EARSS), K. Heckenbach (EARSS); Greece: H. Giamarellou (ESAC), A. Antoniadou (ESAC), A. Tsakris (EARSS), A. Vatopoulos (EARSS); Hungary: G. Ternak (ESAC), M. Fuzi (EARSS); Iceland: K. Kristinsson; Ireland: E. Smyth (ESAC), R. Cunney (ESAC), D. Igoe (EARSS), O. Murphy (EARSS); Israel: R. Raz (EARSS); Italy: G. Cornaglia, A. Pantosti (EARSS), P. D’Ancona (EARSS); Latvia: S. Berzina (ESAC), A. Balode (EARSS); Lithuania: R. Valenteliene (ESAC), J. Miciulevicience; Luxembourg: R. Hemmer, M. Bruch (ESAC); Malta: M. Borg, P. Zarb (ESAC); the Netherlands: R. Janknegt (ESAC), M. Filius (ESAC), H. de Neeling (EARSS), E. Tiemermsa, J Degener (EARSS); Norway: H. Salvesen Blix (ESAC), A. Hoiby (EARSS), G. Simonsen (EARSS); Poland: W. Hryniewicz, P. Grzesiowski; Portugal: L. Caldeira (ESAC), M. Canica (EARSS); Romania: I. Codita; Slovakia: V. Foltan (ESAC), T. Tesar (ESAC), L. Langsadl (EARSS); Slovenia: M. Cizman (ESAC), M. Mueller-Premru (EARSS), J. Kolman (EARSS); Spain: J. Campos, F. Baquero (EARSS); Sweden: O. Cars (ESAC), G. Skoog (ESAC), B. Liljequist (EARSS), G. Kahlmeter (EARSS); Turkey: S. Unal (ESAC), D. Gür (EARSS); United Kingdom: P. Davey (ESAC), A. Johnson (EARSS), R. Hill (EARSS), H. Hughes (EARSS), M. Coyne (EARSS).

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