Journal Article

Reduction of Antibiotic Use in the Community Reduces the Rate of Colonization with Penicillin G—Nonsusceptible <i>Streptococcus pneumoniae</i>

Didier Guillemot, Emmanuelle Varon, Claire Bernède, Philippe Weber, Laurence Henriet, Sylvie Simon, Cécile Laurent, Hervé Lecoeur and Claude Carbon

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 41, issue 7, pages 930-938
Published in print October 2005 | ISSN: 1058-4838
Published online October 2005 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/432721
Reduction of Antibiotic Use in the Community Reduces the Rate of Colonization with Penicillin G—Nonsusceptible Streptococcus pneumoniae

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Background. There is a lack of evidence documenting the impact of optimized antibiotic use on the rates of colonization with penicillin G—nonsusceptible Streptococcus pneumoniae (PNSP) in children. This study evaluates the effect of community-based intervention strategies on the prevalence of PNSP colonization

Methods. A controlled, population-based pharmacoepidemiological trial was conducted from January through May 2000. Three French geographic areas were selected on the basis of demographic similarities. Two intervention strategies were implemented: (1) reduced antibiotic use, which was achieved by not prescribing antibiotics for presumed viral respiratory tract infections (the prescription-reduction group); and (2) better adaptation of dose and duration (the dose/duration group). A control group received no intervention. The target population was children aged 3–6 years who were attending kindergarten. Oropharyngeal pneumococcus colonization and antibiotic use were monitored throughout the 5-month study.

Results. The prescription-reduction, dose/duration, and control groups included 601, 483, and 405 children, respectively. The interventions induced significantly larger decreases in antibiotic use in the prescription-reduction group (-18.8%) and dose/duration group (-17.1%) than in the control group (-3.8%), and the rates of PNSP colonization were initially similar for the 3 groups (52.5%, 55.1%, and 50.0%, respectively). At the end of the 5-month study, the rates of PNSP colonization were 34.5% for the prescription-reduction group (P = .05) and 44.3% for the dose/duration group (P = .8), compared with 46.2% for the control group.

Conclusions. Intensive educational strategies aimed at optimizing antibiotic use can significantly reduce the rate of PNSP colonization in areas with high resistance rates.

Journal Article.  5086 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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