Antibiotic prescribing and changes in antimicrobial resistances in the health area of Segovia (Spain) during the period between 2007 and 2011

espanolIntroduccion. Se analizo la prescripcion de antibioticos y las resistencias de patogenos respiratorios y urinarios mas frecuentes del Area de Salud de Segovia durante el periodo 2007- 2011 para determinar su variabilidad, su tendencia temporal y su posible correlacion con los cambios en los patrones de las resistencias microbianas. Material y metodos. Estudio transversal retrospectivo. El consumo de antibioticos se expreso en dosis diaria definida (DDD) por 1000 habitantes dia (DHD). La resistencia se expreso en porcentajes. El analisis de tendencias se realizo con los coeficientes de correlacion de Spearman y de Pearson. Resultados. La prescripcion media de antibioticos fue 14,17 DHD, el coeficiente y razon de variacion 38,93% y 17,94. Las penicilinas fueron el grupo mas prescrito (73%). La ubicacion rural, la ausencia de formacion MIR, la distancia al hospital y el porcentaje de pacientes >65 anos, mostraron relacion significativa con mayor prescripcion de antibioticos. Las resistencias de E. coli a cotrimoxazol y de H. influenzae a amoxicilina descendieron un 8% y la de S. pyogenes a eritromicina un 5%. Las resistencias de S. pneumoniae a penicilina y de E. coli a cefalosporinas aumentaron ambas un 12%. La correlacion entre prescripcion antibiotica y resistencias antimicrobianas no mostro resultados significativos. Conclusiones. La prescripcion de antibioticos descendio un 3,2% durante el periodo mientras que el uso de farmacos de amplio espectro se incremento. La variabilidad entre medicos prescriptores fue importante, geografica e interindividualmente. No se obtuvieron datos concluyentes de correlacion entre prescripcion antibiotica y resistencias. EnglishIntroduction. We analyzed the antibiotic prescribing and resistances of respiratory and urinary pathogens more common in the Health Area of Segovia in the period 2007-2011. The aim of the study was to investigate variability, time trends of antibiotic prescribing and correlation with changes in the antimicrobial resistance patterns. Material and methods. Retrospective cross-sectional study. Antibiotic consumption was expressed in defined daily doses (DDD) per 1000 inhabitants per day (DHD). The antimicrobial resistance was expressed in percentages. Trend analysis was performed testing Spearman and Pearson correlation coefficients. Results. The average antibiotic prescribing was 14.17 DHD, the coefficient and low ratio was 38.93% and 17.94. Penicillins was the most prescribed group (73%). Rural localization, lack of training MIR, distance to hospital and percentage of patients >65 years; showed significant association with increased antibiotic prescribing. Resistance of E. coli to cotrimoxazole and resistance of H. influenzae to amoxicillin decreased both by 8%. Resistance of S. pyogenes to erythromycin decreased by 5%. Resistances of S. pneumoniae to penicillin and E.coli to cephalosporins were both increased by 12%. Correlation between antibiotic prescription and resistances did not show singnificative results. Conclusions. Prescribing of antibiotics decreased by 3.2% during the period. The use of broad-spectrum antibiotics was increased. Geographic wide variation in antibiotic prescribing was detected, also between physicians. There were not obtained conclusive data from the correlation between antibiotic prescribing and antimicrobial resistance.