Patients receiving a high burden of antibiotics in the community in Spain: a cross-sectional study.

Some patients in the community receive a high burden of antibiotics. We aimed at describing the characteristics of these patients, antibiotics used, and conditions for which they received antibiotics. We carried out a cross-sectional study. Setting: Thirty Health Primary Care Areas from 12 regions in Spain, covering 5,960,191 inhabitants. Patients having at least 30 packages of antibacterials for systemic use dispensed in 2017 were considered. Main outcome measures: Prevalence of antibiotic use, conditions for which antibiotics were prescribed, clinical characteristics of patients, comorbidities, concomitant treatments, and microbiological isolates. Patient's average age was 70 years; 52% were men; 60% smokers/ex-smokers; 54% obese. Overall, 93% of patients had, at least, one chronic condition, and four comorbidities on average. Most common comorbidities were cardiovascular and/or hypertension (67%), respiratory diseases (62%), neurological/mental conditions (32%), diabetes (23%), and urological diseases (21%); 29% were immunosuppressed, 10% were dead at the time of data collection. Patients received three antibiotic treatments per year, mainly fluoroquinolones (28%), macrolides (21%), penicillins (19%), or cephalosporins (12%). Most frequently treated conditions were lower respiratory tract (infections or prophylaxis) (48%), urinary (27%), and skin/soft tissue infections (11%). Thirty-five percent have been guided by a microbiological diagnosis, being Pseudomonas aeruginosa (30%) and Escherichia coli (16%) the most frequent isolates. In conclusion, high antibiotic consumers in the community were basically elder, with multimorbidity and polymedication. They frequently received broad-spectrum antibiotics for long periods of time. The approach to infections in high consumers should be differentiated from healthy patients receiving antibiotics occasionally

Mapa de resistencias bacterianas en Atención Primaria (2010). Una herramienta esencial para el uso racional de antibióticos

Objectives:Gather and reproduce the information issued on the map of bacterial 2010 resistance for patients under the age of 15 primary care conducted by the service of Microbiology of the Hospital Universitario Miguel Servet in Zaragoza. Methods:Document establishes bacteria most frequently isolated in different organic samples (mainly stool, urine, and faringoamigdalar, otic and conjunctival exudate) as well as the percentages of resistance to antimicrobials.The results are set out in number/absolute or percentage. Results:They are offered in different tables for each germ.The most relevant data are prominent in the chapter on comments. Conclusions:Knowledge of the local resistance data facilitates the rational use of medicines.The possibility to get to know these data on an annual basis will make it possible to monitor the evolution of resistance to pathogens most prevalent in Pediatrics.Objetivos:Recopilar y reproducir la información emitida en el Mapa de Resistencias Bacterianas 2010 para pacientes menores de 15 años de Atención Primaria realizado por el Servicio de Microbiología del Hospital Universitario Miguel Servet de Zaragoza. Métodos:El documento establece los gérmenes más frecuentemente aislados en las diferentes muestras orgánicas (principalmente heces, orina, y exudados faringoamigdalar, ótico y conjuntival), así como los porcentajes de resistencias a antimicrobianos. Los resultados se exponen en números absolutos y/o porcentajes. Resultados:Son ofrecidos en tablas diferentes para cada germen. Los datos más relevantes son destacados en el capítulo de comentarios. Conclusiones:El conocimiento de los datos de resistencia locales facilita el uso racional de medicamentos. La posibilidad de ir conociendo estos datos con periodicidad anual permitirá monitorizar la evolución de las resistencias a los patógenos más prevalentes en pediatría