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Abstract
The frequency of resistance to antibiotics among common community-acquired pathogens,
and the number of drugs to which they are resistant have been increasing worldwide.
The relationship between antibiotic usage and resistance is strongly supported by
data from several studies. Countries with the highest per capita antibiotic consumption
have the highest resistance. The emergence of penicillin-resistant Streptococcus pneumoniae
is related to high consumption of antibiotics in general, as well as to increased
use of aminopenicillins and/or probably to wider use of oral cephalosporins. Increased
consumption of macrolides, especially the long-acting ones, correlates significantly
with the level of macrolide resistance of group A streptococci and S. pneumoniae while
increased use of oral cephalosporins might be associated with the increase of beta-lactamase-producing
strains of Moraxella catarrhalis. Trimethoprim/sulphamethoxazole resistance is strongly
associated with resistance to penicillin. A rise in consumption of fluoroquinolones
is consonant with a higher rate of resistance to quinolones of S. pneumoniae, Escherichia
coli and other Gram-negative bacteria. Paediatric bacterial isolates are more often
resistant to various antimicrobial agents than isolates from adult patients; this
higher resistance rate may be due to more frequent antimicrobial treatments in children,
and extensive child to child transmission. Reliable data on antimicrobial consumption
and resistance should form a basis for national policies devised to reduce the resistance
of microorganisms to antibiotics.