Details:

Alternative Title:
Int J Circumpolar Health
Publisher's site:
http://dx.doi.org/10.3402/ijch.v72i0.22297
Personal Author:
Stevens, Ryan W. ; Wenger, Jay ; Bulkow, Lisa ; Bruce, Michael G.
Stevens, Ryan W. ; Wenger, Jay ; Bulkow, Lisa ; Bruce, Michael G. Less -
Description:
Background

American Indian/Alaska Native (AI/AN) people suffer substantially higher rates of invasive pneumococcal disease (IPD) than the general US population. We evaluated antimicrobial prescribing data and their association with non-susceptibility in Streptococcus pneumoniae causing IPD in AI/AN people between 1992 and 2009.

Methods

Antimicrobial use data were gathered from the electronic patient management system and included all prescriptions dispensed to Alaska Native patients aged 5 years and older from outpatient pharmacies at the Alaska Native Medical Center (ANMC). Antimicrobial susceptibility data were gathered from pneumococcal isolates causing IPD among Anchorage Service Unit AI/AN residents aged 5 years and older. Data were restricted to serotypes not contained in the pneumococcal vaccine (PCV7).

Results

Over the study period, overall antimicrobial prescribing increased 59% (285/1,000 persons/year in 1992 to 454/1,000 persons per year in 2009, p<0.001). Trimethoprim/sulfamethoxazole prescribing increased (43/1,000 persons/year in 1992 to 108/1,000 persons/year in 2009, p<0.001) and non-susceptibility to trimethoprim/sulfamethoxazole in AI/AN patients ≥5 years of age increased in non-PCV7 serotypes (0–12%, p<0.05). Similarly, prescribing rates increased for macrolide antibiotics (46/1,000 persons/year in 1992 to 84/1,000 persons/year in 2009, p<0.05). We observed no statistically significant change over time in erythromycin non-susceptibility among non-PCV7 serotypes in AI/AN patients aged 5 years or greater (0–7%, p=0.087).

Conclusion

Antimicrobial prescribing patterns of some antibiotics in the AI/AN population corresponded to increased antimicrobial resistance in clinical isolates. This study highlights the on-going threat of antimicrobial resistance, the critical importance of judicious prescribing of antibiotics and the potential utility of prescribing data for addressing this issue.


Subject:
[+]
Adolescent Alaska Natives Anti-Bacterial Agents Child Child, Preschool Drug Resistance, Multiple, Bacterial Drug Utilization Review Health Services, Indigenous Humans Indians, North American Inuits Outpatient Clinics, Hospital Pneumococcal Infections Pneumococcal Vaccines
Source:
Int J Circumpolar Health. 2013; 72.
Document Type:
Journal Article
Place as Subject:
Alaska
Collection(s):
Arctic Investigations Program CDC Public Access
Main Document Checksum:
[+]
urn:sha256:ccb9e63e45e1fc68810329b68f395f1de4cef6f555866ff84d15a0d82ecda5a1
Download URL:
https://stacks.cdc.gov/view/cdc/21495/cdc_21495_DS1.pdf
File Type:

Supporting Files

• 	IJCH-72-22297-g005.gif	gif
  	IJCH-72-22297-g005.jpg	jpeg
  	IJCH-72-22297.nxml	txt
  	license.txt	txt
  	IJCH-72-22297-g001.gif	gif
  	IJCH-72-22297-g001.jpg	jpeg
  	IJCH-72-22297-g002.gif	gif
  	IJCH-72-22297-g002.jpg	jpeg
  	IJCH-72-22297-g003.gif	gif
  	IJCH-72-22297-g003.jpg	jpeg
  	IJCH-72-22297-g004.gif	gif
  	IJCH-72-22297-g004.jpg	jpeg

More +