Streptococcus pneumoniae non-susceptibility and outpatient antimicrobial prescribing rates at the Alaska Native Medical Center

Details

• Alternative Title:
  Int J Circumpolar Health
• Personal Author:
  Stevens, Ryan W ; Wenger, Jay ; Bulkow, Lisa ; Bruce, Michael G
• 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<0001) Trimethoprim/sulfamethoxazole prescribing increased (43/1,000 persons/year in 1992 to 108/1,000 persons/year in 2009, p<0001) and non-susceptibility to trimethoprim/sulfamethoxazole in AI/AN patients ≥5 years of age increased in non-PCV7 serotypes (0–12%, p<005) Similarly, prescribing rates increased for macrolide antibiotics (46/1,000 persons/year in 1992 to 84/1,000 persons/year in 2009, p<005) 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=0087)
  
  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
  
  
• Subjects:
  Adolescent Alaska Natives Anti-Bacterial Agents Child Child, Preschool Drug Resistance Drug Utilization Review Health Services, Indigenous Humans Indians, North American Inuit Outpatient Clinics, Hospital Pneumococcal Infections Pneumococcal Vaccines

  More +
• Source:
  Int J Circumpolar Health 2013; 72
• Document Type:
  Journal Article
• Place as Subject:
  Alaska
• Location:
  Alaska
• Volume:
  72
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:ccb9e63e45e1fc68810329b68f395f1de4cef6f555866ff84d15a0d82ecda5a1
• Download URL:
  https://stacks.cdc.gov/view/cdc/21495/cdc_21495_DS1.pdf
• File Type:
  [PDF - 1.02 MB ]