Resistance to antibiotics is low among general practice patients in Europe
European research has shown that the prevalence of antibiotic-resistant Staphylococcus aureus is lower in general practice patients than in hospital patients. Although resistance to penicillin is relatively common (73% on average), for many other antibiotics this is less than 10%, which means there are still many options available for treating the various skin infections this bacterium can cause. Research conducted by Evelien van Bijnen at the Netherlands Institute for Health Services Research (NIVEL) has shown that general practitioners (GPs) often prescribe the right drugs for these infections. She conducted this research for her doctoral thesis, and received her PhD from VU University Amsterdam on November 20.
“Resistance to antibiotics means there are fewer effective drugs available for treating certain kinds of bacterial infections, and this leads to an increased disease burden, more deaths, and higher cost. At the same time, the pharmaceutical industry is developing very few new drugs,” says Evelien van Bijnen. “This is why we have to use the antibiotics we currently have wisely: don’t overprescribe, and when you do prescribe a drug, make sure it’s one that’s effective.”
Penicillin resistance
Most infections are caused by commensal bacteria from our own bodies. Van Bijnen studied resistance in these bacteria in nine European countries: Austria, Belgium, Croatia, France, Hungary, Sweden, Spain, the United Kingdom, and the Netherlands. The study made use of nasal swabs from over 32,000 general practice patients who were free from infection at the time the swab was taken. Laboratory analyses indicated that while there are differences within Europe, S. aureus is generally highly resistant to penicillin and shows virtually no resistance to other antibiotics. Risk factors for carrying resistant bacteria include working in the health care sector, age, and penicillin use.
Skin infections
Skin infections are often caused by S. aureus, and so penicillin should not be used to treat them. This has already become part of the treatment guidelines for primary care, which recommend the use of other antibiotics that are effective. The prescription patterns of the participating GPs (twenty per country) show that although they prescribe many different kinds of antibiotics in various doses, they often choose one that is effective.
National borders
Antibiotic resistance is lower and fewer antibiotics are prescribed in the Netherlands, Denmark, and Sweden; these countries were also the first to introduce extensive surveillance systems. Van Bijnen: “Since bacteria take little notice of national borders, international cooperation is vital. At the same time, treatment has to be tailored to local situations in order to tackle resistance.”
Funding
7 th Framework Programme for Research and Technological Development European Commission (APRES)
Cooperating partners
Maastricht University
University of Antwerp
The University of Nottingham (UK)