ArticleBMJ (Clinical research ed.)2004
Presence of bacteriuria caused by trimethoprim resistant bacteria in patients prescribed antibiotics: multilevel model with practice and individual patient data.
Article in BMJ (Clinical research ed.), 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers.
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Who cites it
29 citing papers in PubMed, 87 citations in OpenAlex.
- Ibuprofen versus fosfomycin for uncomplicated urinary tract infection in women: randomised controlled trial.BMJ (Clinical research ed.) · 2015Trial
- Primary Care Antibiotic Prescribing and Infection-Related Hospitalisation.Antibiotics (Basel, Switzerland) · 2023Review
- Ethics and antibiotic resistance.British medical bulletin · 2022Article
- Impact of Prior Antibiotic Use in Primary Care onAntibiotics (Basel, Switzerland) · 2021Article
- Practice-Level Association between Antibiotic Prescribing and Resistance: An Observational Study in Primary Care.Antibiotics (Basel, Switzerland) · 2020Article
- Bystander Selection for Antimicrobial Resistance: Implications for Patient Health.Trends in microbiology · 2019Review
- Lower Urinary Tract Infections: Management, Outcomes and Risk Factors for Antibiotic Re-prescription in Primary Care.EClinicalMedicine · 2019Article
- Changes in resistance among coliform bacteraemia associated with a primary care antimicrobial stewardship intervention: A population-based interrupted time series study.PLoS medicine · 2019Observational
- Impact of an Antimicrobial Stewardship Intervention on Within- and Between-Patient Daptomycin Resistance Evolution in Vancomycin-Resistant Enterococcus faecium.Antimicrobial agents and chemotherapy · 2019Article
- Prevalence, determinants and knowledge of antibacterial self-medication: A cross sectional study in North-eastern Tanzania.PloS one · 2018Article
- The hidden societal cost of antibiotic resistance per antibiotic prescribed in the United States: an exploratory analysis.BMC infectious diseases · 2016Article
- Observational
- An antibiotic prescription induces resistance at the individual level more than the group level.Journal of the American Medical Directors Association · 2013Article
- Antimicrobial agent exposure and the emergence and spread of resistant microorganisms: issues associated with study design.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2013Review
- Epidemiological interpretation of studies examining the effect of antibiotic usage on resistance.Clinical microbiology reviews · 2013Review
- Trimethoprim prescription and subsequent resistance in childhood urinary infection: multilevel modelling analysis.The British journal of general practice : the journal of the Royal College of General Practitioners · 2013Article
- Article
- Impact of outpatient antibiotic use on carriage of ampicillin-resistant Escherichia coli.Antimicrobial agents and chemotherapy · 2011Article
- Managing UTI in primary care: should we be sending midstream urine samples?The British journal of general practice : the journal of the Royal College of General Practitioners · 2010Article
- Antibiotic prescribing patterns and hospital admissions with respiratory and urinary tract infections.European journal of clinical pharmacology · 2008Article
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo look for evidence of a relation between antibiotic resistance and prescribing by general practitioners by analysis of prescribing at both practice and individual patient level.
designRepeated cross-sectional study in 1995 and 1996.
setting28 general practices in the Ninewells Hospital laboratory catchment area, Tayside, Scotland. SUBJECTS REVIEWED: 8833 patients registered with the 28 practices who submitted urine samples for analysis.
main outcome measuresResistance to trimethoprim in bacteria isolated from urine samples at practice and individual level simultaneously in a multilevel model.
resultsPractices showed considerable variation in both the prevalence of trimethoprim resistance (26-50% of bacteria isolated) and trimethoprim prescribing (67-357 prescriptions per 100 practice patients). Although variation in prescribing showed no association with resistance at the practice level after adjustment for other factors (P = 0.101), in the multilevel model resistance to trimethoprim was significantly associated with age, sex, and individual-level exposure to trimethoprim (P < 0.001) or to other antibiotics (P = 0.002). The association with trimethoprim resistance was strongest for people recently exposed to trimethoprim, and there was no association for people with trimethoprim exposure more than six months before the date of the urine sample. DISCUSSION: Analysis of practice level data obscured important associations between antibiotic prescribing and resistance. The results support efforts to reduce unnecessary prescribing of antibiotics in the community and show the added value of individual patient data for research on the outcomes of prescribing.
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