From the Guidelines
To determine the antibiotic resistance rate in your community, it is essential to consult local health department or hospital infection control department surveillance data, as resistance patterns vary significantly by geographic area. When considering the most recent and highest quality study, 1 provides a comprehensive scoping review of the evidence base for using aggregated antibiotic resistance percentages to change empirical antibiotic treatment. The study highlights the importance of understanding local resistance patterns, as bacteria develop different resistance profiles in different geographic areas based on antibiotic use patterns. Some key points to consider when evaluating antibiotic resistance rates in your community include:
- The threshold for switching to alternative antibiotics varies by infection type and antibiotic class, with ranges from 10% to 25% resistance reported in different guidelines [(1], [(@3@], [(@6@]).
- Local health departments and hospital infection control departments track antibiotic resistance surveillance data, which can inform healthcare providers' prescribing decisions [(1].
- Primary care physicians, local pharmacists, and state public health department websites may also have access to this information, providing additional resources for understanding local resistance patterns.
- Culture and sensitivity testing can be used to determine the most effective antibiotics for specific infections, reducing treatment failures and further resistance development [(1]. It is crucial to prioritize local data when making decisions about antibiotic prescribing, as national or international guidelines may not accurately reflect resistance patterns in your community. By consulting local surveillance data and staying up-to-date with the latest guidelines and research, healthcare providers can make informed decisions about antibiotic use and help mitigate the development of antibiotic resistance.
From the Research
Antibiotic Resistance Rates
- The antibiotic resistance rate in a community can vary depending on several factors, including the type of bacteria, antibiotic usage, and geographic location 2, 3, 4.
- A study conducted in Houston, TX, found that among patients with E. coli isolated, antibiotic resistance was highest to ampicillin (63%), trimethoprim-sulfamethoxazole (44%), ciprofloxacin (31%), and cefazolin (30%) 2.
- Another study found that the rate of bacterial resistance to ciprofloxacin observed in a population in Brazil was much higher than expected, with E. coli showing the highest rate of ciprofloxacin resistance, reaching 36% of ciprofloxacin resistant strains in 2014 4.
- Factors that promote antibiotic resistance in community settings include antibiotic selective pressure, prolonged antibiotic treatment, inadequate doses, and prior use of a less effective drug of the same antibiotic class 5.
Factors Associated with Resistance
- Having a prior UTI caused by a trimethoprim-sulfamethoxazole resistant gram-negative organism and being born outside the U.S. increased the odds of trimethoprim-sulfamethoxazole resistance 2.
- Having a complicated UTI, prior fluoroquinolone use, and a prior UTI with ciprofloxacin resistance increased the odds of having ciprofloxacin resistance 2.
- The use of antibiotics such as penicillin and cefixime can increase the incidence of resistant flora, while ciprofloxacin can suppress aerobic bowel flora and reduce the risk of drug-resistant recurrences 6.
Geographic Variation
- Antibiotic resistance rates can vary significantly depending on the geographic location, with some areas having much higher rates of resistance than others 3, 4.
- A study conducted in Brazil found that the rate of bacterial resistance to ciprofloxacin was higher in males than in females, despite the fact that the majority of participants were female 4.
- The antibiotic resistance rate in a community can be influenced by local factors, such as antibiotic usage patterns and infection control practices 5.