BACKGROUND: Drug resistance indexes (DRIs) quantify the cumulative impact of antimicrobial resistance on the likelihood that a given pathogen will be susceptible to antimicrobial therapy.OBJECTIVE: To derive a DRI for community urinary tract infections caused by Escherichia coli in British Columbia for the years 2007 to 2010, and to examine trends over time and across patient characteristics.METHODS: Indication-specific utilization data were obtained from BC PharmaNet for outpatient antimicrobial prescriptions linked to diagnostic information from physician payment files. Resistance data for E coli urinary isolates were obtained from BC Biomedical Laboratories (now part of LifeLabs Medical Laboratory Services). DRIs were derived by multiplying the rate of resistance to a specific antimicrobial by the proportional rate of utilization for that drug class and aggregating across drug classes. Higher index values indicate more resistance.RESULTS: Adaptive-use DRIs remained stable over time at approximately 18% (95% CI 17% to 18%) among adults ≥15 years of age and approximately 28% (95% CI 26% to 31%) among children <15 years of age. Similar results were observed when proportional drug use was restricted to the baseline year (ie, a static-use model). Trends according to age group suggest a U-shaped distribution, with the highest DRIs occurring among children <10 years of age and adults ≥65 years of age. Males had consistently higher DRIs than females for all age groups.CONCLUSIONS: The stable trend in adaptive-use DRIs over time suggests that clinicians are adapting their prescribing practices for urinary tract infections to local resistance patterns. Results according to age group reveal a higher probability of resistance to initial therapy among young children and elderly individuals.

中文翻译：

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总指数在描述大肠埃希菌耐药性趋势影响中的价值。

背景：耐药指数（DRI）量化了抗生素耐药性对给定病原体易受抗生素治疗的可能性的累积影响。目的：得出多年来不列颠哥伦比亚省由大肠杆菌引起的社区泌尿道感染的DRI。方法：从BC PharmaNet获得针对门诊抗菌药物处方的特定适应症利用数据，这些数据与医师付款文件中的诊断信息相关联，从2007年至2010年，并研究随时间变化和跨患者特征的趋势。大肠杆菌的抗药性数据尿液分离株是从BC Biomedical Laboratories（现在是LifeLabs Medical Laboratory Services的一部分）获得的。DRI是通过将对特定抗菌素的耐药率乘以该药物类别的使用比例比例并在各个药物类别中汇总得出的。指数值越高表明抵抗力越强。结果：适应性DRI随时间推移保持稳定，在15岁以上的成年人中约为18％（95％CI为17％至18％），约为28％（95％CI为26％至31％）。 ％）小于15岁的儿童。当将按比例使用药物限制在基准年（即静态使用模型）时，观察到相似的结果。根据年龄组别的趋势表明呈U形分布，DRI最高发生在<10岁的儿童和≥65岁的成年人中。在所有年龄段，男性的DRI始终高于女性。结论：随着时间的推移，适应性DRI的稳定趋势表明，临床医生正在根据当地的耐药性模式调整其尿路感染的处方操作。根据年龄组得出的结果表明，年幼的儿童和老年人对初始治疗产生抗药性的可能性更高。