%0 Journal Article %1 guillemot_reduction_2005 %A Guillemot, Didier %A Varon, Emmanuelle %A Bernède, Claire %A Weber, Philippe %A Henriet, Laurence %A Simon, Sylvie %A Laurent, Cécile %A Lecoeur, Hervé %A Carbon, Claude %D 2005 %J Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America %K Administration Agents, Carrier Child, Community Drug Factors Female, France, G, Health Humans, Infections, Male, Patterns, Penicillin Physician's Pneumococcal Practice Preschool, Prescriptions, Resistance, Routes, Schedule, Services, State, Streptococcus Time Utilization, pneumoniae, {Anti-Bacterial} %N 7 %P 930--938 %R 10.1086/432721 %T Reduction of antibiotic use in the community reduces the rate of colonization with penicillin G-nonsusceptible Streptococcus pneumoniae %U http://www.ncbi.nlm.nih.gov/pubmed/16142656 %V 41 %X BACKGROUND: There is a lack of evidence documenting the impact of optimized antibiotic use on the rates of colonization with penicillin G-nonsusceptible Streptococcus pneumoniae (PNSP) in children. This study evaluates the effect of community-based intervention strategies on the prevalence of pnsp colonization. METHODS: A controlled, population-based pharmacoepidemiological trial was conducted from January through May 2000. Three French geographic areas were selected on the basis of demographic similarities. Two intervention strategies were implemented: (1) reduced antibiotic use, which was achieved by not prescribing antibiotics for presumed viral respiratory tract infections (the prescription-reduction group); and (2) better adaptation of dose and duration (the dose/duration group). A control group received no intervention. The target population was children aged 3-6 years who were attending kindergarten. Oropharyngeal pneumococcus colonization and antibiotic use were monitored throughout the 5-month study. RESULTS: The prescription-reduction, dose/duration, and control groups included 601, 483, and 405 children, respectively. The interventions induced significantly larger decreases in antibiotic use in the prescription-reduction group (-18.8\%) and dose/duration group (-17.1\%) than in the control group (-3.8\%), and the rates of PNSP colonization were initially similar for the 3 groups (52.5\%, 55.1\%, and 50.0\%, respectively). At the end of the 5-month study, the rates of PNSP colonization were 34.5\% for the prescription-reduction group (P=.05) and 44.3\% for the dose/duration group (P=.8), compared with 46.2\% for the control group. CONCLUSIONS: Intensive educational strategies aimed at optimizing antibiotic use can significantly reduce the rate of PNSP colonization in areas with high resistance rates.

@article{guillemot_reduction_2005, abstract = {{BACKGROUND:} There is a lack of evidence documenting the impact of optimized antibiotic use on the rates of colonization with penicillin G-nonsusceptible Streptococcus pneumoniae {(PNSP)} in children. This study evaluates the effect of community-based intervention strategies on the prevalence of pnsp colonization. {METHODS:} A controlled, population-based pharmacoepidemiological trial was conducted from January through May 2000. Three French geographic areas were selected on the basis of demographic similarities. Two intervention strategies were implemented: (1) reduced antibiotic use, which was achieved by not prescribing antibiotics for presumed viral respiratory tract infections (the prescription-reduction group); and (2) better adaptation of dose and duration (the dose/duration group). A control group received no intervention. The target population was children aged 3-6 years who were attending kindergarten. Oropharyngeal pneumococcus colonization and antibiotic use were monitored throughout the 5-month study. {RESULTS:} The prescription-reduction, dose/duration, and control groups included 601, 483, and 405 children, respectively. The interventions induced significantly larger decreases in antibiotic use in the prescription-reduction group (-18.8\%) and dose/duration group (-17.1\%) than in the control group (-3.8\%), and the rates of {PNSP} colonization were initially similar for the 3 groups (52.5\%, 55.1\%, and 50.0\%, respectively). At the end of the 5-month study, the rates of {PNSP} colonization were 34.5\% for the prescription-reduction group {(P=.05)} and 44.3\% for the dose/duration group {(P=.8),} compared with 46.2\% for the control group. {CONCLUSIONS:} Intensive educational strategies aimed at optimizing antibiotic use can significantly reduce the rate of {PNSP} colonization in areas with high resistance rates.}, added-at = {2011-03-11T10:05:34.000+0100}, author = {Guillemot, Didier and Varon, Emmanuelle and Bernède, Claire and Weber, Philippe and Henriet, Laurence and Simon, Sylvie and Laurent, Cécile and Lecoeur, Hervé and Carbon, Claude}, biburl = {https://www.bibsonomy.org/bibtex/2362b36a4f0a9fb86be9916c916820adc/jelias}, doi = {10.1086/432721}, interhash = {5433bdf3a68849ea37c41a0c1d44fc10}, intrahash = {362b36a4f0a9fb86be9916c916820adc}, issn = {1537-6591}, journal = {Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America}, keywords = {Administration Agents, Carrier Child, Community Drug Factors Female, France, G, Health Humans, Infections, Male, Patterns, Penicillin Physician's Pneumococcal Practice Preschool, Prescriptions, Resistance, Routes, Schedule, Services, State, Streptococcus Time Utilization, pneumoniae, {Anti-Bacterial}}, month = oct, note = {{PMID:} 16142656}, number = 7, pages = {930--938}, timestamp = {2011-03-11T10:06:20.000+0100}, title = {Reduction of antibiotic use in the community reduces the rate of colonization with penicillin G-nonsusceptible Streptococcus pneumoniae}, url = {http://www.ncbi.nlm.nih.gov/pubmed/16142656}, volume = 41, year = 2005 }