Photo Credit – CDC PHIL
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Canadian researchers, examining 13 years worth of data from the UK’s General Practice Research Database (GPRD), have come up with what they are calling a `robust association’ between a prior history of antibiotic use and rates of CA-MRSA (Community Acquired Methicillin Resistant Staph Aureus) infection in children.
The GPRD collects anonymous data from 5 million active patients seen at 625 primary care practices throughout the UK. It represents 66 million patient-years of data, and is widely used for population based studies.
The study appeared online yesterday (Aug. 1st) in the Archives of Pediatrics & Adolescent Medicine.
Verena Schneider-Lindner, MD, MSc; Caroline Quach, MD, MSc; James A Hanley, PhD; Samy Suissa, PhD
Arch Pediatr Adolesc Med. Published online August 1, 2011. doi:10.1001/archpediatrics.2011.143
What these researchers found was that while nearly half of children with MRSA in this study had no recent history of antibiotic use, the adjusted relative risk (RR) of developing MRSA was 3.5 times higher among children who had received antibiotic treatment in the previous 30-180 days before infection.
And that relative risk increased substantially among children who received more than one course of antibiotics.
The adjusted relative risk of developing MRSA was highest for those receiving Quinolones, at 14.8 and Macrolides at 5.2, while Penicillins and Sulfonamides produced the lowest RR (.8 and 1.3).
The authors concluded:
While close to half of children were diagnosed as having MRSA in the community without prior antibacterial drugs, such agents are associated with a dose-dependent increased risk, concordant with findings in adults.
Although the full study is behind a pay wall, we get more on this study, including some quotes from the authors, via Pulse Today.
'Robust association' between GP antibacterial prescriptions and MRSA in children
01 Aug 2011
While the authors are not claiming that this study conclusively proves a causal association, they are quoted as saying that ‘the association was not only dose and class dependent but also responsive to modifying the length of the exposure time window, which implies time dependency'.
When antibiotics are truly necessary and administered appropriately, they can often be life saving. While the possibility of later developing a MRSA infection may exist, those dangers are more than offset by the benefits of taking the drug.
But when antibiotics are taken inappropriately – those risks cease to be reasonable, as there is no potential health benefit in taking the antibiotic.
All drugs have side effects. And there is a risk-reward calculation that we must all make when deciding to take a medication.
Among the risks of taking antibiotics: they can upset the balance of the normal flora in the gut, can sometimes spark difficult to treat C. Diff infections, can drive bacteria towards antimicrobial resistance, and as this study implies, may lead to an increased susceptibility to MRSA.
So appropriate use of our declining arsenal of effective antibiotics is imperative.In recent years many medical experts have been working to improve the way antibiotics are prescribed.
Some recent blogs on the judicious use of antibiotics include:
IDSA: Educational Guidelines Lower Antibiotic Use
World Health Day 2011
WHO: The Threat Of Antimicrobial Resistance
ECDC: Situation Update On Antimicrobial Resistance
CDC: Get Smart About Antibiotics Week
