Increased Amoxicillin–Clavulanic Acid Resistance in Escherichia coli Blood Isolates, Spain
2008

Increased Resistance to Amoxicillin-Clavulanic Acid in E. coli in Spain

Sample size: 9090 publication Evidence: high

Author Information

Author(s): Oteo Jesús, Campos José, Lázaro Edurne, Cuevas Óscar, García-Cobos Silvia, Pérez-Vázquez María, de Abajo F. J.

Primary Institution: Instituto de Salud Carlos III, Madrid, Spain

Hypothesis

What are the trends of amoxicillin-clavulanic acid resistance among E. coli isolates in Spain?

Conclusion

The study found a concerning increase in amoxicillin-clavulanic acid resistance among E. coli blood isolates in Spain, coinciding with increased community consumption of the drug.

Supporting Evidence

  • 1,136 out of 9,090 E. coli isolates were nonsusceptible to amoxicillin-clavulanic acid.
  • The prevalence of resistance increased from 9.3% in 2003 to 15.4% in 2006.
  • Multidrug resistance was found in 17.4% of nonsusceptible isolates.
  • Community-acquired infections showed a higher increase in resistance compared to hospital-acquired infections.

Takeaway

Doctors are finding that a common medicine, amoxicillin-clavulanic acid, is becoming less effective against a type of bacteria called E. coli in Spain, which is worrying.

Methodology

The study tested 9,090 blood isolates from 42 Spanish hospitals and compared resistance trends with outpatient consumption data.

Limitations

The study may not account for all factors influencing resistance, such as other antibiotic use or local healthcare practices.

Participant Demographics

49.8% male and 50.2% female patients, with a range of ages including children and older adults.

Statistical Information

P-Value

p<0.0001

Confidence Interval

95% CI 1.08–1.39

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.3201/eid1408.071059

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