According to a recently completed study, patients who received antibiotics on an outpatient basis to treat respiratory or urinary tract infections have a higher risk of resistance of microorganisms to the antibiotic used in later infections.

Researchers from the United Kingdom systematically reviewed 4,373 publications presented in Medline, Embase and the Cochrane Bath database, with the aim of identifying trends in antibiotic resistance of microorganisms in patients receiving outpatient antibiotics. The final meta-analysis included 24 studies with similar results analyzed.

Among them, 22 studies, which included infected patients, and 2 studies carried out on healthy volunteers. The analysis included 19 observational studies (including 2 prospective) and 5 randomized trials.

The combined results of 5 studies were analyzed in 14,348 patients with urinary tract infections (UTIs). The combined odds ratio (OR) for the presence of resistant bacteria in this population was 2.5 (95% confidence interval - CI 2.1 to 2.9) for 2 months after the use of antibiotics and 1.33 (95% CI 1.2 to 1.5) within 12 months of treatment.

In 7 studies, 2,605 participants studied antibiotic resistance in respiratory tract infections. The combined OR for the presence of resistant bacteria in this population was 2.4 (95% CI 1.4 to 3.9) for 2 months after the use of antibiotics and 2.4 (95% CI % from 1.3 to 4.5)) within 12 months of treatment.

According to several studies, which indicated the number of antibiotics used, longer treatment and multiple cycles of antimicrobial therapy were associated with a higher incidence of resistance.

In a prospective study, included in a meta-analysis, the odds ratios of the presence of resistance after treatment in the dynamics over a long period of observation were determined. The combined OS indicators were: 12.2 (95% CI 6.8 to 22.1) 1 week after the use of antibiotics; 6.1 (2.8-3.4) - after 1 month; 3.6 (2.2-6.0) - after 2 months and 2.2 (1.3-3.6) - 6 months after treatment.

Thus, each case of use of antibiotics leads to a significant increase in the risk of resistance to antibiotic microorganisms and the spread of the carriage of resistant bacteria in the population, which requires subsequent "second line" antibiotic therapy. outpatient infections.

The results obtained once again underline the importance of the extremely reasonable and reasonable use of antibiotics in the treatment of outpatient infections.