Social-economic factors and irrational antibiotic use as reasons for antibiotic resistance of bacteria causing common childhood infections in primary healthcare

• Published in: European journal of pediatrics Vol. 171; no. 5; pp. 767 - 777
• Main Authors: ILIC, Katarina, JAKOVLJEVIC, Emil, KODRIC-TRIFUNOVIC, Vesna S
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.05.2012; Springer; Springer Nature B.V
• Subjects: Animals; Anti-Bacterial Agents - therapeutic use; Antibiotics; Antimicrobial agents; Bacteria; Bacterial infections; Bacterial Infections - drug therapy; Bacterial Infections - microbiology; Biological and medical sciences; Cattle; Child; Developing countries; Drug dosages; Drug resistance; Drug Resistance, Bacterial; E coli; General aspects; Health Services Misuse; Humans; Infant; LDCs; Medical sciences; Medicine; Medicine & Public Health; Miscellaneous; Pediatrics; Penicillin; Pneumonia; Primary Health Care; Public health. Hygiene; Public health. Hygiene-occupational medicine; Respiratory Tract Infections - drug therapy; Respiratory Tract Infections - microbiology; Review; Salmonidae; Shigella; Socioeconomic Factors; Staphylococcus aureus; Streptococcus infections; Streptococcus pneumoniae; Urinary Tract Infections - drug therapy; Urinary Tract Infections - microbiology; Serbia; France; United States > US; Switzerland; Germany; Antibiotic use; Antibacterial resistance; Bacterial infections; Children; Human; Pediatrics; Rational irrational; Primary health care; Infection; Resistance; Antibiotic; Medical prescription; Bacteriosis; Bacteria; Economic aspect; Antibacterial agent; Child; Social aspect; Public health
• ISSN: 0340-6199; 1432-1076
• DOI: 10.1007/s00431-011-1592-5

The most prevalent childhood bacterial infections in primary healthcare are respiratory, gastrointestinal and urogenital infections. The main aim of this paper was to consider factors (socio-economic factors and irrational antibiotic use) that contribute to the development of bacterial resistance, as well as measures that resulted in a reduction of this problem. Computerized search through the Medline of published articles on antibiotic resistance from 1996 to 2011 in English or Serbian was completed in August 2011. Combinations of used terms were antimicrobial/antibacterial/antibiotic and resistance/susceptibility in pediatric/children, and Streptococcus pneumoniae / Streptococci / Haemophilus influenzae / Salmonellae / Escherichia coli / Shigella / Staphylococcus aureus as well as antibiotics/antimicrobials/antibacterials and consumption/utilization/use. In many developing countries, antibiotic dispensing and its use in medicine, cattle breeding and agriculture are inadequately regulated, or existing laws are not being appropriately implemented. In addition, human travel contributes to antimicrobial drug resistance around the world. All of these factors have led to a very high level of bacterial resistance. On the contrary, in countries with a clearly defined and implemented legal framework concerning antibiotic prescribing, dispensing and utilization, the use of antibiotics is under constant surveillance. That resulted in a significantly lower antibacterial resistance. In conclusion , bacterial resistance could be reduced by the implementation of systemic and long-term measures at a country level as well as at all levels of healthcare. In order to reduce bacterial resistance, antibiotic use needs to be precisely regulated, and regulations should be coherent with practice. The international community must have a more active role in solving this global problem.