JSM 2005 Online Program

Abstract #303255

This is the preliminary program for the 2005 Joint Statistical Meetings in Minneapolis, Minnesota. Currently included in this program is the "technical" program, schedule of invited, topic contributed, regular contributed and poster sessions; Continuing Education courses (August 7-10, 2005); and Committee and Business Meetings. This on-line program will be updated frequently to reflect the most current revisions.

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Activity Number:	494
Type:	Contributed
Date/Time:	Thursday, August 11, 2005 : 8:30 AM to 10:20 AM
Sponsor:	Section on Statistics in Epidemiology
Abstract - #303255
Title:	Temporal Relationship at the Population Level between Antimicrobial Use and Streptococcus Pneumoniae Penicillin Resistance
Author(s):	Robertino M. Mera*+
Companies:	GlaxoSmithKline
Address:	5 Moore Drive, Durham, NC, 27709, United States
Keywords:	Surveillance ; Penicillin resistance ; Antimicrobial consumption ; Temporal model
Abstract:	The temporal relationship between consumption and penicillin resistance is studied using S. pneumoniae surveillance data for the period 1996 to 2003 from France, Spain, Italy, Germany, the UK, and the US. Antimicrobial use is expressed in defined daily doses per 1,000 persons per year and country. A linear mixed model shows temporal changes in penicillin resistance in any country are better explained by the cumulative antimicrobial consumption with a two-year lag. A multivariate random effects model shows the association of exposure to antimicrobials and resistance is unique for every country; that there is no direct relationship between the year-to-year change in consumption and penicillin resistance, but there is a strong linear relationship between cumulative consumption and penicillin resistance. Large reductions in consumption at the population level are needed to affect resistance. There is a peak level of penicillin resistance associated with cumulative exposure to a combination of antibiotic classes. It may be possible for countries with low levels of penicillin resistance under a specific, steady-state situation to retain that condition for a long period of time.

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