Country-level association between antimicrobial consumption and resistance in Neisseria meningitidis: An ecological study.

BACKGROUND

It is unclear what is responsible for the large variations in the prevalence of meningococcal resistance to cephalosporins and quinolones.

METHODS

We used mixed-effects linear regression to assess if country-level prevalence of reduced susceptibility to cefotaxime and ciprofloxacin was associated with the population-level consumption of cephalosporins and quinolones in 13 European countries.

RESULTS

Positive correlations were found between the prevalence of reduced susceptibility to ciprofloxacin and the consumption of quinolones (coef. 0.16, 95% CI 0.05-0.27; P = 0.003). The same positive association was found for cefotaxime/cephalosporins (coef. 0.1, 95% CI 0.04-0.15; P = 0.001).

CONCLUSIONS

Meningococcal reduced susceptibility to cefotaxime and ciprofloxacin is linked to homologous class antimicrobial consumption. This finding provides additional motivation for strengthening antimicrobial stewardship programs.