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Epidemiological interpretation of antibiotic resistance studies – what are we missing?

Nature Reviews Microbiology volume 2, pages 979–983 (2004)Cite this article

Abstract

Antimicrobial resistance is an emerging public-health threat. Studies of the relationship between antibiotic use and resistance, as well as surveillance programmes, examine changes in the proportion of isolates that are resistant. Although proportions are helpful to the clinician prescribing empirical therapy, proportion-based analyses can be misleading to the public-health professional as they can yield biased estimates. Proportions do not adequately reflect the burden of resistance, a measure often of interest in public health. A more appropriate measure of this burden is the rate of isolation of resistant organisms, that is, the absolute number of resistant isolates in a population over time.

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Figure 1: Outcomes of the introduction of four different antibiotics onto a surgical ward.

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Author information

Authors and Affiliations

  1. Division of Epidemiology, Tel Aviv Sourasky Medical Center, Tel Aviv, 64239, Israel

    Mitchell J. Schwaber & Tali De-Medina

  2. Division of Epidemiology, Tel Aviv Sourasky Medical Center, Tel Aviv, 64239, Israel

    Yehuda Carmeli

  3. Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA

    Yehuda Carmeli

Authors
  1. Mitchell J. Schwaber
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  2. Tali De-Medina
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  3. Yehuda Carmeli
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Correspondence to Mitchell J. Schwaber.

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DATABASES

Entrez

Pseudomonas aeruginosa

Staphylococcus aureus

FURTHER INFORMATION

Antimicrobial resistance

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Schwaber, M., De-Medina, T. & Carmeli, Y. Epidemiological interpretation of antibiotic resistance studies – what are we missing?. Nat Rev Microbiol 2, 979–983 (2004). https://doi.org/10.1038/nrmicro1047

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