Tracking global trends in the effectiveness of antibiotic therapy using the Drug Resistance Index
Background Evaluating trends in antibiotic resistance and communicating the results to a broad audience are important for dealing with this global threat. The Drug Resistance Index (DRI), which combines use and resistance into a single measure, was developed as an easy-to-understand measure of the e...
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BMJ Publishing Group
2019-03-01
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| Series: | BMJ Global Health |
| Online Access: | https://gh.bmj.com/content/4/2/e001315.full |
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| author | Eili Y Klein Katie K Tseng Suraj Pant Ramanan Laxminarayan |
| author_facet | Eili Y Klein Katie K Tseng Suraj Pant Ramanan Laxminarayan |
| author_sort | Eili Y Klein |
| collection | DOAJ |
| description | Background Evaluating trends in antibiotic resistance and communicating the results to a broad audience are important for dealing with this global threat. The Drug Resistance Index (DRI), which combines use and resistance into a single measure, was developed as an easy-to-understand measure of the effectiveness of antibiotic therapy. We demonstrate its utility in communicating differences in the effectiveness of antibiotic therapy across countries.Methods We calculated the DRI for countries with data on antibiotic use and resistance for the disease-causing organisms considered by the WHO as priority pathogens: Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus, Enterococcus faecium and Enterococcus faecalis. Additionally, we estimated pooled worldwide resistance rates for these pathogens.Results 41 countries had the requisite data and were included in the study. Resistance and use rates were highly variable across countries, but A. baumannii resistance rates were uniformly higher, on average, than other organisms. High-income countries, particularly Sweden, Canada, Norway, Finland and Denmark, had the lowest DRIs; the countries with the highest DRIs, and therefore the lowest effectiveness of antibiotic therapy, were all low-income and middle-income countries.Conclusions The DRI is a useful indicator of the problem of resistance. By combining data on antibiotic use with resistance, it captures a snapshot of how the antibiotics a country typically uses match their resistance profiles. This single measure of the effectiveness of antibiotic therapy provides a means of benchmarking against other countries and can, over time, indicate changes in drug effectiveness that can be easily communicated. |
| format | Article |
| id | doaj-art-bfd75e4ffb844a7ab44f2170447cc8b6 |
| institution | OA Journals |
| issn | 2059-7908 |
| language | English |
| publishDate | 2019-03-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Global Health |
| spelling | doaj-art-bfd75e4ffb844a7ab44f2170447cc8b62025-08-20T02:37:46ZengBMJ Publishing GroupBMJ Global Health2059-79082019-03-014210.1136/bmjgh-2018-001315Tracking global trends in the effectiveness of antibiotic therapy using the Drug Resistance IndexEili Y Klein0Katie K Tseng1Suraj Pant2Ramanan Laxminarayan3Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USACenter for Disease Dynamics Economics and Policy, Washington, District of Columbia, USACenter for Disease Dynamics, Economics & Policy, Washington, District of Columbia, USAOne Health Trust, Bengaluru, Karnataka, IndiaBackground Evaluating trends in antibiotic resistance and communicating the results to a broad audience are important for dealing with this global threat. The Drug Resistance Index (DRI), which combines use and resistance into a single measure, was developed as an easy-to-understand measure of the effectiveness of antibiotic therapy. We demonstrate its utility in communicating differences in the effectiveness of antibiotic therapy across countries.Methods We calculated the DRI for countries with data on antibiotic use and resistance for the disease-causing organisms considered by the WHO as priority pathogens: Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus, Enterococcus faecium and Enterococcus faecalis. Additionally, we estimated pooled worldwide resistance rates for these pathogens.Results 41 countries had the requisite data and were included in the study. Resistance and use rates were highly variable across countries, but A. baumannii resistance rates were uniformly higher, on average, than other organisms. High-income countries, particularly Sweden, Canada, Norway, Finland and Denmark, had the lowest DRIs; the countries with the highest DRIs, and therefore the lowest effectiveness of antibiotic therapy, were all low-income and middle-income countries.Conclusions The DRI is a useful indicator of the problem of resistance. By combining data on antibiotic use with resistance, it captures a snapshot of how the antibiotics a country typically uses match their resistance profiles. This single measure of the effectiveness of antibiotic therapy provides a means of benchmarking against other countries and can, over time, indicate changes in drug effectiveness that can be easily communicated.https://gh.bmj.com/content/4/2/e001315.full |
| spellingShingle | Eili Y Klein Katie K Tseng Suraj Pant Ramanan Laxminarayan Tracking global trends in the effectiveness of antibiotic therapy using the Drug Resistance Index BMJ Global Health |
| title | Tracking global trends in the effectiveness of antibiotic therapy using the Drug Resistance Index |
| title_full | Tracking global trends in the effectiveness of antibiotic therapy using the Drug Resistance Index |
| title_fullStr | Tracking global trends in the effectiveness of antibiotic therapy using the Drug Resistance Index |
| title_full_unstemmed | Tracking global trends in the effectiveness of antibiotic therapy using the Drug Resistance Index |
| title_short | Tracking global trends in the effectiveness of antibiotic therapy using the Drug Resistance Index |
| title_sort | tracking global trends in the effectiveness of antibiotic therapy using the drug resistance index |
| url | https://gh.bmj.com/content/4/2/e001315.full |
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