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Antibiotic Resistance May Persist Months After Treatment

Resistance to drugs for respiratory, urinary tract infections likely, especially in first month

WEDNESDAY, May 19 (HealthDay News) -- After a course of antibiotics for respiratory or urinary tract infection, an individual is likely to develop resistance to the antibiotic that may persist for up to 12 months, according to research published online May 18 in the BMJ.

Ceire Costelloe, of the University of Bristol, U.K., and colleagues conducted a review and meta-analysis of studies investigating subsequent antibiotic resistance in patients who had been prescribed antibiotics in a primary care setting. The review included 24 studies, 19 of which were observational and five of which were randomized trials.

In five studies of urinary tract bacteria, within two months of treatment the pooled odds ratio (OR) for bacterial resistance was 2.5; within 12 months the OR for resistance remained elevated at 1.33. In seven studies of respiratory tract bacteria, the risk of resistance was elevated at two months (OR, 2.4) and remained high at 12 months (OR, 2.4). Multiple courses of antibiotics, as well as longer treatment durations, were also associated with increased resistance rates.

"Individuals prescribed an antibiotic in primary care for a respiratory or urinary infection develop bacterial resistance to that antibiotic. The effect is greatest in the month immediately after treatment but may persist for up to 12 months. This effect not only increases the population carriage of organisms resistant to first-line antibiotics, but also creates the conditions for increased use of second-line antibiotics in the community," the authors conclude.

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