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    Am J Trop Med Hyg. 2010 Aug;83(2):301-6.

    Antibiotic use in Thailand: quantifying impact on blood culture yield and estimates of pneumococcal bacteremia incidence.

    Rhodes J, Hyder JA, Peruski LF, Fisher C, Jorakate P, Kaewpan A, Dejsirilert S, Thamthitiwat S, Olsen SJ, Dowell SF, Chantra S, Tanwisaid K, Maloney SA, Baggett HC.

    Source

    Thailand Ministry of Public Health - United States Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand.

    Abstract

    No studies have quantified the impact of pre-culture antibiotic use on the recovery of individual blood-borne pathogens or on population-level incidence estimates for Streptococcus pneumoniae. We conducted bloodstream infection surveillance in Thailand during November 2005-June 2008. Pre-culture antibiotic use was assessed by reported use and by serum antimicrobial activity. Of 35,639 patient blood cultures, 27% had reported pre-culture antibiotic use and 24% (of 24,538 tested) had serum antimicrobial activity. Pathogen isolation was half as common in patients with versus without antibiotic use; S. pneumoniae isolation was 4- to 9-fold less common (0.09% versus 0.37% by reported antibiotic use; 0.05% versus 0.45% by serum antimicrobial activity, P < 0.01). Pre-culture antibiotic use by serum antimicrobial activity reduced pneumococcal bacteremia incidence by 32% overall and 39% in children < 5 years of age. Our findings highlight the limitations of culture-based detection methods to estimate invasive pneumococcal disease incidence in settings where pre-culture antibiotic use is common.

    PMID:
    20682872
    [PubMed - indexed for MEDLINE]
    PMCID:
    PMC2911175
    Free PMC Article

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