Production of Betalactamase by Respiratory Tract Bacteria in Children: Relationship to Antibiotic Use

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Abstract
Sales of antibiotics have increased in Sweden during the past decade. This has been paralleled by an increase in the frequency of βa-lactamase-producing respiratory tract bacteria. To investigate the effects of regional differences in use of antibiotics on β-lactamase production in respiratory tract bacteria, we collected nasopharyngeal specimens and information about antibiotic use from 1133 children attending day-care centres in four rural municipalities with low use, and one urban municipality with high use of antibiotics, use being assessed from pharmacy sales. The frequency of β-lactamase production among isolates of Branhamella catarrhalis and Moraxella nonliquefaciens was(doubt) significantly higher in the urban municipality. This appeared to be a long-term ecological effect of differences in the level of use of antibiotics between the urban and rural populations, rather than an effect of recent antibiotic treatment of individual patients.