Prescriptions of broad-spectrum antibiotics to outpatients do not match increased prevalence and antibiotic resistance of respiratory pathogens in Bavaria.

In this study we present an analysis of prescription numbers of various antibiotic classes to Bavarian (Southern Germany) outpatients between 2000 and 2006 compared to fluctuating resistance patterns in representative respiratory pathogens. Prescriptions of "narrow-spectrum" antibiotics (e.g. penicillins, macrolides) decreased by 39% while prescriptions of "broad-spectrum" antibiotics increased by 38%. The most prominent increase was for quinolones and cephalosporines class II. Prescriptions of these antibiotics exhibited prominent seasonal alterations suggesting that these drugs had been used for treatment of respiratory infections. In contrast, the numbers of S. pneumoniae and H. influenzae detected in respiratory specimen decreased. Almost constant resistance rates of S. pneumoniae for first line antibiotics do not justify an increased use of cephalosporins class II and quinolones. Compared to Europe and Germany in general, consumption of antibiotics is low in Bavaria. Even at this low level we propose an education of physicians treating outpatients in a way to avoid an excessive use of antimicrobials.