{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T12:46:59Z","timestamp":1787230019369,"version":"build-2736575974"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2019,8,2]],"date-time":"2019-08-02T00:00:00Z","timestamp":1564704000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Antibiotic consumption in the paediatric population is one of the key drivers of the emergence and spread of antimicrobial resistance, which is a serious global threat to public health and clinical medicine. The aims of this study were to investigate systemic antibiotic consumption in school children and to assess the associations among antibiotic consumption, carriage rate and resistance of respiratory pathogens residing in the upper respiratory tract mucosa.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In this prospective study, throat and nasopharyngeal swabs from 450 school children, 6\u201315 years of age (225 healthy children and 225 patients who were ambulatory treated for upper respiratory tract infection), were processed in 2014 in Rijeka, Croatia, and clinical data were obtained via a questionnaire.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In total, 17% of the children had consumed an antibiotic in the previous 6 months, including 7% of the healthy children and 27% of the acutely ill patients. The most commonly prescribed antibiotics were amoxicillin (26%), amoxicillin with clavulanic acid (26%) and macrolides (18%). Respiratory pathogens were more frequently isolated from children who had consumed an antibiotic in the previous 6 months [odds ratio (OR) 3.67, P &amp;lt; 0.001]. Antibiotic-resistant bacteria were also more frequent in children who had been exposed to antibiotics (OR 5.44, P &amp;lt; 0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Penicillins are the most frequently used antibiotics among school children. The results of this study demonstrate that antibiotic consumption is linked with higher carriage rates and resistance rates of respiratory tract pathogens. Therefore, rational use of antibiotics could prevent the emergence and spread of resistant bacteria.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurpub\/ckz137","type":"journal-article","created":{"date-parts":[[2019,7,14]],"date-time":"2019-07-14T19:06:25Z","timestamp":1563131185000},"page":"265-269","source":"Crossref","is-referenced-by-count":8,"title":["Impact of antibiotic consumption on the carriage of antibiotic-resistant bacteria by school children"],"prefix":"10.1093","volume":"30","author":[{"given":"Maja","family":"Farka\u0161","sequence":"first","affiliation":[{"name":"Department of Microbiology, Teaching Institute of Public Health of Primorsko-Goranska County, Rijeka, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatjana","family":"\u010culina","sequence":"first","affiliation":[{"name":"Department of School and University Medicine, Teaching Institute of Public Health of Primorsko-Goranska County, Rijeka, Croatia"},{"name":"Department of Family Medicine, University of Rijeka Faculty of Medicine, Rijeka, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jadranka","family":"Si\u0161ul","sequence":"first","affiliation":[{"name":"Private Paediatric Practice, Rijeka, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gordana","family":"Pel\u010di\u0107","sequence":"first","affiliation":[{"name":"Department of Paediatrics, Health Care Centre of Primorsko-Goranska County, Rijeka, Croatia"},{"name":"Department of Social Sciences and Humanities in Medicine, University of Rijeka Faculty of Medicine, Rijeka, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Mavrinac","sequence":"first","affiliation":[{"name":"Department of Medical Informatics, University of Rijeka Faculty of Medicine, Rijeka, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vladimir","family":"Mi\u0107ovi\u0107","sequence":"first","affiliation":[{"name":"Department of Environmental Health, University of Rijeka Faculty of Medicine, Rijeka, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjana","family":"Tambi\u0107 Andra\u0161evi\u0107","sequence":"first","affiliation":[{"name":"Division of Bacteriology and Hospital Infections, Department of Clinical Microbiology, University Hospital for Infectious Diseases \u2018Dr. Fran Mihaljevi\u0107\u2019, Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,8,2]]},"reference":[{"key":"2020042512555156900_ckz137-B1","first-page":"7","article-title":"Antibiotic resistance\u2013the leading medical problem at the beginning of the 21st century. Medicina","volume":"43","author":"Tambi\u0107 Andra\u0161evi\u0107","year":"2007"},{"key":"2020042512555156900_ckz137-B2","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1136\/bmj.317.7159.609","article-title":"Antimicrobial resistance. Is a major threat to public health","volume":"317","author":"Wise","year":"1998","journal-title":"BMJ"},{"key":"2020042512555156900_ckz137-B3","year":"2015"},{"key":"2020042512555156900_ckz137-B4","first-page":"155","volume-title":"Antibiotic Resistance in Croatia, 2015","author":"Payerl Pal","year":"2016"},{"key":"2020042512555156900_ckz137-B5","doi-asserted-by":"crossref","first-page":"1851","DOI":"10.1016\/S0140-6736(00)04972-2","article-title":"Variation in antibiotic use in the European Union","volume":"357","author":"Cars","year":"2001","journal-title":"Lancet"},{"key":"2020042512555156900_ckz137-B6","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1016\/S0140-6736(05)70799-6","article-title":"Outpatient antibiotic use in Europe and association with resistance: a cross-national database study","volume":"365","author":"Goossens","year":"2005","journal-title":"Lancet"},{"key":"2020042512555156900_ckz137-B7","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1016\/S1473-3099(10)70212-7","article-title":"Reducing antibiotic use in Croatia","volume":"10","author":"Vlahovi\u0107-Pal\u010devski","year":"2010","journal-title":"Lancet Infect Dis"},{"key":"2020042512555156900_ckz137-B8","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/1471-2334-14-13","article-title":"A systematic review and meta-analysis of the effects of antibiotic consumption on antibiotic resistance","volume":"14","author":"Bell","year":"2014","journal-title":"BMC Infect Dis"},{"key":"2020042512555156900_ckz137-B9","doi-asserted-by":"crossref","first-page":"c2096","DOI":"10.1136\/bmj.c2096","article-title":"Effects of antibiotic prescribing in primary care on antimicrobial resistance in individual patients: systematic review and meta-analysis","volume":"340","author":"Costelloe","year":"2010","journal-title":"BMJ"},{"key":"2020042512555156900_ckz137-B10","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1136\/adc.2010.183541","article-title":"Differences in antibiotic prescribing in paediatric outpatients","volume":"96","author":"Clavenna","year":"2011","journal-title":"Arch Dis Child"},{"key":"2020042512555156900_ckz137-B11","year":"2015"},{"key":"2020042512555156900_ckz137-B12","first-page":"198","article-title":"Antibiotic resistance in most common childhood bacterial pathogens","volume":"49","author":"Tambi\u0107 Andra\u0161evi\u0107","year":"2005","journal-title":"Paediatr Croat"},{"key":"2020042512555156900_ckz137-B13","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1111\/j.1365-2125.2009.03380.x","article-title":"Determinants of the drug utilization profile in the paediatric population in Italy\u2019 s Lombardy Region","volume":"67","author":"Clavenna","year":"2009","journal-title":"Br J Clin Pharmacol"},{"key":"2020042512555156900_ckz137-B14","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1093\/jac\/dkm032","article-title":"Age- and gender-specific antibacterial prescribing in Norway","volume":"59","author":"Blix","year":"2007","journal-title":"J Antimicrob Chemother"},{"key":"2020042512555156900_ckz137-B15","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1001\/jama.279.11.875","article-title":"Antibiotic prescribing for children with colds, upper respiratory tract infections, and bronchitis","volume":"279","author":"Nyquist","year":"1998","journal-title":"JAMA"},{"key":"2020042512555156900_ckz137-B16"},{"key":"2020042512555156900_ckz137-B17","year":"2016"},{"key":"2020042512555156900_ckz137-B18","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1186\/1471-2431-14-174","article-title":"Systemic antibiotic prescribing to paediatric outpatients in 5 European countries: a population-based cohort study","volume":"14","author":"Holstiege","year":"2014","journal-title":"BMC Pediatr"},{"key":"2020042512555156900_ckz137-B19","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1007\/s00228-008-0479-5","article-title":"Antibiotic drug use of children in the Netherlands from 1999 till 2005","volume":"64","author":"de Jong","year":"2008","journal-title":"Eur J Clin Pharmacol"},{"key":"2020042512555156900_ckz137-B20","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1007\/s00431-013-1958-y","article-title":"Systemic antibiotic use among children and adolescents in Germany: a population-based study","volume":"172","author":"Holstiege","year":"2013","journal-title":"Eur J Pediatr"},{"key":"2020042512555156900_ckz137-B21","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1007\/s00228-007-0376-3","article-title":"Antibiotic prescription and prevalence rate in the outpatient paediatric population: analysis of surveys published during 2000-2005","volume":"63","author":"Rossignoli","year":"2007","journal-title":"Eur J Clin Pharmacol"},{"key":"2020042512555156900_ckz137-B22","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1093\/eurpub\/ckp040","article-title":"Antibiotic prescribing in paediatric populations: a comparison between Viareggio, Italy and Funen, Denmark","volume":"19","author":"Lusini","year":"2009","journal-title":"Eur J Public Health"},{"key":"2020042512555156900_ckz137-B23","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1186\/2193-1801-2-124","article-title":"Antibiotic prescription preferences in paediatric outpatient setting in Estonia and Sweden","volume":"2","author":"Lass","year":"2013","journal-title":"SpringerPlus"},{"key":"2020042512555156900_ckz137-B24","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1093\/jac\/dki147","article-title":"Reduction in outpatient antibiotic sales for pre-school children: interrupted time series analysis of weekly antibiotic sales data in Sweden 1992-2002","volume":"56","author":"H\u00f6gberg","year":"2005","journal-title":"J Antimicrob Chemother"},{"key":"2020042512555156900_ckz137-B25","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/S1473-3099(08)70017-3","article-title":"Sustained reduction of antibiotic use and low bacterial resistance: 10-year follow-up of the Swedish Strama programme","volume":"8","author":"M\u00f6lstad","year":"2008","journal-title":"Lancet Infect Dis"},{"key":"2020042512555156900_ckz137-B26","first-page":"181","article-title":"ISKRA guidelines on sore throat: diagnostic and therapeutic approach\u2013Croatian national guidelines","volume":"131","author":"Tambi\u0107 Andra\u0161evi\u0107","year":"2009","journal-title":"Lije\u010d Vjesn"},{"key":"2020042512555156900_ckz137-B27","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1177\/2042098614554919","article-title":"Antimicrobial resistance: risk associatied with antibiotic overuse and initiatives to reduce the problem","volume":"5","author":"Llor","year":"2014","journal-title":"Ther Adv Drug Saf"},{"key":"2020042512555156900_ckz137-B28","doi-asserted-by":"crossref","first-page":"1292","DOI":"10.1093\/jac\/dkq104","article-title":"A survey of public knowledge and awareness related to antibiotic use and resistance in Sweden","volume":"65","author":"Andr\u00e9","year":"2010","journal-title":"J Antimicrob Chemother"},{"key":"2020042512555156900_ckz137-B29","doi-asserted-by":"crossref","first-page":"1234","DOI":"10.1002\/pds.1479","article-title":"Attitudes, beliefs and knowledge concerning antibiotic use and self-medication: a comparative European study","volume":"16","author":"Grigoryan","year":"2007","journal-title":"Pharmacoepidemiol Drug Saf"},{"key":"2020042512555156900_ckz137-B30","doi-asserted-by":"crossref","first-page":"e84177","DOI":"10.1371\/journal.pone.0084177","article-title":"Public knowledge, attitudes and experience regarding the use of antibiotics in Italy","volume":"8","author":"Napolitano","year":"2013","journal-title":"PLoS One"}],"container-title":["European Journal of Public Health"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/eurpub\/article-pdf\/30\/2\/265\/33128331\/ckz137.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/eurpub\/article-pdf\/30\/2\/265\/33128331\/ckz137.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,4,25]],"date-time":"2020-04-25T16:56:02Z","timestamp":1587833762000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurpub\/article\/30\/2\/265\/5543077"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8,2]]},"references-count":30,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2019,8,2]]},"published-print":{"date-parts":[[2020,4,1]]}},"URL":"https:\/\/doi.org\/10.1093\/eurpub\/ckz137","relation":{},"ISSN":["1101-1262","1464-360X"],"issn-type":[{"value":"1101-1262","type":"print"},{"value":"1464-360X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,4]]},"published":{"date-parts":[[2019,8,2]]}}}