• Albert Boada, Mariona Pons-Vigués, Jordi Real, Elisabet Grezner, Bonventura Bolíbar, and Carl Llor.
• a Equip d'Atenció Primària Guinardó, Gerència d'Àmbit d'Atenció Primària Barcelona Ciutat , Institut Català de la Salut , Barcelona , Spain.
• Eur J Gen Pract. 2018 Dec 1; 24 (1): 125-130.

IntroductionCommensal flora of healthy people is becoming an important reservoir of resistant bacteria.ObjectivesTo evaluate the relationship of previous antibiotic-dispensed and resistance pattern of strains of Staphylococcus aureus in primary care patients.MethodsA cross-sectional study was carried out in seven primary care centres in Catalonia, Spain, from October 2010 to May 2011, as part of the APRES (The appropriateness of prescribing antibiotics in primary care in Europe concerning antibiotic resistance) study. Outpatients aged 4 or more who did not present an infectious disease and had not taken antibiotic or had not been hospitalised in the previous 3 months were invited to participate. Nasal swabs were collected for S. aureus culture, and antimicrobial susceptibility testing was carried out. Antibiotics dispensed boxes in the previous 4 years were extracted from Information System for Research in Primary Care.ResultsA total of 4,001 nasal swabs were collected, and 3,969 were tested for identification, 765 S. aureus were tested for resistance. Resistance rates to penicillin, azithromycin and methicillin were 87.1%, 11.6% and 1.3%, respectively, and a total of 10 MRSA strains were isolated (1.3%). Penicillin-resistant staphylococci were statistically significantly associated with the previous number of packages of penicillin dispensed (OR, 1.18; 95% CI, 1.04-1.35).ConclusionAlthough no causal inference is possible, an association was observed between previous antibiotic dispensation and isolation of resistant organisms in community-dwelling individuals, mainly between packages of penicillin and penicillin-resistant staphylococci.

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