Experiences in prevention and control of antibiotic resistance in Slovenia

During 1991-1999 a significant increase of consumption of macrolides and fluoroquinolones was observed in Slovenia, and this was associated with significant increase of resistance of Streptococcus pneumoniae and Streptococcus pyogenes to macrolides and Escherichia coli to fluoroquinolones, respectively. Between 1999 and 2007 the prevalence of S. pneumoniae resistant to erythromycin increased from 3.7% to 16.8% even though the use of macrolides in the same period decreased from 3.81 to 2.43 defined daily doses (DDD) per 1,000 inhabitants and per day. The co-resistance and the spread of resistant clones were the reason for constant increase in macrolide resistance. Slovenia is one of the few European countries with decreasing prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in hospital care during the last years. As a result of control measures introduced in 1999, the MRSA prevalence rates decreased from 21.4% in 2000 to 8.3% in 2007.