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[Geographical distribution and time trends of suicide mortality in Catalonia and Spain [1986-2002]].

OBJECTIVE: To analyze time trends in Catalonia (1986-2002) and Spain (1986-2001) in suicide mortality and its geographical variation by health areas in Catalonia. METHODS: Standard annual mortality rates were calculated by the direct method for Catalonia (1986-2002) and Spain (1986-2001) (standard population of Catalonia 1991). The adjusted annual percent change was analyzed by means of a Poisson regression by gender and by age group for Catalonia and Spain. For the geographical variation in Catalonia, standardized mortality ratio using the indirect method (SMR) were calculated by gender and for the 46 health areas for the entire period and the comparative mortality figures and its confidence intervals at 95% were analyzed grouping the years in period 1(1986-1994) and period 2 (1995-2002). RESULTS: Men's mortality in Catalonia was lower than in Spain and an increase (not significant) was observed in both places during the period; for women, the evolution and rates were similar, with a small decrease (significant) for Catalonia and Spain. Differences in patterns and trends for age and sex were observed, showing a decrease in the elderly groups for both sexes and an increase for the young for Spain and Catalonia. In terms of geographic distribution, the health sectors of the Central, Northeast and South Catalonia zones show higher than average mortality. CONCLUSIONS: The time trends of mortality by suicide in Catalonia shows different patterns according to age and gender. A progressive homogenization in the territorial distribution by health areas was observed.

Adolescent↗

Variations in APOE genotype distribution in children from areas with different adult cardiovascular disease mortality in Spain.

We investigate whether a varying distribution of the APOE genotype could help explain regional differences in ischemic heart disease (IHD) mortality in Spain. APOE genotypes were examined by PCR in 1,274 randomly selected healthy children from four Spanish regions with different adult IHD mortality rates (northwest and central Spain with low rates and southeast and southern Spain with high rates). In the population as a whole the prevalence of the higher risk APOE*3/*4 genotype is 16.8% and the prevalence of the APOE*4 allele is 10.1%. In northwest Spain the frequencies of the APOE*3/*4 genotype (12.9%) and of the APOE*4 allele (8.3%) are smaller than in the other regions. The southeast region shows statistically higher frequencies of the APOE*3/*4 genotype (22.5%) and of the APOE*4 allele (13.2%) than in the other regions or in the group as a whole. We can conclude that Spain is not homogeneous in terms of APOE genotype distribution. Although the prevalence of the APOE*4 allele is generally low, there are areas with higher prevalence of the APOE*4 allele and a higher incidence of adult IHD mortality. This allows us to conclude that in Spain this genetic determinant can be associated with IHD mortality in relatively isolated populations.

Adult↗

Association of moderate consumption of alcohol with rates of heavy drinking and abstinence in Spain.

BACKGROUND: Moderate consumption of alcohol reduces general mortality among middle-aged and elderly persons through a reduction in cardiovascular risk. Furthermore, higher consumption of wine is associated with lower cardiovascular mortality in northern Spain. This information may be used to promote moderate consumption of alcoholic beverages in Spain. However, alcohol consumption is influenced by the drinking habits of the individual's social environment. Therefore, we examine the relation between average consumption of alcohol and the prevalence of heavy drinkers, who most often have adverse effects from alcohol, and the prevalence of abstainers, who do not benefit from alcohol, in Spain. METHODS: Spain's 17 administrative regions are the units of analysis. Alcohol consumption data were taken from the 1993 National Health Survey. Data were analyzed using weighted correlation coefficients and linear regression. RESULTS AND CONCLUSIONS: Mean alcohol consumption among moderate drinkers showed a positive correlation with the proportions of men (r = 0.63; p = 0.007) and women (r = 0.58; p = 0.015) whose alcohol intake was above the 90th percentile of consumption distribution. Similar results were yielded when median rather than mean consumption was used, and when heavy drinking was defined as the consumption of 210 g and 140 g of alcohol per week, in men and women, respectively. The association also was observed across all ages and all types of beverages. However, no statistically significant association was seen between mean and median alcohol consumption and the proportion of abstainers. SIGNIFICANCE: Moderate consumption of alcohol is associated with the prevalence of heavy drinkers in all regions of Spain. Therefore, promotion of moderate consumption of alcohol in Spain might be associated with a rise in the prevalence of heavy drinkers, those who most frequently suffer the harmful effects of alcohol.

Adult↗

Human papillomavirus and cervical intraepithelial neoplasia grade III/carcinoma in situ: a case-control study in Spain and Colombia.

A case-control study of 525 cases of cervical intraepithelial neoplasia grade III (CIN III) and 512 controls was conducted in Spain and Colombia between 1985 and 1988 to assess the role of human papillomavirus (HPV) in the etiology of CIN III. HPV DNA in cytological scrapes from the cervix was assessed by Virapap and by polymerase chain reaction (PCR) based on the L1 consensus primers. A subsample of 268 specimens was also tested for HPV DNA using Southern hybridization. In Spain, the PCR-based prevalences of HPV DNA were 70.7% among cases and 4.7% among controls. Odds ratio (OR) and 95% confidence interval (numbers in parentheses) for HPV DNA were 56.9 (24.8-130.6). In Columbia HPV DNA was detected by PCR in 63.2% of the cases and in 10.5% of the controls. The OR was 15.5 (8.2-29.4). The estimated fractions of CIN III attributable to HPV were 72.4% in Spain and 60.3% in Colombia. HPV 16 was the predominant viral type and showed the strongest association with CIN III; in Spain the OR was 295.5 (44.8-1946.4) and in Colombia the OR was 27.1 (10.6-69.5). HPV DNA of unknown type was frequent in HPV-positive cases (18.3% in Spain and 38.0% in Colombia) and controls (66.7% in Spain and 47.4% in Colombia). The comparison of results from Virapap and PCR indicated that PCR is the method of choice for epidemiological studies. These data strongly support the hypothesis of the viral origin of CIN III, the common etiology of CIN III and invasive cervical cancer, and the causal nature of the association between HPV and CIN III.

Adult↗

Age at natural menopause in Spain and the United States: results from the DAMES project.

Our research was undertaken to determine the median age of natural menopause and correlates of the timing of menopause in Spain and the United States (U.S.). A population-based sample of 300 women from Madrid, Spain and a random sample of 293 women from Fallon Community Health plan (FCHP), a health maintenance organization (HMO) in central Massachusetts, were interviewed using a semi-structured questionnaire. Logit analysis and logistic regression were used to estimate the median age at menopause and identify factors associated with it. The median age of natural menopause in Spain is estimated at 51.7 years, and in the U.S., it is 52.6 years. In Spain, women with any children (OR = 0.58, 95% CI: 0.25, 1.36) and a lower body mass index (BMI) (OR = 0.45, 95% CI: 0.27, 0.78) had later ages at menopause while current smokers (OR = 5.51, 95% CI: 1.82, 16.7) had earlier ages of menopause in a multivariate model. A multiplicative interaction between smoking status and parity was identified, and an interaction term included in the multivariate model (OR = 0.58, 95% CI: 0.35, 0.94). In the U.S., household income, marital status, and education level were statistically associated with age at natural menopause in bivariate models. These factors were no longer statistically significant after adjustments in a multivariate model. Oral contraceptive use, cycle length, and cycle regularity were not statistically associated with the age of menopause in either country. The ages of natural menopause in Spain and the U.S. are comparable to other industrialized nations. The factors associated with the timing of natural menopause, in particular smoking and BMI, are consistent with those identified in previous studies.

Age Distribution↗

Mortality trends and past and current dietary factors of breast cancer in Spain.

Spain had one of the lowest breast cancer mortality (BCM) rates in Europe a decade ago but this is no longer the case. A study of the trends of breast cancer mortality in Spain during the last 30 years, and an analysis, at the ecological level, of the current and past dietary patterns associated with breast cancer mortality have been conducted. Age standardized rates and standardized mortality rates (SMR) for this period were calculated. Dietary information about 20 different groups of foods for the 50 Spanish provinces was obtained from two National Household Budget and Expenditure Surveys, conducted in 1964-1965 and 1980-1981. Simple correlation coefficients were calculated, and multiple regression (dependent variables: BCM and breast cancer SMR) with a stepwise procedure was performed. Trends of breast cancer mortality in Spain for the last 35 years indicated a 100% increase in the 35-64 years group. Results indicate important changes in food consumption patterns in Spain, departure from the traditional Spanish diet, and the association of breast cancer mortality with past (15 years period) consumption of beef and total meat and the current consumption of vegetable oils, among other features of interest. Past consumption of meat and particularly beef meat seems to be associated with current breast cancer mortality rates in Spain. However, results at ecological level need to be confirmed in individuals.

Adult↗

Red-legged partridges (Alectoris rufa) as bioindicators for persistent chlorinated chemicals in Spain.

Persistent organochlorine residues such as hexachlorobenzene (HCB), hexachlorocyclohexane isomers (HCHs), chlorocyclodienes, and the DDT group (DDTs) were determined in fat and muscle samples of resident red-legged partridges (Alectoris rufa) hunted in Spain. Chlorinated contamination pattern varied largely depending on geographical distribution. Birds collected from the northern part of Spain contained greater concentrations of lindane (34.4 ng/g fat basis) than those from central or southern Spain. In contrast, red-legged partridges collected in southern locations exhibited elevated levels of p,p-DDE (62.3 ng/g fat basis) as compared with central (31.2 ng/g fat basis) and northern areas (5.6 ng/g fat basis). The only cyclodiene detected, dieldrin, showed higher amounts (3.4 ng/g fat basis) in partridges collected in central Spain. The sex differences in pollutant occurrence and concentrations were negligible. One-year-old birds accumulated greater concentrations of beta-HCH, and dieldrin than older birds. Global comparison of organochlorine concentrations indicated that northern partridges are more contaminated by compounds of industrial origin, whereas southern birds contained greater amounts of agricultural chemicals. Estimates of hazards associated with organochlorine levels in resident red-legged partridges in Spain suggested that southern birds may be at risk from exposure to DDTs, and northern birds may be affected by excessive concentrations of lindane. The use of red-legged partridge as bioindicator for OCP contamination is discussed.

Adipose Tissue↗

Supranational comparison of Neospora caninum seroprevalences in cattle in Germany, The Netherlands, Spain and Sweden.

Herd, within-herd and animal prevalences for Neospora caninum in beef and dairy cattle were compared between four countries. In randomly selected herds from regions of Germany, The Netherlands, Spain and Sweden that were representative for the cattle production of these countries, all animals > or = 2 years were examined serologically by enzyme-linked immunosorbent assays (ELISAs) with high test specificity (> 98.0%). In a previous study, the ELISAs had been validated against each other. Single reacting animals within a herd were confirmed by immunobloting. At the time of sampling, animal (age, breed, herdtype, sex, lactation stage) and herd data (region) were collected. Considerable differences in N. caninum herd, within-herd, and overall animal prevalence estimations were observed between countries, regions, herdtype, age categories and breeds. Herd prevalences, based on confirmation of single reactors, for dairy herds were estimated to be 16% (95%CI: 10-24%) in Sweden, 49% (95%CI: 39-59%) in Germany, 63% (95%CI: 57-69%) in Spain and 76% (95%CI: 67-84%) in The Netherlands and for beef herds 41% (95%CI: 31-50%) in Germany, 46% (95%CI: 41-51%) in Spain and 61% (95%CI: 50-72%) in The Netherlands. No beef herds were examined in Sweden. The lowest animal true prevalence was estimated in dairy cattle in Sweden (0.5% (95%CI: 0.1-0.8%)) while the highest animal true prevalence was estimated for dairy cattle in Spain (16.2% (95%CI: 14.9-17.5%)). Within-herd prevalences varied greatly, with very few farms in Sweden having more than 10% seropositive animals while in Spain more than 10% of the herds had within-herd prevalences between 50 and 100%. Seropositivity was significantly associated with herdtype (beef versus dairy), age, breed and region within countries. The results of this supranational comparative study showed that the importance of N. caninum infection varied greatly within in Europe. Estimates of prevalence can be used to calculate the economic impact of N. caninum infection as well as to evaluate the effect of prevention and control strategies over time.

Age Factors↗

Seroprevalence of Neospora caninum in non-carnivorous wildlife from Spain.

Serum samples from 1034 non-carnivorous wildlife from Spain were tested for antibodies to Neospora caninum by competitive screening enzyme linked immunosorbent assay (ELISA) and confirmed by an indirect fluorescent antibody test (IFAT). High agreement was observed between results in both techniques (kappa value higher than 0.9). Prevalences of N. caninum antibodies positive by both techniques were 11.8% of 237 red deer (Cervus elaphus), 7.7% of 13 barbary sheep (Ammotragus lervia), 6.1% of 33 roe deer (Capreolus capreolus) and 0.3% of 298 wild boar (Sus scrofa). In one of 53 hares (Lepus granatensis), antibodies were found in the ELISA but could not be confirmed by IFAT due to lack of sample. Antibodies to N. caninum were not found in any of 251 wild rabbits (Oryctolagus cuniculus), 79 fallow deer (Dama dama), 27 mouflon (Ovis ammon), 40 chamois (Rupicapra pyrenaica) and three Spanish ibex (Capra pyrenaica). Statistically significant differences were observed between N. caninum seroprevalence in red deer and management of hunting estates (open versus fenced) with higher prevalence in fenced estates, and among sampling sites. Seroprevalence was particularly high in some areas (MO estate in South-Central Spain or some estates of Catalonia, North-East Spain), while no contact with N. caninum was observed in others. Results indicate that in certain areas of Spain, N. caninum is present in wildlife, especially in red deer. These results have important implications in both sylvatic cycles and may influence the prevalence of infection in cattle farms in those areas. To our knowledge, this is the first report of antibodies to N. caninum in wildlife from Spain and the first report of N. caninum antibodies in barbary sheep and wild boar.

Animals↗

[Melanoma epidemiology in Spain].

Spain has one of Europe's lowest melanoma incidence and mortality rates. Nevertheless, it is one of the fastest-growing pathologies in our country, with a 181.3% increase in the incidence rate in men and 205.3% increase in women. It represents 1.3% and 2.5% of malignant tumors in men and women, respectively, while the current standardized worldwide rate is respectively 2.4% and 4.9%. The highest incidence levels correspond to Tarragona for men (6.81%) and Gerona for women (8.24%), and lowest to the Canary Islands and Zaragoza (3.55% and 4.27% for women and men, respectively). This higher incidence among females differentiates Spain from the rest of Europe, where the opposite occurs. Mortality has also increased in Spain in the last few decades (1.76% in males and 1.26% in females), although this rising trend has stabilized in recent years. Spain's mortality rate is the lowest in Europe, as the EUROCARE-III study revealed. This study found an increase of 70.4% in the survival rate for men and 84.1% for women in the 1980s, while the figures for the 1990s were 73.9% for men and 89.8% for women. This low mortality rate in Spain may be due to the increase in thin melanomas, due to early diagnosis and surgical treatment.

Adolescent↗

[Heart failure mortality in Spain: is there an andalusian paradox?].

Congestive heart failure has a high mortality, as reflected in different clinical trials and observational studies. Spain, as other countries around the Mediterranean basin, have a relatively low rate of coronary deaths, attributed to the so-called Mediterranean lifestyle. Andalusia, in the southern most part of Spain, constitutes the paradigm of Mediterranean lifestyle. However, different reports show that the prevalence of ischemic heart disease is higher in Andalusia than in other zones of Spain. Thus the mortality rate due to heart failure in Spain in the year 2000 per 100,000 inhabitants was 27.3 in men and 28.88 in women and each one of the eight Andalusia provinces had greater rates than the national mean in both men and woman. Even in countries with a relatively low prevalence of coronary heart disease as is the case in Spain, heart failure mortality seems to be parallel to local differences in IHD prevalence.

Adolescent↗

Use of antipsychotic agents in Spain through 1985-2000.

OBJECTIVE: To analyze the trend of antipsychotic drug consumption in Spain from 1985 to 2000, and the impact of atypical antipsychotics on the overall consumption and on clozapine use. METHODS: Data on antipsychotic consumption were drawn from the ECOM database of the Spanish Ministry of Health, which contains the retail community pharmacies sales of medicinal products reimbursed by the National Health System. Data are presented as defined daily doses (DDDs) per 1000 inhabitants per day, for each year. To evaluate the impact of atypical antipsychotics on clozapine use, data from the Spanish "Clozapine Monitoring Program" were analyzed. Consumption data from Nordic countries were obtained from national statistics. RESULTS: The use of antipsychotics in Spain increased progressively from 1.51 DDD/1000 inhabitants/d in 1985 to 5.73 DDD/1000 inhabitants/d in 2000. The pattern of use of individual drugs changed greatly over the study period. In 1985, haloperidol, fluphenazine and thioridazine, all typical antipsychotics, were the drugs most widely used, whereas in 2000, the three drugs most frequently used were risperidone, olanzapine and haloperidol. The introduction of olanzapine in December 1996 reduced the number of new treatments with clozapine to half. Antipsychotic use is still lower in Spain than in Nordic countries, despite the prevalence of schizophrenia being similar worldwide. CONCLUSIONS: Antipsychotic agent use in Spain has increased progressively since 1985, reducing the differences between Spain and other European countries (Nordic countries). Substantial differences in the pattern of drug use from 1985 to 2000 have been observed.

Antipsychotic Agents↗

Does the liberalisation of abortion laws increase the number of abortions? The case study of Spain.

BACKGROUND: Over the course of the 1980s a public debate on abortion took place in Spain culminating in a more permissive social climate and, in 1985, the partial decriminalisation of abortion. Before this, women were forced to abort illegally or abroad in countries which had decriminalised abortions. The aim of this study is to present jointly the evolution of abortions in Spanish women in England and Wales between 1974 and 1995, The Netherlands between 1980 and 1995 and Spain since the start of the register in 1987 through to 1995 and to compare trends both before and after the law in Spain. METHODS: Incidence rates were calculated in each of the countries studied and the slopes of the curves for 1974-1984 and 1987-1995 were compared. Data were obtained from reports published by the offices of abortion surveillance in England and Wales, The Netherlands and Spain. RESULTS: The rates increased constantly throughout the study period. From 1974 to 1985, a total of 204,736 Spanish women aborted in England and Wales and The Netherlands. After the law was passed, 34,895 Spanish women had abortions in those countries over the period 1986-1995. During 1987-1995, 340,214 Spanish women terminated their pregnancies in Spain. The regression coefficients before and after the passing of the law were beta = 0.3538 (0.307-0.400) and beta = 0.319 (0.243-0.394) respectively; no difference was observed. CONCLUSIONS: During the study period a significant proportion of reproductive-aged Spanish women had abortions in England and Wales and The Netherlands. Decriminalisation has had no observed effect on the trends in abortion, but rather it has benefited Spanish women by making abortion available locally and, therefore, reducing the inequalities implied by lack of access to proper health care services. These data demonstrate the impact of the liberalisation of abortion on the trends of procedures performed in other countries.

Abortion Applicants↗

Changes in cancer mortality in Catalonia and Spain (1975-77 and 1987-89). A comparison with other European countries.

Comparisons of cancer mortality in Catalonia and Spain have shown an intermediate position of these areas in relation to the rest of Europe. This study compares the overall cancer mortality in Catalonia and Spain in the periods 1975-77 and 1987-89 in relation to other European countries selected on the basis of geographical proximity and availability of information. Adjusted and truncated cancer mortality rates and relative changes in these rates have been assessed for both sexes. The mortality rate for males in Catalonia, Spain, Italy, Portugal and France has increased from 1975-77 to 1987-89 with relative increments of 13.5%, 13.7%, 10.1%, 9.6% and 4.3% respectively, whereas in Switzerland and England and Wales this rate has decreased. The mortality rate for females showed a slight drop between the two periods in all the studied countries except England and Wales and Portugal. By age groups, in males, the 0-44 year interval in Catalonia, Spain, France and Portugal, in descending order, showed the highest rates. The marked contrast of the evolution of the cancer mortality rate in Catalonia, Spain, Italy, France and Portugal, compared with Switzerland and England and Wales, and especially the considerable increase of the mortality in young people in Catalonia, indicates the extremely urgent need for all countries to adopt the measures to control cancer that have already shown themselves to be effective elsewhere.

Adult↗

Analysis of Mycobacterium tuberculosis genotypes in Madrid and identification of two new families specific to Spain-related settings.

In Spain, tuberculosis (TB) patterns are changing because of the recent increase in the number of cases among immigrants. To establish the composition of circulating Mycobacterium tuberculosis strains before the effects of foreign strains appear, this study focused on molecular characterization of 233 patient isolates using spoligotyping. The spoligotyping data were further analyzed using an international database, SpolDB4. The results obtained showed that the general features of the M. tuberculosis population in Spain are coherent with those of other European countries, with the Latin American and Mediterranean group, and with the Haarlem 3 and T1 families as the most prevalent genotypes. The Spanish isolates clustered mostly with genotypes which had previously been isolated in countries linked with Spain. We also describe and fully characterize two novel M. tuberculosis families, Madrid1 and Madrid2, which are specific to Spain-related settings. The data reported here provide a solid reference when monitoring changes in the composition of the M. tuberculosis population in Spain as a consequence of the increasing rate of TB in the foreign population.

Adult↗

What happened to life expectancy in Spain in the 1980s?

BACKGROUND: Life expectancy at birth in Spain improved between 1972 and 1982, by 2.5 years for males and 3.2 years for females. This slowed considerably in the following decade, with increases of only 0.5 and 1.7 years respectively. OBJECTIVE: To determine the causes of death that have been responsible for the failure by Spain to maintain in the 1980s and 1990s the rate of improvement in life expectancy seen during the 1970s. DESIGN: Data from WHO mortality tapes grouped in a series of clinically meaningful categories were used to calculate the contribution of each category, in five year age groups, to the changing life expectancy at birth in the two periods. SETTING: Spain. RESULTS: The trend in life expectancy at birth in Spain over this 20 year period can be considered to have two components, both with important consequences for public health policy. Underlying trends include a steady negative contribution from respiratory cancer in men and a reduction in cardiovascular disease. More recent trends include a considerable deterioration in deaths among young adults, most notably from accidents and, possibly, AIDS. CONCLUSION: The failure to maintain the rate of earlier gains in life expectancy in Spain can be attributed largely to a few conditions, although these may indicate less obvious underlying problems. These findings have important consequences for prioritising public health policies.

Accidents↗

[Gender, paid work, domestic chores and health in Spain].

The present study reviews gender-related differences and inequalities in paid work and domestic chores in Spain. The impact of both types of work on health are analyzed and the main policies of the European Union (EU) and Spain to achieve gender equality at work are described. In Spain, fewer women are in paid work than in other EU countries. The labor market displays horizontal segregation (men and women work in different sectors), as well as vertical segregation (men hold more senior positions), leading to gender-related differences in employment conditions and exposure to occupational hazards. The precariousness of work is significantly higher in women (19% unemployment in women versus 9% in men) and women are more likely than men to have temporary contracts. Men are more frequently exposed to physical risks and suffer a greater number of occupational accidents; women, especially manual workers, are more frequently exposed to psychosocial risks. Most domestic chores continue to be performed by women, even by working women, which negatively affects their health. The EU has made an increase in female employment a priority, which means that from 2000-2010 Spain should create 3 million jobs for women and implement work/family policies. Achieving gender equality at work requires employment policies that would guarantee equal opportunities for both sexes, as well as shared responsibility for domestic chores between men and women. In Spain, moreover, there is an urgent need to significantly increase public childcare facilities and resources for the care of other dependent individuals.

European Union↗

Antibacterial resistance in Streptococcus pneumoniae and Haemophilus influenzae from Italy and Spain: data from the PROTEKT surveillance study, 1999-2000.

Antibacterial resistance was evaluated among Streptococcus pneumoniae (n=252) and Haemophilus influenzae (n=202) from two centres in Spain (Barcelona and Madrid) and two centres in Italy (Genoa and Catania) collected during 1999-2000 as part of the ongoing PROTEKT (Prospective Resistant Organism Tracking and Epidemiology for the Ketolide Telithromycin) international surveillance program. Pneumococcal nonsusceptibility to penicillin G was found to be considerably higher in Spain (53.4%) than in Italy (15.1%), whereas erythromycin A resistance was higher in Italy (42.9%) than in Spain (28.6%). Among macrolide-resistant isolates investigated for resistance genes, the prevalence of mefA was higher among isolates from Italy (20/51, 39.2%) than among Spanish isolates (2/38, 5.3%). All other macrolide-resistant isolates possessed ermB. Telithromycin possessed good anti-pneumococcal activity against isolates from both countries (MIC90 0.03 mg/L [Spain]; 0.25 mg/L [Italy]), irrespective of resistance to other antibacterials. Beta-lactamase production among H. influenzae was low: Spain, 10.9%; Italy, 1.8%. With the exception of ampicillin and co-trimoxazole, all H. influenzae isolates were highly susceptible to the antibacterials tested, and all were inhibited by telithromycin at a concentration of < or = 2 mg/L. The findings of PROTEKT 1999-2000 highlight the importance of local resistance patterns in guiding the choice of empirical antibacterials for community-acquired respiratory tract infections.

Anti-Bacterial Agents↗