Prevalence of bacterial resistance to antibiotics was found to be substantially different in two separate regions of the world. The average percent resistant to individual antibiotics was nearly three times greater, and the percent of isolates resistant to six or more antibiotics 14 times greater among isolates at the Hôpital St Joseph in Paris than among those at the Peter Bent Brigham Hospital in Boston or at any of six US hospitals. Differences were not due to culture sampling or susceptibility testing methods used in the hospitals. Differences were nearly as great between isolates from patients recently admitted to the two hospitals, suggesting differences in the bacterial flora of their communities. Similar systematic comparisons of resistance prevalence in different parts of the world might help to define optimal antibiotic usage practices.
(JAMA 239:1518-1523, 1978)
O'Brien TF, Acar JF, Medeiros AA, Norton RA, Goldstein F, Kent RL. International Comparison of Prevalence of Resistance to Antibiotics. JAMA. 1978;239(15):1518–1523. doi:10.1001/jama.1978.03280420054018