{"id":1076,"date":"2016-06-23T15:17:20","date_gmt":"2016-06-23T15:17:20","guid":{"rendered":"http:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/?p=1076"},"modified":"2017-08-21T10:52:28","modified_gmt":"2017-08-21T10:52:28","slug":"primary-care-corner-with-geoffrey-modest-md-response-and-further-comments-on-e-coli-superbug-is-spreading","status":"publish","type":"post","link":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/2016\/06\/23\/primary-care-corner-with-geoffrey-modest-md-response-and-further-comments-on-e-coli-superbug-is-spreading\/","title":{"rendered":"Primary Care Corner with Geoffrey Modest MD: Response and Further Comments On: E. coli Superbug is Spreading"},"content":{"rendered":"

By Dr. Geoffrey Modest <\/strong><\/p>\n

An article\u00a0was sent by Burak Alsan, from an interview with his wife Marcie Alsan\u00a0(see http:\/\/blogs.plos.org\/publichealth\/2016\/05\/31\/to-fight-superbugs-fight-poverty<\/a>).\u00a0She stresses the connection between socioeconomic disparities and infectious diseases, specifically noting\u00a0that “out of pocket payments were the most significant correlate of antimicrobial resistance across countries” and that “the entire correlation was driven by countries that had in place a policy by which copayments were imposed in\u00a0the public sector”. In particular, she found that of 47 countries, out-of-pocket health expenditures were the only factor<\/strong> significantly associated with antibiotic resistance, controlling for socioeconomic and\u00a0environmental factors (e.g.\u00a0sanitation, animal husbandry, and poverty) and structural health-care features (e.g. physician density, hospital bed density, total health expenditures). In particular, a “ten\u00a0point increase in percentage\u00a0of health expenditures that were out-of-pocket was associated with a 3.2 percentage point increase in resistant isolates”.\u00a0For details, see Alsan, M. Lancet Infect Dis 2015; 15: 1203.<\/p>\n

Commentary<\/p>\n