Objectives: To test the hypothesis that certain levels of air pollution may lead to increases in 1) antimicrobial consumption in the general population and 2) the presence of antibiotic resistance genes. Methods: The project will consist of two sub-studies: 1. A time series analysis of the association between daily antimicrobial consumption and air pollution in the 11 largest cities in Catalonia (2006-2022). Outcome variable: daily consumption of antimicrobials. Independent variables: air pollution and confounding variables. The analysis will use generalized additive models: through a random effects meta-analysis, the concentration-response estimates for each city will be added together to calculate the overall estimates. 2. Descriptive observational study of the relationship between the concentration of resistance genes and antimicrobial consumption in the Barcelona area (2021-2023). Outcome variable: concentration of antibiotic resistance genes. Independent variables: defined daily dose of antimicrobials per 1000 inhabitants-day. Descriptive analysis of the concentration and diversity of antibiotic resistance genes according to air quality monitoring station (urban vs. hospital environment), month, and correlation with antimicrobial consumption.
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DDD of antimicrobials per 1000 inhabitants-day
Timeframe: 2006 - 2023
Concentration of antibiotic resistance genes.
Timeframe: 2021 - 2023
Concentration of the PM10
Timeframe: 2006 - 2023
Concentration of the PM 2.5
Timeframe: 2006 - 2023
Concentration of the NO2
Timeframe: 2006 - 2023
Concentration of the SO2
Timeframe: 2006 - 2023