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Nevertheless, some discrepancies could be observed when the three different methods were compared (Table?). Indeed, Lapatinib ic50 the results of the Vitek? system are in total agreement for amphotericin�B and voriconazole (with a low MIC), but for fluconazole, a lower MIC of only 8�mg/L was determined. Moreover, the isolate was found to be resistant to fluconazole with the EUCAST method, and also to posaconazole and voriconazole. The patient had a favourable outcome after 4�months of adapted antifungal therapy with voriconazole, avoiding amputation. The duration of treatment is not well established, owing to the low frequency of such infections; however, improved tissue perfusion may be a key factor. Some commercial yeast identification systems, such as the ID32C system, have difficulties in distinguishing C.�haemulonii from other species, owing to database limitations. This species, which has been described as an emergent one [5,7], is still rarely isolated clinically, and would perhaps be more satisfactorily identified with new automated systems and molecular methods. In summary, we describe a case of C.�haemulonii septic osteitis occurring in the context of peripheral arterial disease. Despite its low frequency, we suggest that there should be prompt consideration of C.�haemulonii infection in cases of fungal osteitis with an absence of clinical response to fluconazole. The authors want to thank C. Ravel for ITS gene sequencing. There are no conflicts of interest S6 Kinase to declare. ""Clin Microbiol Infect 2011; 17: 1698�C1703 Antibiotic resistance is closely related to antibiotic use and Italy is a country with high levels of both antibiotic use and antimicrobial resistance. We analysed the trend in antibiotic use in the community among adults (��15?years) and elderly, in the period 2003�C2009, in Emilia-Romagna, Italy, a region with over 4?000?000 inhabitants. Data regarding antibiotic use were obtained from the regional public health system databases. Between 2003 and 2009 the antibiotic check details consumption increased from 15.4 to 18.7 defined daily doses/1000 inhabitants per day (DID) (+21.4%, p?