Population-based outpatient antimicrobial use in Newfoundland and Labrador: a retrospective descriptive study.

CMAJ open Pub Date : 2023-11-28 Print Date: 2023-11-01 DOI:10.9778/cmajo.20220221
Benjamin Edwards, Robert Wilson, Gerald McDonald, Peter Daley
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引用次数: 0

Abstract

Background: Data that have been reported on antimicrobial use in Newfoundland and Labrador (NL) do not appear to be representative of use at the population level. We sought to use pharmacy network data on prescriptions to describe outpatient antimicrobial use in NL.

Methods: We analyzed all outpatient antimicrobial prescriptions dispensed between June 1, 2017, and June 8, 2021, from the provincial pharmacy network database and translated deidentified data into SPSS. We excluded prescriptions for parenteral and topical antimicrobials, antivirals and antifungals. We described antimicrobial use using the prescription rate and defined daily dose (DDD) rate.

Results: Overall, we analyzed 1 586 534 prescriptions dispensed to 394 708 people by 3431 prescribers. The rate of antimicrobial use was 741 prescriptions per 1000 population per year (7161 DDD/1000 population/yr). The median duration of prescriptions was 7 (interquartile range 7-10) days. The prescription rate decreased from 867 to 546 per 1000 population per year (-37%) over the study period, and the mean DDD rate decreased from 8387 to 5356 DDD per 1000 population per year (-36.1%). Antimicrobials with the highest DDD rate were amoxicillin (1568 DDD/1000/yr), doxycycline (864 DDD/1000/yr) and ciprofloxacin (633 DDD/1000/yr). Prescribers wrote a mean of 102 (standard deviation 248) prescriptions per year; 3 prescribers wrote more than 2500 prescriptions per year. Overall, 9203 (2.3%) of the 394 708 people in the study population received 4 or more prescriptions per year.

Interpretation: The rate of antimicrobial use in NL is lower than previously described in national surveillance data. Potential targets for stewardship intervention include prolonged duration of prescriptions, high-rate prescribers and high-rate patients, but further research is needed to assess the appropriateness of prescriptions according to diagnosis.

纽芬兰和拉布拉多以人群为基础的门诊抗菌药物使用:一项回顾性描述性研究。
背景:纽芬兰和拉布拉多(NL)抗菌药物使用的报告数据似乎不能代表人口水平的使用情况。我们试图使用药房网络处方数据来描述NL门诊抗菌药物的使用。方法:分析2017年6月1日至2021年6月8日从省级药房网络数据库中发放的所有门诊抗菌药物处方,并将未识别数据翻译成SPSS。我们排除了注射和外用抗菌剂、抗病毒药物和抗真菌药物的处方。我们使用处方率和限定日剂量(DDD)率来描述抗菌药物的使用。结果:共对3431名处方人员开具的处方1586 534张、394 708人次进行了分析。抗菌药物使用率为每1000人每年741张处方(每1000人每年7161 DDD)。处方持续时间中位数为7天(四分位数间距7-10天)。研究期间,处方率从867 / 1000人/年下降到546 / 1000人/年(-37%),平均DDD率从8387 / 1000人/年下降到5356 / 1000人/年(-36.1%)。DDD率最高的抗菌药物为阿莫西林(1568 DDD/1000/年)、多西环素(864 DDD/1000/年)和环丙沙星(633 DDD/1000/年)。开处方者平均每年开102张处方(标准差为248张);3名开处方者每年开的处方超过2500张。总体而言,研究人群中394,708人中有9203人(2.3%)每年接受4次或更多处方。解释:NL的抗菌药物使用率低于以前国家监测数据中描述的使用率。管理干预的潜在目标包括处方持续时间延长、高比率开处方者和高比率患者,但需要进一步研究根据诊断评估处方的适当性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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CiteScore
5.40
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