COVID-19 大流行对苏格兰基层医疗机构抗生素使用情况和质量的影响:基于人群的分段间断时间序列分析。

IF 4.2 2区 医学 Q1 INFECTIOUS DISEASES
Hayam Al Balushi, Amanj Kurdi, Najla Almutairi, Kirmanj Ismail Baker, Karwan M Amen, Hardee Karwi, Andrew Seaton, Brian Godman
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引用次数: 0

摘要

背景:在 COVID-19 大流行期间,抗生素的不当使用预计会增加,但有关 COVID-19 的长期影响的数据却很有限。我们评估了 COVID-19 对苏格兰抗生素使用数量和质量的影响:利用 2019 年 3 月至 2023 年 3 月的处方成本分析数据,对每月配发的抗生素进行分段间断时间序列分析。抗生素的使用通过配药次数/1000 居民(TID)和定义日剂量/1000 居民/日(DID)进行量化。抗生素使用质量采用关键质量指标进行评估,包括世界卫生组织 AWaRe 分类中广谱抗生素和 4C 抗生素的比例:总体而言,对于所有抗生素,在第一次封锁(2020 年 3 月)(β1)之前,TID 和 DID 的增加并不显著,但在第一次封锁(β2)和第二次封锁(β4)(2020 年 11 月)之后,TID 和 DID 的水平立即下降,尽管并不显著。不过,在第二次封锁(β5)后,所有抗生素类别的时间趋势都有明显增加。COVID-19 对 AWaRe 的使用没有负面影响,所有抗生素的使用比例从 2019 年 3 月的 76% 增加到 2023 年 3 月的 90%。4C抗生素的比例在第二次封锁后显著下降:COVID-19似乎并未对抗生素总使用量和质量产生重大影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of the COVID-19 pandemic on the utilisation and quality of antibiotic use in the Scottish primary care setting: a population-based segmented interrupted time-series analysis.

Background: Inappropriate use of antibiotics is expected to increase during the COVID-19 pandemic, but there are limited data on COVID-19's long-term impact. We assessed the impact of COVID-19 on the quantity and quality of antibiotic use in Scotland.

Research design and methods: A segmented interrupted time series was applied to monthly dispensed antibiotics using prescription cost analysis data from March/2019 to March/2023. Antibiotic use was quantified using the number of items dispensed/1000 inhabitants (TIDs) and defined daily dose/1000 inhabitants/day (DIDs). The quality of antibiotic use was assessed using key quality indicators including the WHO AWaRe classification, proportion of broad-spectrum and "4C"-antibiotics.

Results: Overall, for all antibiotics, there was a non-significant increase in TIDs and DIDs before the first lockdown (March/2020) (β1), but a decline in the level immediately after the first (β2) and second lockdowns (β4) (November/2020), albeit non-significant. However, a significant increase in the time trend after the second lockdown (β5) for all antibiotic classes was observed. COVID-19 had no negative impact on AWaRe utilisation, with the proportion of all antibiotics from the Access group increasing from 76% in March/2019 to 90% in March/2023. The proportion of "4C" antibiotic reduced significantly after the second lockdown.

Conclusions: Neither the utilisation nor the quality of total antibiotic use appeared to have been significantly affected by COVID-19.

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来源期刊
CiteScore
11.20
自引率
0.00%
发文量
66
审稿时长
4-8 weeks
期刊介绍: Expert Review of Anti-Infective Therapy (ISSN 1478-7210) provides expert reviews on therapeutics and diagnostics in the treatment of infectious disease. Coverage includes antibiotics, drug resistance, drug therapy, infectious disease medicine, antibacterial, antimicrobial, antifungal and antiviral approaches, and diagnostic tests.
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