Antibiotic prescribing patterns in out-of-hours primary care: A population-based descriptive study
Antibiotic prescribing patterns in out-of-hours primary care: A population-based descriptive study
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DOI：
10.3109/02813432.2014.972067
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发表时间：
2014-12-01
影响因子：
2.1
通讯作者：
Vedsted, Peter
中科院分区：
文献类型：
--
作者：
Huibers, Linda;Moth, Grete;Vedsted, Peter
Objective.描述丹麦非工作时间（OOH）初级保健服务中不同类型接触者的抗生素处方频率和特征。设计基于人群的观察性登记研究，使用来自OOH登记系统的患者接触者和ATC编码处方的常规登记数据。设置.丹麦中部地区的户外初级保健服务。科目在12个月期间（2010年6月至2011年5月）与户外初级保健的所有接触。主要结果指标。按抗生素类型、患者年龄和性别、接触类型和工作日或周末分层的抗生素处方比例的描述性分析。结果在研究期间登记的644777名接触者中，15.0%接受了抗生素处方：26.1%来自诊所咨询，10.7%来自电话咨询，10.9%来自家访。周末处方比例（17.6%）高于工作日（10.6%）。最常处方的抗生素药物是β-内酰胺酶敏感青霉素（34.9%）、抗生素滴眼液（21.2%）和广谱青霉素（21.0%）。大多数抗生素滴眼液（73%）是在电话咨询中处方的。大多数抗生素是在工作日下午4-6点开的。婴幼儿接受最多的抗菌滴眼液（41.3%），5-17岁和18-60岁患者接受最多的β-内酰胺酶敏感青霉素（分别为44.6%和38.9%），而60岁以上患者接受最多的广谱青霉素（占所有抗生素处方的32.9%）。结论抗生素最常在诊所咨询时开处方，但从绝对数量来看，也有许多是通过电话开的。高处方比例，特别是用于婴幼儿的抗菌眼药水，表明在合理使用抗生素方面有改进的空间。
Objective. To describe the frequency and characteristics of antibiotic prescribing for different types of contacts with the Danish out-of-hours (OOH) primary care service. Design. Population-based observational registry study using routine registry data from the OOH registration system on patient contacts and ATC-coded prescriptions. Setting. The OOH primary care service in the Central Denmark Region. Subjects. All contacts with OOH primary care during a 12-month period (June 2010-May 2011). Main outcome measures. Descriptive analyses of antibiotic prescription proportions stratified for type of antibiotic, patient age and gender, contact type, and weekdays or weekend. Results. Of the 644 777 contacts registered during the study period, 15.0% received an antibiotic prescription: 26.1% resulted from clinic consultations, 10.7% from telephone consultations, and 10.9% from home visits. The prescription proportion was higher for weekends (17.6%) than for weekdays (10.6%). The most frequently prescribed antibiotic drugs were beta-lactamase sensitive penicillins (34.9%), antibiotic eye drops (21.2%), and broad-spectrum penicillins (21.0%). Most antibiotic eye drops (73%) were prescribed in a telephone consultation. Most antibiotics were prescribed at 4-6 p.m. on weekdays. Young infants received most antibacterial eye drops (41.3%), patients aged 5-17 years and 18-60 years received most beta-lactamase sensitive penicillins (44.6% and 38.9%, respectively), while patients aged 60 + years received most broad-spectrum penicillins (32.9% of all antibiotic prescriptions). Conclusion. Antibiotics were most often prescribed in clinic consultations, but, in absolute terms, many were also prescribed by telephone. The high prescription proportion, particularly antibacterial eye drops for young infants, suggests room for improvement in rational antibiotic use.