Antibiotic prescribing amongst South African general practitioners in private practice: an analysis of a health insurance database.
Antibiotic prescribing amongst South African general practitioners in private practice: an analysis of a health insurance database.
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DOI：
10.1093/jacamr/dlac101
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发表时间：
2022-10
影响因子：
3.4
通讯作者：
中科院分区：
文献类型：
--
作者：
目的：调查南非私人初级卫生保健部门全科医生抗生素处方的适宜性。从一家大型医疗保险公司获得了抗生素处方索赔的匿名国家数据库。根据Chua等人制定的分类方案，根据国际疾病分类（ICD-10）代码将抗生素处方分类为“适当”、“可能适当”和“不适当”（BMJ 2019; 364: k5092）。对抗生素选择、剂量和治疗持续时间进行了进一步评估，以确定与治疗指南相比“适当”和“潜在适当”处方的适当性。2018年2月，向私营部门全科医生咨询的174 889名患者开了188 141种抗生素。青霉素是最常用的抗生素类别，占所有抗生素处方的40.7%。阿莫西林/克拉维酸是最常用的抗生素，占所有抗生素处方的28.6%。呼吸系统疾病的处方数量最多，占所有诊断的46.1%。处方中适宜处方占8.8%，潜在适宜处方占32.0%，不适宜处方占45.4%，无法评价处方占13.8%。在适当和可能适当处方的抗生素中，30.8%的抗生素选择正确。在正确选择的成人抗生素中，57.7%的人剂量正确。在处方正确剂量的成人抗生素中，76.7%的人有正确的剂量频率和治疗时间。研究表明，私人初级卫生保健部门的全科医生经常不适当地开具抗生素处方。因此，有必要在该部门制定管理干预措施。
To investigate the appropriateness of antibiotic prescribing among GPs in the private primary healthcare sector in South Africa. An anonymized national database of claims for antibiotic prescriptions was obtained from a large medical insurer. Antibiotic prescriptions were categorized based on International Classification of Diseases (ICD-10) codes as ‘appropriate’, ‘potentially appropriate’ and ‘inappropriate’ using a classification scheme developed by Chua et al. (BMJ 2019; 364: k5092). Further assessments of antibiotic choice, dosage and duration of treatment were carried out to determine the appropriateness of ‘appropriate’ and ‘potentially appropriate’ prescriptions in comparison with treatment guidelines. In February 2018, 188 141 antibiotics were prescribed for 174 889 patients who consulted GPs in the private sector. Penicillins were the most frequently prescribed antibiotic class, making up 40.7% of all antibiotics prescribed. Amoxicillin/clavulanic acid was the most frequently prescribed antibiotic, making up 28.6% of all antibiotics prescribed. Diseases of the respiratory system generated the highest number of prescriptions, making up 46.1% of all diagnoses. Of all prescriptions, 8.8% were appropriate, 32.0% were potentially appropriate, 45.4% were inappropriate and 13.8% could not be assessed. Of the appropriately and potentially appropriately prescribed antibiotics, 30.8% were correct antibiotic selections. Of the correctly selected antibiotics for adults, 57.7% had correct doses. Of the antibiotics prescribed with correct doses for adults, 76.7% had correct dosage frequencies and durations of treatment. The study revealed that antibiotics were frequently prescribed inappropriately by GPs in the private primary healthcare sector. There is thus a need to develop stewardship interventions in the sector.
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DOI：
10.1016/j.japh.2017.03.014
发表时间：
2017-07-01
影响因子：
2.1
作者：
Dobson, Erica L.;Klepser, Michael E.;Suda, Katie J.
通讯作者：
Suda, Katie J.
影响因子：
39
作者：
Hersh AL;Fleming-Dutra KE;Shapiro DJ;Hyun DY;Hicks LA;Outpatient Antibiotic Use Target-Setting Workgroup
通讯作者：
Outpatient Antibiotic Use Target-Setting Workgroup
DOI：
10.1007/978-1-4419-0981-7_6
发表时间：
2010-01-01
期刊：
HOT TOPICS IN INFECTION AND IMMUNITY IN CHILDREN VI
影响因子：
--
作者：
English, B. Keith;Gaur, Aditya H.
通讯作者：
Gaur, Aditya H.
影响因子：
120.7
作者：
Fleming-Dutra, Katherine E.;Hersh, Adam L.;Hicks, Lauri A.
通讯作者：
Hicks, Lauri A.
影响因子：
4.2
作者：
Fleming-Dutra, Katherine E.;Bartoces, Monina;Hicks, Lauri A.
通讯作者：
Hicks, Lauri A.