Changes in Fluoroquinolone Use for Gonorrhea Following Publication of Revised Treatment Guidelines
Changes in Fluoroquinolone Use for Gonorrhea Following Publication of Revised Treatment Guidelines
复制标题
DOI：
10.2105/ajph.2011.300283
复制
发表时间：
2012-01-01
影响因子：
12.7
通讯作者：
Newman, Lori M.
中科院分区：
文献类型：
--
作者：
Dowell, Deborah;Tian, Lin H.;Newman, Lori M.
目标.我们评估了修订后的国家治疗建议对选定州使用氟喹诺酮类药物治疗淋病的影响。我们使用中断时间序列分析评估了2006年7月1日至2008年5月31日期间通过性传播疾病监测网络报告的淋病病例。结果是氟喹诺酮类药物治疗的总体情况，按地区和实践设置。在此期间有治疗日期的16126例病例中，15669例记录了使用的药物。修订后的建议发布后，氟喹诺酮类药物的使用总体上突然下降（21.5%; 95%置信区间[CI] = 15.9%，27.2%），在大多数评估的地理区域和性传播疾病诊所（28.5%; 95% CI= 19.0%，37.9%）。在初级保健（8.6%; 95%CI = 2.6%，14.6%）和急诊科、紧急护理和医院（2.7%; 95%CI = 1.7%，3.7%）中观察到更多的逐渐下降。修订后的国家指南公布后，氟喹诺酮类药物的使用减少，特别是在性传播疾病诊所。需要建立额外的机制来加快初级保健、急诊科、紧急护理和医院处方的变化速度和幅度。(Am J公共卫生。2012;102：148-155. doi：10.2105/AJPH.2011.300283）
Objectives. We evaluated the impact of revised national treatment recommendations on fluoroquinolone use for gonorrhea in selected states.Methods. We evaluated gonorrhea cases reported through the Sexually Transmitted Disease Surveillance Network as treated between July 1, 2006 and May 31, 2008, using interrupted time series analysis. Outcomes were fluoroquinolone treatment overall, by area, and by practice setting.Results. Of 16126 cases with treatment dates in this period, 15669 noted the medication used. After revised recommendations were released, fluoroquinolone use decreased abruptly overall (21.5%; 95% confidence interval [CI] = 15.9%, 27.2%), in most geographic areas evaluated, and in sexually transmitted disease clinics (28.5%; 95% CI=19.0%, 37.9%). More gradual decreases were seen in primary care (8.6%; 95% CI=2.6%, 14.6%), and in emergency departments, urgent care, and hospitals (2.7%; 95% CI=1.7%, 3.7%).Conclusions. Fluoroquinolone use decreased after the publication of revised national guidelines, particularly in sexually transmitted disease clinics. Additional mechanisms are needed to increase the speed and magnitude of changes in prescribing in primary care, emergency departments, urgent care, and hospitals. (Am J Public Health. 2012;102:148-155. doi:10.2105/AJPH.2011.300283)