Trends in systemic antifungal use in Australia, 2005-2016: a time-series analysis.
Trends in systemic antifungal use in Australia, 2005-2016: a time-series analysis.
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2005-2016 年澳大利亚全身抗真菌药物使用趋势：时间序列分析。
DOI：
10.7883/yoken.jjid.2021.505
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发表时间：
2021-09
影响因子：
2.2
通讯作者：
Samantha A Hollingworth
中科院分区：
文献类型：
--
作者：
Wang Yan;Mieke L Van Driel;Treasure M McGuire;Samantha A Hollingworth
关于抗真菌药物使用趋势的数据对于鼓励抗真菌药物管理非常重要。本研究探讨了澳大利亚全身使用抗真菌药物的利用率和报销政策变化的影响。我们分析了澳大利亚药品福利计划（PBS）（2005-2016）的国家数据。我们用一个中断的时间序列模型研究了随着时间的推移的使用模式和报销决定对抗真菌药物使用的影响。2005-2016年，大多数抗真菌药的使用都有所增加，尤其是氟康唑、伊曲康唑和泊沙康唑。酮康唑是最常见的分配系统性抗真菌药（46.0%）之前，其PBS列表删除，当它被氟康唑（69.8%）取代。PBS事件“氟康唑和伊曲康唑限制放宽”导致氟康唑使用增加（每天0.025/1000，无延迟）。最大的比率和数字增长都是在妇产科医生（1，969%; 1，851张处方）和皮肤科医生（1，723%; 1，689张处方）中，除了全科医生（2010-2016）。这是第一个澳大利亚国家纵向估计系统性抗真菌药的使用。它显示在研究期间，大多数抗真菌药的处方量总体增加，报销决定影响了利用率。这些数据为制定国家抗真菌指南和政策提供了基础，以鼓励更有针对性的抗真菌管理。
Data on antifungal utilization trends are important to encourage antifungal stewardship. This study explored the utilization of antifungal agents for systemic use and the impact of reimbursement policy changes in Australia. We analyzed national data from the Australian Pharmaceutical Benefits Scheme (PBS) (2005-2016). We examined patterns of use over time and the impact of reimbursement decisions on antifungal use with an interrupted time-series model. In 2005-2016, there has been an increase in the use of most antifungals, especially fluconazole, itraconazole and posaconazole. Ketoconazole was the most commonly dispensed systemic antifungal (46.0%) before its PBS listing removal, when it was replaced by fluconazole (69.8%). The PBS event "Fluconazole and itraconazole restrictions eased" led to increased use of fluconazole (0.025/1000 per day with no delay). Both the largest rates and numerical increase were among obstetricians and gynecologists (1,969%; 1,851 dispensed prescriptions) and dermatologists (1,723%; 1,689 dispensed prescriptions) except general practitioner (2010-2016). This is the first Australian national longitudinal estimate of systemic antifungal use. It shows an overall increase in prescribing of most antifungals during study period, with reimbursement decisions impacting utilization. These data provide a baseline to inform development of national antifungal guidelines and policies to encourage more targeted antifungal stewardship.