Inappropriate antibiotic prescription for respiratory tract indications: most prominent in adult patients
Inappropriate antibiotic prescription for respiratory tract indications: most prominent in adult patients
复制标题
DOI：
10.1093/fampra/cmv019
复制
发表时间：
2015-08-01
期刊：
影响因子：
2.2
通讯作者：
van der Velden, Alike W.
中科院分区：
文献类型：
--
作者：
Dekker, Anne R. J.;Verheij, Theo J. M.;van der Velden, Alike W.
背景许多研究表明，过度处方抗生素用于呼吸道适应症（RTI），而没有真正验证不适当的处方;指南建议的严格标准没有考虑到具体诊断，患者特征和疾病严重程度的信息不可用。本研究的目的是量化和定性不适当的抗生素处方的RTIS. Methods。这是一项观察性研究，使用全科医生（GP）详细登记RTI咨询，对RTI患者进行（抗生素）管理。根据急性中耳炎（AOM）、急性咽喉痛、鼻窦炎或急性咳嗽的处方指南对所有必要信息可用的咨询进行基准化。确定这些适应症的过度处方水平和与过度处方相关的因素。总体抗生素处方率为38%。在这些处方中，46%没有被指南所指示。咽喉（包括扁桃体炎）的相对过量处方最高，耳部咨询（包括AOM）的相对过量处方最低。绝对过度处方是最高的较低的呼吸道感染（包括支气管炎）。对于18至65岁的患者，当全科医生感到患者有压力进行抗生素治疗时，对于发烧和主诉超过1周的患者，过度处方最多。在以下患者中观察到处方不足
Background. Numerous studies suggest overprescribing of antibiotics for respiratory tract indications (RTIs), without really authenticating inappropriate prescription; the strict criteria of guideline recommendations were not taken into account as information on specific diagnoses, patient characteristics and disease severity was not available.Objective. The aim of this study is to quantify and qualify inappropriate antibiotic prescribing for RTIs.Methods. This is an observational study of the (antibiotic) management of patients with RTIs, using a detailed registration of RTI consultations by general practitioners (GPs). Consultations of which all necessary information was available were benchmarked to the prescribing guidelines for acute otitis media (AOM), acute sore throat, rhinosinusitis or acute cough. Levels of overprescribing for these indications and factors associated with overprescribing were determined.Results. The overall antibiotic prescribing rate was 38%. Of these prescriptions, 46% were not indicated by the guidelines. Relative overprescribing was highest for throat (including tonsillitis) and lowest for ear consultations (including AOM). Absolute overprescribing was highest for lower RTIs (including bronchitis). Overprescribing was highest for patients between 18 and 65 years of age, when GPs felt patients' pressure for an antibiotic treatment, for patients presenting with fever and with complaints longer than 1 week. Underprescribing was observed in