Outpatient Antibiotic Prescribing in Massachusetts, 2011-2015
Outpatient Antibiotic Prescribing in Massachusetts, 2011-2015
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DOI：
10.1093/ofid/ofz169
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发表时间：
2019-05-01
影响因子：
4.2
通讯作者：
Grad, Yonatan H.
中科院分区：
文献类型：
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作者：
Klevens, R. Monina;Caten, Evan;Grad, Yonatan H.
背景本研究的目的是开发方法来衡量马萨诸塞州基于人群的门诊抗生素处方，并将研究结果描述为建立持续监测的第一步。方法。我们分析了2011年至2015年马萨诸塞州所有支付者索赔数据库中的门诊处方索赔。我们使用国家医学图书馆的RXNorm数据库，根据世界卫生组织的解剖学治疗学化学分类系统对抗生素的声明进行分组。我们将开处方者分为17个专业。计算抗生素使用率，并使用简单频率来描述模式。0-64岁人群门诊抗生素使用的总体年比率为每1000人696张处方。2015年，马萨诸塞州68%的人没有抗生素处方，17%的人只有1个处方。有显着的变化，抗生素使用率的人口普查范围内的国家（青霉素的使用率范围从31至265处方每1000人，大环内酯类从28至333，头孢菌素从8至89，喹诺酮类从13至118）。城市人口普查区的抗生素使用率普遍较低。从2011年到2015年，抗生素处方下降了17%，其中大环内酯类下降幅度最大（28%）。在马萨诸塞州内，不同年龄、性别和抗生素类别的抗生素处方存在差异。该州人口普查区抗生素使用的变化与美国各州使用的变化相似。持续测量和详细的马萨诸塞州当地人群抗生素使用率将为当地处方医生提供反馈。
Background. The objectives of this study were to develop methods to measure population-based outpatient antibiotic prescribing in Massachusetts and to describe the findings as a first step toward institution of ongoing surveillance.Methods. We analyzed outpatient prescription claims from the Massachusetts All-Payers Claims Database from 2011 to 2015. We grouped claims for antibiotics according to the World Health Organization's Anatomical Therapeutic Chemical Classification System using the National Library of Medicine's RXNorm database. We grouped prescribers into 17 specialties. Antibiotic use rates were calculated, and simple frequencies were used to describe patterns.Results. The overall annual rate of outpatient antibiotic use for individuals aged 0-64 years was 696 prescriptions per 1000 people. During 2015, 68% of people in Massachusetts had no antibiotic prescription, and 17% had only 1 prescription. There was dramatic variability in antibiotic use rates by census tract within the state (rates of penicillin use ranged from 31 to 265 prescriptions per 1000 people, macrolides from 28 to 333, cephalosporins from 8 to 89, quinolones from 13 to 118). Antibiotic use rates were generally lower in urban census tracts. From 2011 to 2015, there was a 17% decline in antibiotic prescribing, with the greatest decline for macrolides (28%).Conclusions. There was variability in antibiotic prescribing within Massachusetts by age, sex, and antibiotic class. Variation in antibiotic use across census tracts within the state was similar to the variation in use across US states. Continued measurement and detailed local population rates of antibiotic use in Massachusetts will provide feedback for local prescribers.