Changes in ciprofloxacin utilization as shown in a large pharmacy claims database: effects of proximity to criminal anthrax exposure in October 2001.
Changes in ciprofloxacin utilization as shown in a large pharmacy claims database: effects of proximity to criminal anthrax exposure in October 2001.
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DOI：
10.1331/154434503321831085
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发表时间：
2003-05-01
期刊：
影响因子：
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通讯作者：
Beitz, Julie
中科院分区：
文献类型：
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作者：
Brinker, Allen;Pamer, Carol;Beitz, Julie
目的：在2001年10月的炭疽病犯罪暴露期间，确定环丙沙星使用的变化和任何已确定变化的地理模式。设计：观察。设置：美国。患者：通过药房福利管理公司进行处方索赔的个人。干预：AdvancePCS药房索赔数据库的分析。主要结果指标：2000年和2001年以及2001年9月和10月各地区环丙沙星使用的百分比变化。2001日历年的环丙沙星片剂使用率明显低于2000日历年（中位数下降，10.3%），除10月，当使用环丙沙星增加9.8%。在炭疽暴露期间（2001年10月对2001年9月），受影响的地理区域，包括纽约（增长62.5%），其他一些大西洋中部州和佛罗里达（28.5%），在环丙沙星利用率方面有一些最高的百分比增长。在2001年10月炭疽袭击期间，许多美国人积极寻求环丙沙星预防，在有公开病例的地区，使用率更高，但不限于此。药剂师、临床医生和公共卫生官员应该注意到，在发生类似袭击的情况下，这种行为可能是意料之中的，他们应该熟悉目前对炭疽暴露的评估和管理的建议。
OBJECTIVE: Identify, during the period of criminal anthrax exposures in October 2001, changes in utilization of ciprofloxacin and geographic patterns of any identified variations.DESIGN: Observational.SETTING: United States.PATIENTS: Individuals making prescription claims through a pharmacy benefits management company.INTERVENTIONS: Analysis of AdvancePCS pharmacy claims database.MAIN OUTCOME MEASURES: Percentage change in ciprofloxacin utilization for 2000 and 2001 and, by locale, for September and October 2001.RESULTS: Utilization of ciprofloxacin tablets was significantly lower in calendar year 2001 than in calendar year 2000 (median decline, 10.3%) for all months except October, when utilization of ciprofloxacin increased 9.8%. During the period of anthrax exposures (October 2001 versus September 2001), affected geographic areas, including New York (an increase of 62.5%), some other Mid-Atlantic states, and Florida (28.5%), had some of the highest percentage increases in the rate of ciprofloxacin utilization.CONCLUSION: Many Americans actively sought prophylaxis with ciprofloxacin during the course of the October 2001 anthrax attack and that utilization was higher in, but not limited to, locales with publicized cases of disease. Pharmacists, clinicians, and public health officials should note that such behavior may be expected in the event of a similar attack and should be familiar with current recommendations for the assessment and management of anthrax exposure.