Trends and Patterns of Antibiotic Prescriptions in Primary Care Institutions in Southwest China, 2017-2022.
Trends and Patterns of Antibiotic Prescriptions in Primary Care Institutions in Southwest China, 2017-2022.
复制标题
DOI：
10.2147/idr.s425787
复制
发表时间：
2023
影响因子：
3.9
通讯作者：
中科院分区：
文献类型：
--
作者：
目的探讨2017 - 2022年中国欠发达地区基层医疗机构抗生素处方模式及使用趋势。对贵州省25家基层医疗机构2017-2022年抗生素处方进行回顾性分析。将抗生素处方分为适当使用和不适当使用。适当使用可进一步分类为首选药物，可使用或替代抗生素。不适当使用进一步分为不必要使用、抗生素谱不正确和抗生素联合使用。使用广义估计方程研究了与不适当使用相关的因素。采用Holt-Winters模型和SARIMA模型作为备选模型预测抗生素处方不当数量。共纳入941,924张处方，显示2017 - 2022年抗生素处方数量和不适当率均呈下降趋势。呼吸系统疾病（70.66%）是抗生素使用的最常见目标，其中多部位和未明确部位的急性上呼吸道感染占52.04%。最常用的抗生素是青霉素类（64.44%）。在所有处方中，抗生素处方不当占66.19%。年龄在35岁以上、拥有11年以上副主任医师职称的医师更有可能不恰当地开抗生素。不适当使用抗生素的现象在5岁及以下儿童中较为常见。通过比较模型参数，确定SARIMA模型在预测初级保健机构不适当抗生素处方数量方面优于Holt-Winters模型。2017 - 2022年，西南地区抗生素处方数量和不适宜率呈下降趋势，但不适宜处方仍是基层医疗机构存在的严重问题。因此，今后应着重加强医师教育、培训和临床实践。此外，必须提高医生对不适当使用抗生素的常见误解的认识，并改变医生通过开抗生素来满足患者期望的处方行为。
To explore the prescription patterns and usage trends of antibiotics within primary care institutions located in underdeveloped regions of China from 2017 to 2022. A retrospective analysis of antibiotic prescriptions was conducted from 25 primary care institutions in Guizhou Province during the period of 2017–2022. Antibiotic prescriptions were categorized into appropriate and inappropriate use. Appropriate use is further categorized into preferred medication, and antibiotics can be used or substituted. Inappropriate use is further categorized into unnecessary use, incorrect spectrum of antibiotics and combined use of antibiotics. Factors associated with inappropriate use were investigated using generalized estimation equations. Holt-Winters and SARIMA models were employed to predict the number of inappropriate antibiotic prescriptions as the alternative model. A total of 941,924 prescriptions were included, revealing a decreasing trend in both the number and inappropriate rates of antibiotic prescriptions from 2017 to 2022. Diseases of the respiratory system (70.66%) was the most frequent target of antibiotic use, with acute upper respiratory infections of multiple and unspecified sites representing 52.04% of these cases. The most commonly used antibiotics were penicillins (64.44%). Among all prescriptions, inappropriate antibiotic prescriptions reached 66.19%. Physicians aged over 35, holding the title of associate chief physician and possessing more than 11 years of experience were more likely to prescribe antibiotics inappropriately. The phenomenon of inappropriate antibiotic use was commoner among children aged five or younger. By comparing model parameters, it was determined that the SARIMA model outperforms the Holt-Winters model in predicting the number of inappropriate antibiotic prescriptions among primary care institutions. The number and inappropriate rates of antibiotic prescriptions in southwest China exhibited a downward trend from 2017 to 2022, but inappropriate prescription remains a serious problem in primary care institutions. Therefore, future efforts should focus on strengthening physician education, training, and clinical practice. Additionally, physicians’ awareness of common misconceptions about inappropriate antibiotic use must be improved, and the prescribing behavior of physicians who fulfill patients’ expectations by prescribing antibiotics needs to be modified.
影响因子：
1
作者：
Almansoori N;Parag N
通讯作者：
Parag N
影响因子：
3.3
作者：
Choi, Yoon Young;Lee, Kyeong Hee
通讯作者：
Lee, Kyeong Hee