Carrie A G, Metge C J, Zhanel G G
Faculty of Pharmacy, University of Manitoba, Winnipeg, Canada.
Ann Pharmacother. 2000 Apr;34(4):459-64. doi: 10.1345/aph.19131.
Antibiotics are among the most commonly used classes of agents in community practice; yet, studies of antibiotic use in this setting are scarce. Data from developed countries suggest increasing use of newer broad-spectrum agents, which has implications for the development of antibiotic resistance as well as cost of therapy. In this study, we quantified changing patterns of antibiotic use in community practice in Manitoba, Canada, from 1995 to 1998.
A descriptive, population-based study of antibiotic use in Manitoba was facilitated by the Drug Programs Information Network (DPIN) of Manitoba Health; a data management system responsible for recording details of prescriptions dispensed for all Manitoba residents. Antibiotic use data, defined as numbers of prescriptions dispensed, were extracted from the DPIN from January 1, 1995, to March 31, 1998. Antibiotic use is reported as prescriptions per 1000 persons per year (Rx/1000/Yr) based on quarterly use.
Penicillins (48.3%), macrolides (16.0%), and sulfonamides (12.5%) accounted for 75% of total antibiotic use; total use decreased 19.1% between 1995 and 1998. Use of the four most commonly prescribed agents decreased over the study period (amoxicillin, -17.4%; erythromycin, -29.0%; trimethoprim/sulfamethoxazole, -18.7%; penicillins G and V, -19.2%). In contrast, use of newer and/or broad-spectrum agents increased (ciprofloxacin, 21.9%; cefuroxime, 30.7%; and azithromycin/clarithromycin, 29.5%). Use of second-line agents as a percentage of total antibiotic use increased from 14.4% to 19.3% between January 1995 and March 1998 (p < 0.001).
Penicillins, macrolides, and sulfonamides accounted for 75% of antibiotic use. Total antibiotic use declined over the study period; however, use of newer, broad-spectrum agents increased while use of older, narrow-spectrum agents decreased.
抗生素是社区医疗中最常用的药物类别之一；然而，关于社区环境中抗生素使用情况的研究却很匮乏。来自发达国家的数据表明，新型广谱抗生素的使用呈上升趋势，这对抗生素耐药性的发展以及治疗成本都有影响。在本研究中，我们对1995年至1998年加拿大曼尼托巴省社区医疗中抗生素使用模式的变化进行了量化。
曼尼托巴省卫生厅的药物项目信息网络（DPIN）推动了一项基于人群的曼尼托巴省抗生素使用描述性研究；该数据管理系统负责记录为所有曼尼托巴省居民配药的详细信息。抗生素使用数据定义为配药处方数量，从1995年1月1日至1998年3月31日从DPIN中提取。抗生素使用情况按每季度使用量报告为每年每1000人处方数（Rx/1000/Yr）。
青霉素（48.3%）、大环内酯类（16.0%）和磺胺类（12.5%）占抗生素总使用量的75%；1995年至1998年期间总使用量下降了19.1%。在研究期间，四种最常用药物的使用量有所下降（阿莫西林，-17.4%；红霉素，-29.0%；甲氧苄啶/磺胺甲恶唑，-18.7%；青霉素G和V，-19.2%）。相比之下，新型和/或广谱药物的使用量增加了（环丙沙星，21.9%；头孢呋辛，30.7%；阿奇霉素/克拉霉素，29.5%）。1995年1月至1998年3月期间，二线药物占抗生素总使用量的百分比从14.4%增加到19.3%（p<0.001）。
青霉素、大环内酯类和磺胺类占抗生素使用量的75%。在研究期间，抗生素总使用量下降；然而，新型广谱药物的使用量增加，而旧的窄谱药物的使用量减少。
