德国门诊抗生素处方的地区差异。

Regional variation in outpatient antibiotic prescribing in Germany.

作者信息

Kern W V, de With K, Nink K, Steib-Bauert M, Schröder H

机构信息

Center for Infectious Diseases and Travel Medicine, University Hospital, Hugstetter Str. 55, 79106, Freiburg, Germany.

出版信息

Infection. 2006 Oct;34(5):269-73. doi: 10.1007/s15010-006-6618-y.

DOI:10.1007/s15010-006-6618-y

PMID:17033751

Abstract

OBJECTIVE

According to recent surveys, outpatient antibiotic prescribing in Germany has been comparatively low among European countries. We assessed regional variation in outpatient antibiotic use within Germany both for overall use as well as for specific antibiotic drug classes.

METHODS

Prescription data for the year 2003 covering approximately 90% of the total population were analysed using the ATC/WHO defined daily dose (DDD) methodology. Data were expressed in DDD per 1,000 persons covered by the insurance and day (DID).

RESULTS

Outpatient antibiotic prescribing in 2003 was 13.6 DID and ranged between 9.2 and 17.9 DID in the different regions examined. Low consumption regions were eastern and southern states. High consumption areas were in the west near the French and Belgian border. This regional prescribing pattern was similar for children and adults. Penicillins were the most frequent prescribed drugs, but their use density showed a relatively large regional variation (factor 3.5), with relatively low prescription frequency in the eastern states. In almost all regions quinolones were used more often than trimethoprim-sulfamethoxazole.

CONCLUSION

The regional variation in recent outpatient antibiotic prescribing in Germany is substantial. The relatively high antibiotic use in the western part of the country is remarkable, remains unexplained and requires further study.

摘要

目的

根据最近的调查，在欧洲国家中，德国门诊抗生素处方量相对较低。我们评估了德国国内门诊抗生素使用的地区差异，包括总体使用情况以及特定抗生素药物类别的使用情况。

方法

采用解剖学治疗学及化学分类系统/世界卫生组织规定日剂量（DDD）方法，对2003年覆盖约90%总人口的处方数据进行分析。数据以每1000名参保人员每天的DDD数（DID）表示。

结果

2003年门诊抗生素处方量为13.6 DID，在所调查的不同地区，该数值在9.2至17.9 DID之间波动。低消费地区为东部和南部各州。高消费地区位于靠近法国和比利时边境的西部。儿童和成人的这种地区处方模式相似。青霉素是最常开具的药物，但其使用密度显示出相对较大的地区差异（系数为3.5），在东部各州的处方频率相对较低。在几乎所有地区，喹诺酮类药物的使用频率都高于甲氧苄啶 - 磺胺甲恶唑。