Jan I-Shiow, Cheng Shou-Hsia, Hsu Hui-Chun, Hsueh Po-Ren
Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
J Microbiol Immunol Infect. 2007 Dec;40(6):532-6.
Guidelines for prescribing antibiotics for uncomplicated urinary tract infection (UTI) were established in Taiwan in 2000. This study investigated the extent of physicians' adherence to the guidelines for treating ambulatory women with UTI.
National Health Insurance claims data were used to evaluate antibiotic prescription behavior for UTI among physicians serving in hospitals across the range of accreditation levels in Taiwan, including medical centers, regional hospitals, district teaching/non-teaching hospitals and community clinics. A random sample of 5047 female ambulatory care visits during 2001 and 2003 was analyzed.
Sulfonamides (trimethoprim and trimethoprim-sulfamethoxazole), first-generation cephalosporins and quinolones were the most commonly prescribed drugs. The overall guideline adherence rate for physicians was 72.1%. The differences in guideline adherence rates for physicians in medical centers (86.6%), regional hospitals (81.3%), district teaching/non-teaching hospitals (76.9%) and community clinics (69.5%) were statistically significant (chi-squared test; p<0.0001).
Physicians in community clinics were less likely to adhere to guidelines in the treatment of ambulatory cases of UTI than physicians in any of the different levels of accredited hospitals in Taiwan.
2000年台湾制定了非复杂性尿路感染（UTI）的抗生素处方指南。本研究调查了医生在治疗门诊UTI女性患者时遵循该指南的程度。
利用全民健康保险理赔数据，评估台湾各级别医院（包括医学中心、区域医院、地区教学/非教学医院和社区诊所）医生对UTI的抗生素处方行为。分析了2001年至2003年期间5047例女性门诊就诊的随机样本。
磺胺类药物（甲氧苄啶和甲氧苄啶-磺胺甲恶唑）、第一代头孢菌素和喹诺酮类是最常用的处方药物。医生的总体指南遵循率为72.1%。医学中心（86.6%）、区域医院（81.3%）、地区教学/非教学医院（76.9%）和社区诊所（69.5%）医生的指南遵循率差异具有统计学意义（卡方检验；p<0.0001）。
与台湾任何不同级别认证医院的医生相比，社区诊所的医生在治疗门诊UTI病例时不太可能遵循指南。
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