Internal Medicine Ward C, Haemek Medical Center, Afula, Israel.
Infection. 2010 Feb;38(1):12-8. doi: 10.1007/s15010-009-9065-8. Epub 2010 Jan 27.
Antibiotic consumption has an important effect on microbial resistance. Nationwide data on the comparative use of antibiotics in outpatient settings in Israel have only been partially collected and published. The aim of our study was to analyze the use of antibiotics in the outpatient setting in Israel and assess a number of influencing factors.
Defined daily doses per 1,000 inhabitants per day (DID) of total antibiotic use, consumption in different age groups, and consumption of different antibiotic groups were calculated for the years 2003-2005 in the districts of Israel. The data was collected from prescription data compiled by the pharmaceutical services of "Clalit Health Services", the largest health maintenance organization (HMO) in Israel, covering 55% of the population.Trends in use and variables associated with antibiotic consumption were analyzed.
There was a significant decrease in antibiotic use from 2003 to 2005, ranging from 1.8 to 8.2% in the different districts. The highest consumption was noted in the youngest age groups, with more than half of all antibiotics prescribed to children < or = 18 years of age. Antibiotic consumption was significantly different between the different regions in Israel. A multivariate analysis revealed that a higher prevalence of diabetes mellitus was the only significant variable associated with antibiotic use. Variability in the use of different antibiotics was also found; for example, amoxicillin comprised 19.5-33.4% of total antibiotic consumption in the different districts, while fluoroquinolone consumption ranged from 3.2 to 7.3%.
Outpatient antibiotic use in the population insured by "Clalit Health Services" declined between 2003 and 2005. Children had the highest consumption rates. There were large differences in antibiotic use between geographic regions, and diabetes mellitus was the only variable significantly associated with antibiotic use. We therefore conclude that most of the differences in antibiotic use are likely due to doctor preferences, local routines, and patients' attitudes and expectations.
抗生素的使用对微生物的耐药性有重要影响。以色列仅部分收集和公布了全国范围内门诊环境中抗生素使用的比较数据。我们的研究目的是分析以色列门诊环境中抗生素的使用情况，并评估一些影响因素。
计算了 2003-2005 年以色列各地区每 1000 居民每日抗生素总使用量、不同年龄组使用量和不同抗生素组使用量的限定日剂量（DID）。数据来自以色列最大的健康维护组织（HMO）“Clalit 健康服务”的药品服务部门汇编的处方数据，该数据覆盖了 55%的人口。分析了使用趋势和与抗生素使用相关的变量。
抗生素的使用从 2003 年到 2005 年显著下降，不同地区的降幅从 1.8%到 8.2%不等。抗生素的使用量在年龄最小的人群中最高，超过一半的抗生素用于<或=18 岁的儿童。以色列不同地区之间的抗生素使用情况存在显著差异。多变量分析显示，糖尿病患病率较高是唯一与抗生素使用相关的显著变量。不同抗生素的使用也存在差异；例如，阿莫西林占不同地区抗生素总使用量的 19.5-33.4%，而氟喹诺酮类药物的使用量从 3.2%到 7.3%不等。
“Clalit 健康服务”保险人群的门诊抗生素使用量在 2003 年至 2005 年间下降。儿童的使用率最高。抗生素的使用在地理区域之间存在很大差异，糖尿病是唯一与抗生素使用显著相关的变量。因此，我们得出的结论是，抗生素使用的大部分差异可能是由于医生的偏好、当地的常规做法以及患者的态度和期望造成的。
