Aging Research Center, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet and Stockholm University, Gävlegatan 16, 113 30 Stockholm, Sweden.
Eur J Clin Pharmacol. 2013 Mar;69(3):665-71. doi: 10.1007/s00228-012-1374-7. Epub 2012 Aug 25.
We compared the quality and pattern of use of antibiotics to treat urinary tract infection (UTI) between institutionalized and home-dwelling elderly.
We analyzed the quality of use of UTI antibiotics in Swedish people aged ≥ 65 years at 30 September 2008 (1,260,843 home-dwelling and 86,721 institutionalized elderly). Data regarding drug use, age and sex were retrieved from the Swedish Prescribed Drug Register and information about type of housing from the Social Services Register. In women, we assessed: (1) the proportion who use quinolones (should be as low as possible); (2) the proportion treated with the recommended drugs (pivmecillinam, nitrofurantoin, or trimethoprim) (proportions should be about 40 %, 40 % and 15-20 %, respectively); In men, we assessed: (1) the proportion who used quinolones or trimethoprim (should be as high as possible).
The 1-day point prevalence for antibiotic use for UTI was 1.6 % among institutionalized and 0.9 % among home-dwelling elderly. Of these, about 15 % of institutionalized and 19 % of home-dwelling women used quinolones. The proportion of women treated with the recommended drugs pivmecillinam, nitrofurantoin or trimethoprim was 29 %, 27 % and 45 % in institutions and 40 %, 28 % and 34 % for home-dwellers. In men treated with antibiotics for UTI, quinolones or trimethoprim were used by about 76 % in institutions and 85 % in home-dwellers.
Our results indicate that recommendations for UTI treatment with antibiotics are not adequately followed. The high use of trimethoprim amongst institutionalized women and the low use of quinolones or trimethoprim among institutionalized men need further investigation.
我们比较了住院和居家老年人群中治疗尿路感染（UTI）的抗生素质量和使用模式。
我们分析了 2008 年 9 月 30 日年龄≥65 岁的瑞典人（1260843 名居家和 86721 名住院老年人）UTI 抗生素使用质量的数据。药物使用、年龄和性别信息来自瑞典处方药物登记处，住房类型信息来自社会服务登记处。对于女性，我们评估了以下内容：（1）使用喹诺酮类药物的比例（应尽可能低）；（2）使用推荐药物（匹美西林、呋喃妥因或甲氧苄啶）的比例（分别约为 40%、40%和 15-20%）。对于男性，我们评估了：（1）使用喹诺酮类药物或甲氧苄啶的比例（应尽可能高）。
住院和居家老年人 UTI 的 1 天抗生素使用率分别为 1.6%和 0.9%。其中，约 15%的住院和 19%的居家女性使用了喹诺酮类药物。住院女性接受推荐药物匹美西林、呋喃妥因或甲氧苄啶治疗的比例分别为 29%、27%和 45%，居家女性的相应比例为 40%、28%和 34%。接受抗生素治疗 UTI 的男性中，约 76%的住院患者和 85%的居家患者使用了喹诺酮类药物或甲氧苄啶。
我们的结果表明，抗生素治疗 UTI 的建议并未得到充分遵循。住院女性中广泛使用甲氧苄啶和住院男性中喹诺酮类药物或甲氧苄啶使用率低需要进一步调查。
