Pipalova Rachel, Vlcek Jiri, Slezak Radovan
Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Kralove, Charles University in Prague, Hradec Kralove, Czech Republic.
Int Dent J. 2014 Jun;64(3):138-43. doi: 10.1111/idj.12089. Epub 2014 Jan 11.
We assessed antibiotic prescribing in practical dentistry in the Czech Republic, as antibiotics are widely prescribed by dental practitioners and warning signals of their overuse can be observed. The individual antibiotic prescriptions were extracted from the database of the General Health Insurance Company and further analysed. The proportion of dentists' prescription within the whole primary health-care sector and the rate of prescriptions of particular antibiotics were both in defined daily doses per 1,000 insurees and day (DID) and in number of prescriptions calculated. The proportion of antibiotic use in dentistry increased from 0.63 DID in 2006 to 0.75 DID. We found a decline in use of narrow-spectrum penicillins by 4.8%, tetracyclines by 3.5% and macrolides by 3.6%, accompanied by increasing rate of prescription of aminopenicillins combined with beta-lactamase inhibitor by 8.9% and lincosamides by 8.5%. The consumption of clindamycin and amoxicillin combined with clavulanate in DID has increased by approximately 60% since 2006 thanks to the exclusive prescribing of two commercial oral products only. Factors contributing to this unfavourable trend are commercial influence or defensive medicine practice.
我们评估了捷克共和国实际牙科治疗中抗生素的处方情况，因为牙科医生广泛开具抗生素，且能观察到抗生素过度使用的警示信号。从国家健康保险公司的数据库中提取了个体抗生素处方并进行进一步分析。牙医处方在整个初级卫生保健部门中的占比以及特定抗生素的处方率，均以每1000名被保险人每天的限定日剂量（DID）以及计算出的处方数量来表示。牙科治疗中抗生素的使用占比从2006年的0.63 DID增至0.75 DID。我们发现窄谱青霉素的使用量下降了4.8%，四环素下降了3.5%，大环内酯类下降了3.6%，与此同时，氨基青霉素与β-内酰胺酶抑制剂联合使用的处方率上升了8.9%，林可酰胺类上升了8.5%。自2006年以来，由于仅两种商业口服产品的独家处方，克林霉素和阿莫西林与克拉维酸盐联合使用的DID消耗量增加了约60%。造成这种不利趋势的因素是商业影响或防御性医疗行为。
