Ness Valerie, Malcolm William, McGivern Guy, Reilly Jacqui
Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, Scotland, UK
Health Protection Scotland, NHS National Services Scotland, 4th Floor, Meridian Court, 5 Cadogan Street, Glasgow G2 6QE, Scotland, UK.
J Antimicrob Chemother. 2015 Dec;70(12):3384-9. doi: 10.1093/jac/dkv255. Epub 2015 Aug 25.
The objective of this study was to retrospectively analyse patterns of primary care antibiotic prescribing by nurse prescribers in Scotland.
Data on dispensed antibiotic prescriptions written by nurse prescribers in 2007-13 were obtained from the Prescribing Information System, a database of all NHS prescriptions dispensed in Scotland.
Since 2007, there has been a steady increase in the volume of antibiotic prescribing in primary care undertaken by nurse prescribers. There was considerable variability in the frequency of antibiotic prescribing among nurses and across NHS regions. Since 2007, an increasing proportion of antibiotics prescribed by nurses are those recommended for first-line empirical treatment of infection, with a reduction in the proportion of broader-spectrum agents. Other measures of prescribing quality (duration of treatment of adult females with urinary tract infection and use of recommended doses) have improved since 2007.
This paper is the first, to our knowledge, to present an analysis of data on antibiotic prescribing in primary care by nurse prescribers. Inappropriate prescribing is a problem and, given the impact that antibiotic prescribing has on antimicrobial resistance, it is important that the prescribing behaviour of nurses is explored. This is especially significant as this is a growing body of prescribers who predominately work in the community, where the majority of antibiotics are prescribed. This analysis showed that practice varies across NHS regions and between prescribers and although more information is needed to establish whether nurse prescribers are prescribing appropriately, some quality indicators may suggest that they are following best practice.
本研究的目的是回顾性分析苏格兰护士处方医生在初级保健中开具抗生素的模式。
2007 - 2013年护士处方医生开具的抗生素配药处方数据来自处方信息系统，该系统是苏格兰所有国民保健制度（NHS）配药处方的数据库。
自2007年以来，护士处方医生在初级保健中开具的抗生素数量稳步增加。护士之间以及不同NHS地区的抗生素开具频率存在很大差异。自2007年以来，护士开具的抗生素中，推荐用于感染一线经验性治疗的比例不断增加，广谱抗生素的比例有所下降。自2007年以来，其他处方质量指标（成年女性尿路感染的治疗时长和推荐剂量的使用）有所改善。
据我们所知，本文首次对护士处方医生在初级保健中开具抗生素的数据进行了分析。不适当的处方是一个问题，鉴于抗生素处方对抗菌药物耐药性的影响，探究护士的处方行为很重要。这一点尤为重要，因为这是一个不断壮大的处方医生群体，他们主要在社区工作，而大多数抗生素都是在社区开具的。该分析表明，不同NHS地区以及不同处方医生之间的做法存在差异，尽管需要更多信息来确定护士处方医生的处方是否恰当，但一些质量指标可能表明他们遵循了最佳实践。
