Tupai-Firestone Ridvan, Tsai Jia-Yun Catherine, Anderson Philippa, Broome Laura, McKee Tracy, Lennon Diana R
Centre for Public Health Research, Massey University, P O Box 756, Wellington, New Zealand.
Research Fellow, Department of Molecular Medicine and Pathology, The University of Auckland, Grafton Campus, School of Medical Sciences, Private Bag 92019, Auckland, 1023, New Zealand.
N Z Med J. 2016 May 27;129(1435):29-38.
To evaluate antimicrobial usage in the school-based clinics against operating guidelines.
Antimicrobial prescribing data (2014) from 10/18 participating pharmacies serving 14,153/23,588 primary school children of the programme were accessible. Prescriptions from 5/10 pharmacies were available for identifying type, amount, and indication of the medicine. One pharmacy serving a defined population (n=3,513) with single healthcare provider delivering the school programme was selected for detailed evaluation and identifying individuals receiving multiple treatments.
Data from 10 pharmacies (n=7,889 prescriptions) showed 91.2% of prescriptions were for group A streptococcal-positive throat swab, 8.8% for skin infections. More detail from 5/10 pharmacies showed only 2% of group A streptococcal pharyngitis treatments (107/4,672) were not first-line (56 cephalexin and 51 rifampin prescriptions). Fusidic acid (159/452, 35.18%) or cephalexin (169/452, 37.39%) were most commonly used for skin infection. Analysis in the defined population showed <4% (151/4,325) of assessed skin conditions received antimicrobials, and only 6 individuals received more than one course of oral antimicrobial over the year.
Antimicrobial administration demonstrates high compliance with the protocol. There was very limited use of second-line antimicrobials for recurrent pharyngitis. Most skin infections did not require antimicrobial treatment. Repeated antimicrobials for individuals were rare.
评估校内诊所抗菌药物的使用是否符合操作指南。
可获取来自参与该项目的18家药房中的10家（为该项目中23588名小学生中的14153名提供服务）的抗菌药物处方数据（2014年）。10家药房中有5家的处方可用于确定药物的类型、用量和适应证。选择一家为特定人群（n = 3513）服务、由单一医疗服务提供者开展校内项目的药房进行详细评估，并确定接受多种治疗的个体。
来自10家药房的数据（n = 7889张处方）显示，91.2%的处方用于A组链球菌阳性咽拭子，8.8%用于皮肤感染。来自10家药房中5家的更详细数据显示，A组链球菌性咽炎治疗中只有2%（107/4672）不是一线治疗（56张头孢氨苄和51张利福平处方）。夫西地酸（159/452，35.18%）或头孢氨苄（169/452，37.39%）最常用于皮肤感染。在特定人群中的分析显示，评估的皮肤疾病中<4%（151/4325）接受了抗菌药物治疗，且一年中只有6名个体接受了不止一个疗程的口服抗菌药物治疗。
抗菌药物的使用显示出高度符合方案。复发性咽炎二线抗菌药物的使用非常有限。大多数皮肤感染不需要抗菌药物治疗。个体重复使用抗菌药物的情况很少见。
