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新西兰门诊抗生素消费的趋势、人口统计学特征及差异:一项全国性研究。

Trends, demographics and disparities in outpatient antibiotic consumption in New Zealand: a national study.

作者信息

Williamson Deborah A, Roos Rebekah, Verrall Ayesha, Smith Alesha, Thomas Mark G

机构信息

Institute of Environmental Science and Research, Wellington, New Zealand

Microbiological Diagnostic Unit Public Health Laboratory, Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Australia.

出版信息

J Antimicrob Chemother. 2016 Dec;71(12):3593-3598. doi: 10.1093/jac/dkw345. Epub 2016 Sep 6.

Abstract

OBJECTIVES

Knowledge of the patterns of antibiotic consumption within a population provides valuable information on when, where and to whom antibiotics are prescribed. Such knowledge is critical in informing possible public health interventions to reduce inappropriate antibiotic use. The aims of this study were to (i) determine national patterns of antibiotic consumption, including assessment of seasonal variation in prescribing, and (ii) explore potential associations between antibiotic consumption and patient characteristics, such as age, sex and ethnicity.

METHODS

Data on all subsidized antibiotic dispensing in New Zealand between 1 January 2006 and 31 December 2014 were obtained and stratified according to age, sex and ethnicity. Antibiotic dispensing was expressed as the number of DDDs per 1000 population per day (DID).

RESULTS

Total antibiotic consumption in New Zealand increased by 49% from 17.3 DID in 2006 to 25.8 DID in 2014. The increase in antibiotic consumption occurred in all ages and amongst all ethnic groups. The use of extended-spectrum penicillins, which almost doubled in the study period, made a major contribution to the overall increase and was highest in young children and in Pacific peoples. Consumption of quinolones increased early in the study period and then declined from 2011 onwards.

CONCLUSIONS

Future work should focus on identifying the appropriateness of antibiotic prescribing, particularly for penicillin prescribing in Pacific peoples and children, and on both reducing unwarranted antibiotic use and improving antibiotic selection when therapy is indicated.

摘要

目的

了解人群中抗生素消费模式,可为抗生素处方的时间、地点和对象提供有价值的信息。这些信息对于指导可能的公共卫生干预措施以减少不适当的抗生素使用至关重要。本研究的目的是:(i)确定全国抗生素消费模式,包括评估处方的季节性变化;(ii)探讨抗生素消费与患者特征(如年龄、性别和种族)之间的潜在关联。

方法

获取2006年1月1日至2014年12月31日新西兰所有补贴抗生素配药数据,并按年龄、性别和种族进行分层。抗生素配药以每1000人口每天的限定日剂量数(DID)表示。

结果

新西兰的抗生素总消费量从2006年的17.3 DID增加到2014年的25.8 DID,增长了49%。各年龄段和所有种族的抗生素消费量均有所增加。在研究期间几乎翻倍的广谱青霉素的使用,对总体增长起到了主要作用,在幼儿和太平洋岛民中最高。喹诺酮类药物的消费量在研究初期增加,然后从2011年起下降。

结论

未来的工作应侧重于确定抗生素处方的合理性,特别是太平洋岛民和儿童的青霉素处方,同时减少不必要的抗生素使用,并在有治疗指征时改善抗生素的选择。

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