比利时口腔医疗机构的牙医 2010-2016 年的抗菌药物处方情况。
Antimicrobial prescribing by Belgian dentists in ambulatory care, from 2010 to 2016.
机构信息
Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
Sciensano, Healthcare-associated Infections & Antimicrobial Resistance, Brussels, Belgium.
出版信息
Int Dent J. 2019 Dec;69(6):480-487. doi: 10.1111/idj.12512. Epub 2019 Aug 2.
OBJECTIVES
To describe antimicrobial prescribing by Belgian dentists in ambulatory care, from 2010 until 2016.
MATERIALS AND METHODS
Reimbursement data from the Belgian National Institute for Health and Disability Insurance were analysed to evaluate antimicrobial prescribing (WHO ATC-codes J01/P01AB). Utilisation was expressed in defined daily doses (DDDs), and in DDDs and packages per 1000 inhabitants per day (DID and PID, respectively). Additionally, the number of DDD and packages per prescriber was calculated.
RESULTS
In 2016, the dentistry-related prescribing rate of 'Antibacterials for systemic use' (J01) and 'Antiprotozoals' (P01AB) was 1.607 and 0.014 DID, respectively. From 2010 to 2016, the DID rate of J01 increased by 6.3%, while the PID rate declined by 6.7%. Amoxicillin and amoxicillin with an enzyme inhibitor were the most often prescribed products, followed by clindamycin, clarithromycin, doxycycline, azithromycin and metronidazole. The proportion of amoxicillin relative to amoxicillin with an enzyme inhibitor was low. The narrow-spectrum antibiotic penicillin V was almost never prescribed.
CONCLUSIONS
Antibiotics typically classified as broad- or extended-spectrum were prescribed most often by Belgian dentists during the period 2000-2016. Although the DID rate of all 'Antibacterials for systemic use' (J01) increased over the years, the number of prescriptions per dentist decreased since 2013. The high prescription level of amoxicillin with an enzyme inhibitor is particularly worrying. It indicates that there is a need for comprehensive clinical practice guidelines for Belgian dentists.
目的
描述 2010 年至 2016 年期间，比利时口腔医疗机构的牙医开具抗菌药物处方的情况。
材料和方法
对比利时国家健康和残疾保险研究所的报销数据进行分析，以评估抗菌药物的使用情况（WHO ATC 代码 J01/P01AB）。使用限定日剂量（DDD）表示利用情况，并分别以每千名居民每日 DDD 和包装数（DID 和 PID）表示。此外，还计算了每位医生开具的 DDD 和包装数。
结果
2016 年，“全身用抗菌药物”（J01）和“抗寄生虫药”（P01AB）的处方率分别为 1.607 和 0.014 DDD。2010 年至 2016 年，J01 的 DID 率增加了 6.3%，而 PID 率下降了 6.7%。阿莫西林和阿莫西林与酶抑制剂是最常开的药物，其次是克林霉素、克拉霉素、多西环素、阿奇霉素和甲硝唑。阿莫西林与酶抑制剂的比例较低。窄谱抗生素青霉素 V 几乎从未开出处方。
结论
2000-2016 年期间，比利时牙医最常开的是通常被归类为广谱或扩展谱的抗生素。尽管所有“全身用抗菌药物”（J01）的 DID 率多年来有所增加，但自 2013 年以来，每位牙医的处方数量有所减少。阿莫西林与酶抑制剂的高处方水平尤其令人担忧。这表明比利时牙医需要制定全面的临床实践指南。
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