Department of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands.
Department of Clinial Pharmacy and Toxicology, Leiden University Medical Center, Leiden, the Netherlands.
Prim Health Care Res Dev. 2021 Apr 5;22:e11. doi: 10.1017/S1463423621000116.
To study whether changes in drug preferences in the Dutch guideline for the treatment of Urinary Tract Infection (UTI) for General Practitioners (GPs) in 2013, resulted in corresponding changes in antibiotic dispensing.
For the treatment of uncomplicated UTI, nitrofurantoin remained the first choice, while fosfomycin became the second choice and changed ranks with trimethoprim. For a subsequent febrile UTI, ciprofloxacin became the first choice and changed ranks with amoxicillin/clavulanic acid, co-trimoxazole remained the third choice.
In this observational cross-sectional study, routinely collected dispensing data from the Dutch Foundation of Pharmaceutical Statistics from 2012 to 2017 were used. The number of women 18 years and older, treated with one of the guideline antibiotics for uncomplicated UTI and subsequent febrile UTI were analysed annually. Proportions were calculated. Data were stratified for age categories. Failure of uncomplicated UTI treatment was defined as the dispensing of an antibiotic for febrile UTI within 14 days after the dispensing of an antibiotic for uncomplicated UTI.
Data were available from 81% of all pharmacies in 2012 to 89% in 2017. Percentages of women dispensed nitrofurantoin were relatively stable with 87.4% in 2012 and 84.4% in 2017. Percentages of women dispensed fosfomycin increased from 5.4% in 2012 to 21.8% in 2017, whereas percentages of women dispensed trimethoprim decreased from 17.8% to 8.0%. Within age categories, the percentage of women dispensed fosfomycin increased from 12.4% in women 18-30 years old to 36.7% in women above 80 years old. Percentages of women dispensed antibiotics for febrile UTI remained stable at 5% annually. Percentages of women receiving ciprofloxacin increased from 1.9% in 2012 to 3.3% in 2017, while those receiving amoxicillin/clavulanic acid decreased from 2.9% to 1.8%. New guideline recommendations resulted in corresponding changes in dispensed antibiotics for uncomplicated UTI and subsequent febrile UTI. Drug choices differed for age categories.
研究 2013 年荷兰普通科医生尿路感染治疗指南中药物偏好的变化是否导致抗生素配药相应变化。
对于单纯性尿路感染的治疗，呋喃妥因仍然是首选药物，而磷霉素则成为了第二选择，并取代了甲氧苄啶。对于后续发热性尿路感染，环丙沙星成为了首选药物，取代了阿莫西林/克拉维酸，复方磺胺甲噁唑仍然是第三选择。
在这项观察性横断面研究中，使用了荷兰药物统计基金会 2012 年至 2017 年的常规收集配药数据。每年分析接受指南抗生素治疗的 18 岁及以上女性单纯性尿路感染和后续发热性尿路感染的人数。计算比例。数据按年龄类别分层。单纯性尿路感染治疗失败的定义为在单纯性尿路感染配药后 14 天内配药治疗发热性尿路感染的抗生素。
2012 年至 2017 年，81%的药店提供了数据，2017 年为 89%。2012 年和 2017 年接受呋喃妥因配药的女性比例相对稳定，分别为 87.4%和 84.4%。接受磷霉素配药的女性比例从 2012 年的 5.4%增加到 2017 年的 21.8%，而接受甲氧苄啶配药的女性比例从 17.8%下降到 8.0%。在年龄类别内，接受磷霉素配药的女性比例从 18-30 岁女性的 12.4%增加到 80 岁以上女性的 36.7%。每年接受发热性尿路感染抗生素治疗的女性比例稳定在 5%。接受环丙沙星配药的女性比例从 2012 年的 1.9%增加到 2017 年的 3.3%，而接受阿莫西林/克拉维酸配药的女性比例从 2.9%下降到 1.8%。新的指南建议导致单纯性尿路感染和后续发热性尿路感染的配药抗生素相应变化。不同年龄组的药物选择不同。
