Leslie Dan Faculty of Pharmacy at the University of Toronto, Toronto, Ontario, Canada.
Women's College Hospital Research Institute, Toronto, Ontario, Canada.
J Antimicrob Chemother. 2021 Aug 12;76(9):2472-2478. doi: 10.1093/jac/dkab205.
On 1 November 2018, Choosing Wisely Canada launched their Using Antibiotics Wisely primary care campaign, which aimed to reduce unnecessary antibiotic prescriptions for respiratory tract infections (RTIs) through educational tools for patients and providers.
We explored the impact of this campaign on antibiotic utilization in Canada.
We conducted a population-based study in Canada between January 2015 and December 2019. We used interventional autoregressive integrated moving average models to study the impact of the Using Antibiotics Wisely campaign on the prescribing rate (prescriptions per 1000 population) of RTI-indicated antibiotics. We analysed prescription rates overall and stratified by age group, drug class and province, in each month over the study period.
There was a 1.5% reduction in the annual prescribing rate of RTI-indicated antibiotics over the study period, which was generally consistent across age groups and provinces. Following the 2018 Using Antibiotics Wisely clinician toolkit release, we observed no significant change in RTI-indicated antibiotic prescribing rates nationally (P = 0.13). This was consistent by age group (children, P = 0.91; adults, P = 0.58; and older adults, P = 0.67) and drug class (narrow-spectrum penicillins, P = 0.88; macrolides, P = 0.85; broad-spectrum penicillins, P = 0.60; cephalosporins, P = 0.45; tetracyclines, P = 0.55; and fluoroquinolones, P = 0.98). In our secondary analysis of prescription rates in provinces that self-identified as prioritizing Using Antibiotics Wisely, we observed no significant change following the launch of the campaign.
The introduction of the Using Antibiotics Wisely campaign in Canada has not caused a significant change in short-term antibiotic prescribing patterns. Community antibiotic stewardship campaigns that include components beyond education may be more impactful.
2018 年 11 月 1 日，加拿大明智选择（Choosing Wisely Canada）推出了明智使用抗生素初级保健运动，旨在通过为患者和医疗服务提供者提供教育工具来减少不必要的呼吸道感染（RTI）抗生素处方。
我们探讨了该运动对加拿大抗生素使用的影响。
我们在 2015 年 1 月至 2019 年 12 月期间在加拿大进行了一项基于人群的研究。我们使用干预自回归综合移动平均模型来研究明智使用抗生素运动对 RTI 指征抗生素处方率（每 1000 人处方数）的影响。我们分析了研究期间每个月的总体处方率以及按年龄组、药物类别和省份分层的处方率。
在研究期间，RTI 指征抗生素的年处方率下降了 1.5%，这在各个年龄组和省份基本一致。在 2018 年明智使用抗生素临床医生工具包发布后，我们没有观察到全国范围内 RTI 指征抗生素处方率的显著变化（P=0.13）。这在年龄组（儿童，P=0.91；成人，P=0.58；老年人，P=0.67）和药物类别（窄谱青霉素，P=0.88；大环内酯类，P=0.85；广谱青霉素，P=0.60；头孢菌素，P=0.45；四环素类，P=0.55；氟喹诺酮类，P=0.98）上都是一致的。在我们对自我认定为优先考虑明智使用抗生素的省份的处方率的二次分析中，我们没有观察到运动启动后的显著变化。
加拿大明智使用抗生素运动的引入并没有导致短期抗生素处方模式的显著变化。可能需要包括教育以外的其他措施的社区抗生素管理运动才能更有影响力。
