社区获得性肺炎的抗生素治疗：丹麦全科医疗中的问卷调查

Antibiotic treatment of community-acquired pneumonia: A questionnaire survey in Danish general practice.

作者信息

Eggers-Kaas Lotti, Bisgaard Lise, Thomsen Janus Laust, Jarbøl Dorte Ejg, Llor Carl, Christensen Morten Bondo, Bjerrum Lars, Siersma Volkert, Hansen Malene Plejdrup

机构信息

Center for General Practice, Aalborg University, Aalborg, Denmark.

Research Unit of General Practice, Department for Public Health, University of Southern Denmark, Odense, Denmark.

出版信息

Basic Clin Pharmacol Toxicol. 2022 Jan;130(1):151-157. doi: 10.1111/bcpt.13684. Epub 2021 Nov 16.

DOI:10.1111/bcpt.13684

PMID:34747101

Abstract

BACKGROUND

Discrepancies exist in Danish guidelines for the treatment of bacterial community-acquired pneumonia (CAP). This study aimed to investigate how general practitioners (GPs) treat adults with CAP and explore associations between GP characteristics and treatment duration.

METHODS

In autumn 2020, GPs in the North Denmark Region were asked to complete an electronic questionnaire on antibiotic prescribing for CAP. Information about GP gender, age, experience and type of practice was obtained. Multivariable logistic regression was used to analyse the association between GP characteristics and treatment duration.

RESULTS

A total of 298 GPs were invited to participate of whom 108 completed the survey. Penicillin V was used as first line treatment for CAP by all participants. Treatment duration varied from 5 (54.6%) to 10 days (8.3%). A 5-day course of penicillin was less likely to be prescribed by male GPs (odds ratio [OR] 0.35, 95% confidence interval [CI] 0.13-0.94) and more likely to be prescribed by GPs with 5-9 years of experience in general practice (OR 5.03, 95% CI 1.09-23.21) compared to those with 10-19 years of experience.

CONCLUSION

Variation in antibiotic treatment of CAP emphasises the importance of generating solid evidence about the optimal duration regarding both effectiveness and safety.

摘要

背景

丹麦关于细菌性社区获得性肺炎（CAP）治疗的指南存在差异。本研究旨在调查全科医生（GP）如何治疗成人CAP，并探讨全科医生特征与治疗持续时间之间的关联。

方法

2020年秋季，丹麦北部地区的全科医生被要求完成一份关于CAP抗生素处方的电子问卷。获取了有关全科医生的性别、年龄、经验和执业类型的信息。采用多变量逻辑回归分析全科医生特征与治疗持续时间之间的关联。

结果

共邀请了298名全科医生参与，其中108名完成了调查。所有参与者均将青霉素V用作CAP的一线治疗药物。治疗持续时间从5天（54.6%）到10天（8.3%）不等。与有10 - 19年经验的全科医生相比，男性全科医生开具5天疗程青霉素的可能性较小（比值比[OR] 0.35，95%置信区间[CI] 0.13 - 0.94），而有5 - 9年全科执业经验的全科医生开具的可能性较大（OR 5.03，95% CI 1.09 - 23.21）。