MSD, Clos du Lynx 5, Sint-Lambrechts-Woluwe, 1200, Brussels, Belgium.
Real World Evidence, IQVIA, Zaventem, Belgium.
BMC Infect Dis. 2021 Nov 11;21(1):1150. doi: 10.1186/s12879-021-06848-4.
Varicella is a highly contagious infection that typically occurs in childhood. While most cases have a generally benign outcome, infection results in a considerable healthcare burden and serious complications may occur.
The objective of this study was to characterize the burden of varicella in a real-world primary care setting in Belgium, including the rate of varicella-related complications, medication management and general practitioner (GP) visits.
The study was a retrospective observational study using data from a longitudinal patient database in a primary care setting in Belgium. Patients with a GP visit and a varicella diagnosis between January 2016 and June 2019 were eligible and data one month prior and three months after the diagnosis were included. Outcomes included varicella-related complications, antibiotic use, antiviral use, and GP follow-up visits. Antibiotic use could be specified by class of antibiotic and linked to a diagnosis. Complications were identified based on concomitant diagnosis with varicella during the study period.
3,847 patients with diagnosis of varicella were included, with a mean age of 8.4 years and a comparable distribution of gender. 12.6% of patients with varicella had a concomitant diagnosis of a varicella-related complication. During the follow-up period, 27.3% of patients with varicella were prescribed antibiotics, either systemic (19.8%) and/or topical (10.3%). The highest rate of antibiotic prescriptions was observed in patients with complications (63.5%) and in patients younger than 1 year (41.8%). Nevertheless, 5.3% of the patients were prescribed antibiotics without a concomitant diagnosis of another infection. The most commonly prescribed systemic antibiotics were amoxicillin alone or combined with beta-lactamase inhibitor, and thiamphenicol. Fusidic acid and tobramycin were the most prescribed topical antibiotics. Antivirals were prescribed for 2.7% of the study population. 4.7% of the patients needed a follow-up visit with their GP.
This study reports a substantial burden of varicella in a primary care setting in Belgium, with high rates of complications and antibiotic use.
水痘是一种高度传染性的感染，通常发生在儿童时期。虽然大多数病例的结局通常良好，但感染会导致相当大的医疗保健负担，并且可能发生严重的并发症。
本研究旨在描述比利时初级保健环境中水痘的负担，包括水痘相关并发症的发生率、药物管理和全科医生（GP）就诊情况。
这是一项回顾性观察性研究，使用了比利时初级保健环境中纵向患者数据库的数据。2016 年 1 月至 2019 年 6 月期间，有 GP 就诊和水痘诊断的患者符合条件，并纳入了诊断前一个月和后三个月的数据。结果包括水痘相关并发症、抗生素使用、抗病毒药物使用和 GP 随访就诊。抗生素的使用可按抗生素类别进行指定，并与诊断相关联。并发症是根据研究期间与水痘同时诊断出来的。
纳入了 3847 例水痘诊断患者，平均年龄为 8.4 岁，性别分布相当。12.6%的水痘患者同时诊断出与水痘相关的并发症。在随访期间，27.3%的水痘患者使用了抗生素，包括全身（19.8%）和/或局部（10.3%）。在有并发症的患者（63.5%）和年龄小于 1 岁的患者（41.8%）中，抗生素的处方率最高。然而，5.3%的患者在没有合并另一种感染诊断的情况下使用了抗生素。最常开的全身抗生素是阿莫西林单独或与β-内酰胺酶抑制剂联合使用，以及噻苯青霉素。夫西地酸和妥布霉素是最常开的局部抗生素。抗病毒药物用于 2.7%的研究人群。4.7%的患者需要与他们的 GP 进行随访就诊。
本研究报告了比利时初级保健环境中水痘的负担很大，并发症和抗生素的使用率都很高。
