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2010 至 2017 年丹麦老年人群体中的抗生素处方

Antibiotic prescribing in Danish general practice in the elderly population from 2010 to 2017.

机构信息

Department of Clinical Microbiology, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark.

The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.

出版信息

Scand J Prim Health Care. 2021 Dec;39(4):498-505. doi: 10.1080/02813432.2021.2004754. Epub 2021 Nov 24.

Abstract

OBJECTIVE

This study aimed to describe prescription of antibiotics to the elderly population in general practice in Denmark from 2010-2017.

DESIGN

This is a national register-based observational study.

SETTING

General practice, Denmark.

MAIN OUTCOME MEASURE

The main outcome measure was prescriptions/1,000 inhabitants/day (PrID) in relation to year, age and sex, indication, and antibiotic agent.

SUBJECTS

In this study, we included inhabitants of Denmark, ≥65 years of age between 01st July 2010-30th June 2017.

RESULTS

A total of 5,168,878 prescriptions were included in the study. Antibiotic prescriptions decreased from 2.2 PrID to 1.7 (-26.9%, CI95% [-31.1;-22.4]) PrID during the study. The decrease in PrID was most noticeable among 65-74-year-olds (-25%). The ≥85-year-olds were exposed to twice as many PrID than the 65-74-year-olds, but only accounted for 20% of the total use. Urinary tract infection (UTI) was the most common indication for antibiotic prescription and increased with advancing age. The most commonly prescribed antibiotics were pivmecillinam and phenoxymethylpenicillin. Prescribing with no informative indication was present in one third of all cases.

CONCLUSION

The prescription of antibiotics in the elderly population in general practice decreased from 2010 to 2017. The oldest age group was exposed twice as frequently to antibiotic prescriptions as the 65-74-year-olds. The smallest reduction was observed for the ≥85-year-olds, suggesting targeting interventions at this group.Key PointsHigh antibiotic use among elderly is well known and studies indicate mis- and overuse within this population. Our study shows.The prescription rate is decreasing within all age groups of the elderly population.The ≥85-year-olds receive twice as many prescriptions/1000/day as the 65-74-years-olds.

摘要

目的

本研究旨在描述 2010-2017 年丹麦全科医疗中老年人抗生素处方情况。

设计

这是一项全国性基于登记的观察性研究。

地点

丹麦的全科医疗。

主要观察指标

主要观察指标为每年、年龄和性别、适应证和抗生素药物相关的每千人处方数(PrID)。

研究对象

本研究纳入 2010 年 7 月 1 日至 2017 年 6 月 30 日期间≥65 岁的丹麦居民。

结果

共纳入 5168878 例处方。在研究期间,抗生素处方从 2.2 PrID 降至 1.7 PrID(-26.9%,95%CI95%[-31.1;-22.4])。65-74 岁年龄组的 PrID 下降最为显著(-25%)。≥85 岁年龄组的 PrID 是 65-74 岁年龄组的两倍,但仅占总用量的 20%。下尿路感染(UTI)是抗生素处方最常见的适应证,并随年龄增长而增加。最常开的抗生素是匹美西林和苯氧甲基青霉素。三分之一的处方没有明确适应证。

结论

2010 年至 2017 年,全科医疗中老年人的抗生素处方量有所减少。最年长的年龄组接受抗生素处方的频率是 65-74 岁年龄组的两倍。≥85 岁年龄组的降幅最小,提示应针对该组人群采取干预措施。

关键点

老年人抗生素使用量高已众所周知,研究表明该人群中存在误用和过度使用的情况。本研究显示:

  • 所有老年人群组的处方率都在下降。

  • ≥85 岁年龄组的每日处方数是 65-74 岁年龄组的两倍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bba6/8725860/ff2d3b22fd52/IPRI_A_2004754_F0001_B.jpg

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