Infectious Diseases Unit, Meir Medical Center, Kfar Saba, Israel; Department of Family Medicine, Sharon-Shomron District, Clalit Health Services, Kfar Saba, Israel.
Health Policy Department, Innovation and Research Division, Clalit Health Services, Tel Aviv, Israel.
Clin Microbiol Infect. 2022 Aug;28(8):1134-1139. doi: 10.1016/j.cmi.2022.02.035. Epub 2022 Mar 10.
This study investigated the association between the COVID-19 pandemic and antibiotic prescription ratios and the determinants of antibiotic prescription in the community.
The study was based on a retrospective population cohort of adults in a community setting. Antibiotic prescription ratios from March 1, 2020 to February 28, 2021 (COVID-19 period) were compared to similar months in previous years. Differences in visit type, infectious disease-related visit, and antibiotic prescription ratios during these visits were compared. A logistic regression model was used to identify independent determinants of antibiotic prescription during the study period.
The cohort included almost 3 million individuals with more than 33 million community medical encounters per year. In the COVID-19 period, the antibiotic prescription ratio decreased 45% (from 34.2 prescriptions/100 patients to 19.1/100) compared to the previous year. Visits due to an infectious disease etiology decreased by 10% and prescriptions per visit decreased by 39% (from 1 034 425 prescriptions/3 764 235 infectious disease visits to 587 379/3 426 451 respectively). This decrease was observed in both sexes and all age groups. Telemedicine visits were characterized by a 10% lower prescription ratio compared to in-person visits. Thus, a threefold increase in telemedicine visits resulted in a further decrease in prescription ratios. The COVID-19 period was independently associated with a decrease in antibiotic prescription, with an OR of 0.852 (95% CI 0.848-0.857).
We describe a significant decrease in antibiotic prescription ratios during the COVID-19 periods that was likely related to a decrease in the incidence of certain infectious diseases, the transfer to telemedicine, and a change in prescription practices among community-based physicians.
本研究旨在调查 COVID-19 大流行期间社区抗生素处方比率的变化情况及其相关决定因素。
本研究基于社区成年人群的回顾性队列研究。将 2020 年 3 月 1 日至 2021 年 2 月 28 日（COVID-19 期间）的抗生素处方比率与前几年同期进行比较。比较了不同就诊类型、与传染病相关的就诊以及这些就诊中抗生素处方比率的差异。采用 logistic 回归模型确定研究期间抗生素处方的独立决定因素。
该队列纳入了近 300 万人，每年有超过 3300 万次社区医疗就诊。与前一年相比，COVID-19 期间抗生素处方比率下降了 45%（从 34.2 处方/100 患者降至 19.1/100）。因传染病病因就诊的人数减少了 10%，每次就诊的处方量减少了 39%（从 3764235 次传染病就诊中的 1034425 张处方降至 3426451 次就诊中的 587379 张）。这种下降在男女和所有年龄段都观察到。与面对面就诊相比，远程医疗就诊的处方比率降低了 10%。因此，远程医疗就诊量增加三倍会进一步降低处方比率。COVID-19 期间与抗生素处方减少独立相关，比值比（OR）为 0.852（95%CI 0.848-0.857）。
我们描述了 COVID-19 期间抗生素处方比率显著下降，这可能与某些传染病发病率下降、向远程医疗转移以及社区医生处方习惯改变有关。
