Skajaa Nils, Gehrt Lise, Nieminen Heta, Laake Ida, Englund Hélène, Sönksen Ute Wolff, Feiring Berit, Benn Christine Stabell, Trogstad Lill, Palmu Arto A, Sørup Signe
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
Clin Epidemiol. 2022 Aug 7;14:937-947. doi: 10.2147/CLEP.S362262. eCollection 2022.
To compare the use of antibiotics in children in four Northern European countries.
We conducted a register-based study based on individual-level prescription data from national prescription registers. We identified all redeemed outpatient prescriptions for systemic antibiotics in children aged 0-14 years from July 2006 to June 2017 in Denmark, Finland, Norway, and Sweden. We computed incidence rates and incidence rate ratios of treatment episodes with any antibiotic and different antibiotic classes.
In 2016/2017, the rates of antibiotic treatment episodes per 1000 person-years in children aged 0-14 years were 429, 284, 219, and 184 in Finland, Denmark, Sweden, and Norway, respectively, and the rate ratios (95% confidence intervals) compared with Norway were 2.33 (2.33-2.34), 1.54 (1.54-1.55), and 1.19 (1.19-1.20) in Finland, Denmark, and Sweden, respectively. The rate of antibiotic treatment episodes declined over time in all countries. The relative reductions in 2016/2017 compared with 2006/2007 were 36% in Finland, 40% in Denmark, 49% in Sweden, and 29% in Norway. Treatment episodes peaked between age 12 and 18 months. The most used antibiotic class was beta-lactamase sensitive penicillins among all children in Norway and Sweden and among children above two years in Denmark, while penicillins with extended spectrum were most used in Finland and among the youngest children in Denmark.
In all countries, the use of antibiotics in children declined between 2006 and 2017. However, there were still considerable differences in antibiotic use between otherwise quite similar Nordic countries, with a more than 2-fold difference between the countries with the lowest and highest rates. Interventions to reduce the number of antibiotic treatment episodes in the countries with higher rates could reduce the total antibiotic use.
比较北欧四个国家儿童抗生素的使用情况。
我们基于国家处方登记处的个人层面处方数据进行了一项基于登记的研究。我们确定了2006年7月至2017年6月期间丹麦、芬兰、挪威和瑞典0至14岁儿童所有已兑现的全身性抗生素门诊处方。我们计算了使用任何抗生素和不同抗生素类别的治疗发作的发病率和发病率比。
在2016/2017年，0至14岁儿童每1000人年的抗生素治疗发作率在芬兰、丹麦、瑞典和挪威分别为429、284、219和184，与挪威相比，芬兰、丹麦和瑞典的率比（95%置信区间）分别为2.33（2.33 - 2.34）、1.54（1.54 - 1.55）和1.19（1.19 - 1.20）。所有国家的抗生素治疗发作率随时间下降。与2006/2007年相比，2016/2017年芬兰下降了36%，丹麦下降了40%，瑞典下降了49%，挪威下降了29%。治疗发作在12至18个月龄时达到峰值。在挪威和瑞典的所有儿童以及丹麦两岁以上的儿童中，最常用的抗生素类别是对β-内酰胺酶敏感的青霉素，而广谱青霉素在芬兰和丹麦最小的儿童中使用最多。
在所有国家，2006年至2017年期间儿童抗生素的使用有所下降。然而，在其他方面相当相似的北欧国家之间，抗生素使用仍存在相当大的差异，最低和最高使用率国家之间相差两倍多。在抗生素使用率较高的国家采取干预措施减少抗生素治疗发作次数，可能会降低抗生素的总体使用量。
