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全科医生为 SARS-CoV-2 感染诊断患者开具抗生素处方:对法国电子健康记录的分析。

Prescription of antibiotics by general practitioners for patients with a diagnosis of SARS- CoV-2 infection: Analysis of an electronic French health record.

机构信息

Infectious Diseases Unit, Groupe Hospitalier Sud Ile de France, Melun, France; DYNAMIC research Unit, Université Paris-Est-Creteil, France.

Infectious Diseases Unit, Groupe Hospitalier Sud Ile de France, Melun, France.

出版信息

Int J Antimicrob Agents. 2023 May;61(5):106778. doi: 10.1016/j.ijantimicag.2023.106778. Epub 2023 Mar 10.

DOI:10.1016/j.ijantimicag.2023.106778
PMID:36905947
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9998278/
Abstract

OBJECTIVE

To define the factors associated with overprescription of antibiotics by general practitioners (GPs) for patients diagnosed with COVID-19 during the first wave of the pandemic.

METHODS

Anonymised electronic prescribing records of 1370 GPs were analysed. Diagnosis and prescriptions were retrieved. The initiation rate by GP for 2020 was compared with 2017-2019. Prescribing habits of GPs who initiated antibiotics for > 10% of COVID-19 patients were compared with those who did not. Regional differences in prescribing habits of GPs who had consulted at least one COVID-19 patient were also analysed.

RESULTS

For the March-April 2020 period, GPs who initiated antibiotics for > 10% of COVID-19 patients had more consultations than those who did not. They also more frequently prescribed antibiotics for non-COVID-19 patients consulting with rhinitis and broad-spectrum antibiotics for treating cystitis. Finally, GPs in the Île-de-France region saw more COVID-19 patients and more frequently initiated antibiotics. General practitioners in southern France had a higher but non-significant ratio of azithromycin initiation rate over total antibiotic initiation rate.

CONCLUSION

This study identified a subset of GPs with overprescribing profiles for COVID-19 and other viral infections; they also tended to prescribe broad-spectrum antibiotics for a long duration. There were also regional differences concerning antibiotic initiation rates and the ratio of azithromycin prescribed. It will be necessary to evaluate the evolution of prescribing practices during subsequent waves.

摘要

目的

定义与全科医生(GP)治疗 COVID-19 患者时过度开具抗生素相关的因素,该研究在大流行的第一波期间进行。

方法

分析了 1370 名全科医生匿名电子处方记录。检索诊断和处方。比较了 2020 年和 2017-2019 年的起始率。比较了为超过 10%的 COVID-19 患者开抗生素的 GP 与未开抗生素的 GP 的处方习惯。还分析了至少咨询过一位 COVID-19 患者的 GP 之间的处方习惯的区域差异。

结果

对于 2020 年 3 月至 4 月期间,为超过 10%的 COVID-19 患者开抗生素的 GP 比未开抗生素的 GP 有更多的就诊量。他们也更频繁地为因鼻炎就诊的非 COVID-19 患者和为治疗膀胱炎而开广谱抗生素。最后,法兰西岛地区的 GP 看到更多的 COVID-19 患者,并且更频繁地开抗生素。法国南部的 GP 开始使用阿奇霉素的比率高于总抗生素开始使用比率,但无统计学意义。

结论

本研究确定了一组在 COVID-19 及其他病毒感染方面过度开具抗生素的 GP,他们也倾向于长时间开具广谱抗生素。在抗生素起始率和开阿奇霉素的比率方面也存在区域差异。需要评估在随后的波次中处方实践的演变。

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Knowledge, attitude, and practice (KAP) of antimicrobial prescription and its resistance among health care providers in the COVID-19 era: A cross sectional study.在 COVID-19 时代,医疗保健提供者对抗菌药物处方及其耐药性的知识、态度和实践(KAP):一项横断面研究。
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