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[私立门诊急性非肺炎性呼吸道感染的抗生素处方]

[Prescription of antibiotics in acute respiratory infections non-pneumonia in a private outpatient practice].

作者信息

Alvear Gonzalo, Santibáñez Luis, Sepúlveda Ricardo, Ramírez Víctor, Martínez Benjamín

机构信息

Integramédica, Santiago, Chile.

Escuela de Odontología, Universidad Mayor, Santiago, Chile.

出版信息

Rev Med Chil. 2022 Aug;150(8):1000-1009. doi: 10.4067/S0034-98872022000801000.

Abstract

BACKGROUND

The over prescription of antibiotics for acute respiratory infections is a major public health problem worldwide.

AIM

To evaluate the frequency of prescription of antibiotics for non-pneumonia acute respiratory infections in private outpatient clinics in individuals without chronic diseases or immunosuppression.

MATERIAL AND METHODS

All medical records of adult consultants in a national network of private ambulatory medical centers during May 2018 whose primary diagnosis corresponded to acute respiratory infections not pneumonia (ICD10) were identified and retrospectively analyzed, excluding those with chronic respiratory conditions or states of immunosuppression.

RESULTS

Of the 38,072 consultants (aged 36 years, 63% women) who met this criterion, 54% (n = 20,499) received a prescription for at least one antibiotic. The diagnoses that most frequently received this prescription were acute bronchitis (28.7%), acute sinusitis (16.5%) and acute tonsillitis (16.2%). The most frequently prescribed antibiotic globally was azithromycin (37.4%), followed by amoxicillin (20.1%) and amoxicillin plus clavulanic acid (17.7%). Levofloxacin prescription reached 12.5% of total prescriptions.

CONCLUSIONS

An antibiotic was prescribed in more than half of the non-pneumonia outpatient acute respiratory infections. Azithromycin was the most prescribed antibiotic, while levofloxacin exceeded 10% of prescriptions. These results reinforce the need to implement an antibiotic prescription surveillance system at the outpatient level.

摘要

背景

急性呼吸道感染抗生素的过度处方是全球主要的公共卫生问题。

目的

评估在无慢性疾病或免疫抑制的个体中,私立门诊诊所针对非肺炎急性呼吸道感染的抗生素处方频率。

材料与方法

确定并回顾性分析了2018年5月期间全国私立门诊医疗中心网络中成年会诊医生的所有病历,其主要诊断对应于非肺炎急性呼吸道感染(国际疾病分类第10版),排除患有慢性呼吸道疾病或免疫抑制状态的患者。

结果

在符合该标准的38072名会诊医生(年龄36岁,63%为女性)中,54%(n = 20499)接受了至少一种抗生素的处方。最常接受该处方的诊断为急性支气管炎(28.7%)、急性鼻窦炎(16.5%)和急性扁桃体炎(16.2%)。全球最常处方的抗生素是阿奇霉素(37.4%),其次是阿莫西林(20.1%)和阿莫西林加克拉维酸(17.7%)。左氧氟沙星处方占总处方的12.5%。

结论

超过一半的非肺炎门诊急性呼吸道感染患者开具了抗生素。阿奇霉素是最常处方的抗生素,而左氧氟沙星超过了处方的10%。这些结果强化了在门诊层面实施抗生素处方监测系统的必要性。

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