Division of Population Health and Genomics, University of Dundee School of Medicine, Dundee, UK
Division of Population Health and Genomics, University of Dundee School of Medicine, Dundee, UK.
BMJ Open. 2024 Apr 19;14(4):e081930. doi: 10.1136/bmjopen-2023-081930.
This study aims to examine community antibiotic prescribing across a complete geographical area for people with a positive COVID-19 test across three pandemic waves, and to examine health and demographic factors associated with antibiotic prescribing.
A population-based study using administrative data.
A complete geographical region within Scotland, UK.
Residents of two National Health Service Scotland health boards with SARS-CoV-2 virus test results from 1 February 2020 to 31 March 2022 (n=184 954). Individuals with a positive test result (n=16 025) had data linked to prescription and hospital admission data ±28 days of the test, general practice data for high-risk comorbidities and demographic data.
The associations between patient factors and the odds of antibiotic prescription in COVID-19 episodes across three pandemic waves from multivariate binary logistic regression.
Data included 768 206 tests for 184 954 individuals, identifying 16 240 COVID-19 episodes involving 16 025 individuals. There were 3263 antibiotic prescriptions ±28 days for 2395 episodes. 35.6% of episodes had a prescription only before the test date, 52.3% of episodes after and 12.1% before and after. Antibiotic prescribing reduced over time: 20.4% of episodes in wave 1, 17.7% in wave 2 and 12.0% in wave 3. In multivariate logistic regression, being female (OR 1.31, 95% CI 1.19 to 1.45), older (OR 3.02, 95% CI 2.50 to 3.68 75+ vs <25 years), having a high-risk comorbidity (OR 1.45, 95% CI 1.31 to 1.61), a hospital admission ±28 days of an episode (OR 1.58, 95% CI 1.42 to 1.77) and health board region (OR 1.14, 95% CI 1.03 to 1.25, board B vs A) increased the odds of receiving an antibiotic.
Community antibiotic prescriptions in COVID-19 episodes were uncommon in this population and likelihood was associated with patient factors. The reduction over pandemic waves may represent increased knowledge regarding COVID-19 treatment and/or evolving symptomatology.
本研究旨在调查在 COVID-19 检测呈阳性的人群中，在三个大流行波次期间，在一个完整的地理区域内社区开具抗生素的情况，并研究与抗生素开具相关的健康和人口统计学因素。
一项基于人群的研究，使用行政数据。
苏格兰，英国，一个完整的地理区域。
2020 年 2 月 1 日至 2022 年 3 月 31 日期间，有 SARS-CoV-2 病毒检测结果的两个苏格兰国民保健署（NHS）卫生局的居民（n=184954）。检测结果呈阳性的个体（n=16025）的数据与抗生素处方和住院数据（检测后±28 天）、一般实践高风险合并症数据和人口统计学数据相关联。
通过多元二项逻辑回归，分析患者因素与三个大流行波次中 COVID-19 发作期间使用抗生素的可能性之间的关联。
数据包括 768206 次针对 184954 人的检测，确定了 16025 名个体的 16240 例 COVID-19 发作。有 3263 例抗生素处方（±28 天）用于 2395 例发作。35.6%的发作在检测日期之前只有处方，52.3%的发作在检测日期之后，12.1%的发作在检测日期之前和之后。抗生素的开具随着时间的推移而减少：第 1 波次为 20.4%，第 2 波次为 17.7%，第 3 波次为 12.0%。多元逻辑回归显示，女性（比值比[OR]1.31，95%置信区间[CI]1.19 至 1.45）、年龄较大（OR 3.02，95%CI 2.50 至 3.68，75 岁及以上 vs <25 岁）、存在高风险合并症（OR 1.45，95%CI 1.31 至 1.61）、在发作后±28 天内住院（OR 1.58，95%CI 1.42 至 1.77）和卫生局区域（OR 1.14，95%CI 1.03 至 1.25，卫生局 B 与 A）增加了接受抗生素治疗的几率。
在该人群中，COVID-19 发作时社区开具抗生素的情况并不常见，可能性与患者因素相关。在大流行波次期间的减少可能反映了 COVID-19 治疗知识的增加和/或症状的演变。
