比较皮肤科和非皮肤科门诊医生对化脓性汗腺炎的抗生素处方模式。
Comparing antibiotic prescribing patterns for hidradenitis suppurativa between dermatology and non-dermatology ambulatory providers.
作者信息
Tolson Hannah, Kikuchi Robin, Yamamoto Rebecca K, Sadrolashrafi Kaviyon, Guo Lily, Hao Audrey, Bilimoria Sara, Yee Danielle, Armstrong April W
机构信息
University of Arizona College of Medicine Phoenix Arizona USA.
Keck School of Medicine of University of Southern California Los Angeles California USA.
出版信息
Skin Health Dis. 2024 Aug 28;4(5):e451. doi: 10.1002/ski2.451. eCollection 2024 Oct.
BACKGROUND
Oral antibiotics are a mainstay of treatment for hidradenitis suppurativa (HS) primarily due to their anti-inflammatory and anti-microbial properties. Because antibiotics are frequently prescribed to treat HS, concerns exist regarding antibiotic stewardship. There is a paucity of literature comparing how antibiotic prescribing patterns for HS differ between dermatology and non-dermatology clinicians in the ambulatory setting.
OBJECTIVE
This study aims to compare the antibiotic prescribing patterns of dermatology versus non-dermatology clinicians treating HS in the ambulatory setting.
METHODS
We utilised the National Ambulatory Medical Care Survey (NAMCS) to identify visits for HS patients from 2005 to 2016. We performed multivariate logistic regression analysis to compare the likelihood of prescribing (1) antibiotics and (2) tetracyclines between dermatology and non-dermatology clinicians in the ambulatory setting.
RESULTS
We identified a total of 2 424 125 (weighted) HS visits. Approximately 28.0% of visits were conducted by dermatology clinicians, while 72.0% were conducted by non-dermatology clinicians. Antibiotics were prescribed in 51.9% of visits. Tetracyclines were the most commonly prescribed antibiotics among visits with dermatology clinicians (33.4%), while penicillins/cephalosporins were the most commonly prescribed antibiotic among visits with non-dermatology clinicians (14.9%). Multivariate logistic regression analysis demonstrated no difference in the overall likelihood of prescribing antibiotic therapy between dermatology and non-dermatology clinicians ( = 0.35). However, dermatology clinicians were significantly more likely to prescribe tetracyclines than non-dermatology clinicians (OR 5.48, 95% CI 1.19-25.26, = 0.03).
CONCLUSION
In conclusion, dermatology clinicians were significantly more likely to prescribe tetracyclines than non-dermatology clinicians for HS patient visits.
背景
口服抗生素是治疗化脓性汗腺炎（HS）的主要手段，主要是因为其具有抗炎和抗菌特性。由于抗生素常用于治疗HS，因此人们对抗生素管理存在担忧。在门诊环境中，比较皮肤科和非皮肤科临床医生治疗HS时抗生素处方模式差异的文献较少。
目的
本研究旨在比较门诊环境中治疗HS的皮肤科和非皮肤科临床医生的抗生素处方模式。
方法
我们利用国家门诊医疗调查（NAMCS）来确定2005年至2016年HS患者的就诊情况。我们进行了多变量逻辑回归分析，以比较皮肤科和非皮肤科临床医生在门诊环境中开具（1）抗生素和（2）四环素的可能性。
结果
我们共确定了2424125次（加权）HS就诊。约28.0%的就诊由皮肤科临床医生进行，而72.0%由非皮肤科临床医生进行。51.9%的就诊开具了抗生素。在皮肤科临床医生的就诊中，四环素是最常用的抗生素（33.4%），而在非皮肤科临床医生的就诊中，青霉素/头孢菌素是最常用的抗生素（14.9%）。多变量逻辑回归分析表明，皮肤科和非皮肤科临床医生开具抗生素治疗的总体可能性没有差异（=0.35）。然而，皮肤科临床医生比非皮肤科临床医生开具四环素的可能性显著更高（OR 5.48，95%CI 1.19-25.26，=0.03）。
结论
总之，在HS患者就诊中，皮肤科临床医生比非皮肤科临床医生开具四环素的可能性显著更高。
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