Koh Sky Wei Chee, Low Si Hui, Goh Jun Cong, Hsu Li Yang
National University Polyclinics, National University Health System, Singapore 119228, Singapore.
Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore.
Antibiotics (Basel). 2025 Mar 17;14(3):309. doi: 10.3390/antibiotics14030309.
: The COVID-19 pandemic has disrupted antibiotic use; easing public health measures may alter infection presentations and antibiotic prescribing in primary care. The study investigated post-pandemic antibiotic utilisation trends in primary care. : A multi-centre, retrospective cohort study was conducted across seven public primary care clinics in Western Singapore, which included all patients prescribed oral antibiotics between 2022 and 2023. Descriptive statistics were used to visualise the prevalence and conditions of the prescribed antibiotics. Antibiotic quality was evaluated using the WHO's AWaRe (access, watch, reserve) classification. Antibiotic use was quantified using the number of items dispensed per 1000 inhabitants (NTI), defined daily doses (DDD) per 1000 inhabitants per day (DID), and DDD per 100 visits. Segmented regression analysis was applied to monthly prescriptions to assess the utilisation trends. : Antibiotic prescription rates increased significantly, from 3.5% in 2022 to 4.0% in 2023 ( = 0.001), with a 9.5% relative increase (38,920 prescriptions for 1,112,574 visits to 42,613 prescriptions for 1,063,646 visits). Respiratory conditions drove the increase in antibiotics use, with a 68.3% rise in prescriptions, with upper respiratory tract infections being the most common diagnosis for antibiotic prescriptions (n = 9296 prescriptions in 2023), with a steady monthly upward trend. Access group antibiotics accounted for >90% of prescriptions. The most antibiotics were prescribed for acne, with 36,304 DDD per 100 visits in 2023. Both NTI and DID significantly increased in 2022, largely contributed by a >100% increase in Watch group antibiotic use. Total antibiotic NTI dipped slightly in 2023, with a stable trend in both NTI and DID for all antibiotics. : The post-COVID-19 pandemic surge in the antibiotic prescription rate for respiratory conditions and Watch group antibiotic use highlight the need for targeted stewardship interventions. Optimising acne treatment and diagnosis coding are key strategies to further reduce unnecessary prescriptions.
新冠疫情扰乱了抗生素的使用；放松公共卫生措施可能会改变基层医疗中的感染表现和抗生素处方情况。本研究调查了基层医疗中疫情后抗生素的使用趋势。：在新加坡西部的七家公立基层医疗诊所开展了一项多中心回顾性队列研究，纳入了2022年至2023年间所有开具口服抗生素的患者。使用描述性统计来呈现所开具抗生素的流行情况和病症。使用世界卫生组织的AWaRe（使用、观察、储备）分类法评估抗生素质量。抗生素使用情况通过每1000名居民的配药数量（NTI）、每1000名居民每天的限定日剂量（DDD）（DID）以及每100次就诊的DDD来量化。对月度处方应用分段回归分析以评估使用趋势。：抗生素处方率显著上升，从2022年的3.5%升至2023年的4.0%（=0.001），相对增长9.5%（1112574次就诊的38920张处方增至1063646次就诊的42613张处方）。呼吸道疾病导致抗生素使用增加，处方量上升了68.3%，上呼吸道感染是抗生素处方最常见的诊断（2023年有9296张处方），且呈每月稳步上升趋势。使用组抗生素占处方的90%以上。痤疮的抗生素处方量最多，2023年每100次就诊有36304 DDD。NTI和DID在2022年均显著增加，主要是由于观察组抗生素使用量增加了100%以上。2023年抗生素总NTI略有下降，所有抗生素的NTI和DID均呈稳定趋势。：新冠疫情后呼吸道疾病抗生素处方率的激增以及观察组抗生素的使用凸显了有针对性的管理干预措施的必要性。优化痤疮治疗和诊断编码是进一步减少不必要处方的关键策略。
