Fortin Patrick, Fortin Élise, Sirois Caroline, Quach Caroline, Simard Marc, Magali-Ufitinema Nadine, Sauvageau Chantal
Institut National de Santé Publique du Québec, Quebec, Quebec, Canada.
Département de Médecine Sociale et Préventive, Université Laval, Quebec, Quebec, Canada.
BMJ Open. 2025 Aug 27;15(8):e096283. doi: 10.1136/bmjopen-2024-096283.
To describe community antibiotic utilisation in Quebec from 2018 to 2022 and to measure the combined impact of the COVID-19 pandemic and of the number of comorbidities on utilisation rates.
Data from the Quebec Integrated Chronic Disease Surveillance System were used to describe monthly (for the overall antibiotics use) and annual (for the main antibiotic classes) changes in antibiotic utilisation rates from 2018 to 2022, stratified by the number of comorbidities (0, 1, 2 and ≥3) and age group (0-17, 18-64 and ≥65 years old). Poisson regression was used to measure the impact of the pandemic and of comorbidities on antibiotic utilisation rates.
The study included an annual average of 424 792 children, 1 761 582 adults 18-64 years of age and 1 490 081 adults at least 65 years old. For each number of comorbidities within each age group, the utilisation rates of overall antibiotics decreased with the arrival of the pandemic and remained low despite the return of respiratory viruses in late summer 2021. This reduction was observed for all major antibiotic classes, except for fosfomycin/nitrofurantoin in adults. The pandemic and respiratory viruses' resurgence periods in adults (≥18 years) without comorbidities were associated with decreases of 25% (95% CI 25% to 25%) and 19% (18% to 19%) (children: 63% (62% to 63%) and 37% (36% to 38%)) in antibiotic utilisation compared with the prepandemic period. In adults with three or more comorbidities, utilisation decreased less, by 13% (12% to 14%) and 7% (6% to 8%) (children: 33% (21% to 43%) and 23% (8% to 35%)), respectively. Children with two comorbidities during the pandemic period also experienced a smaller decrease in antibiotic utilisation than children without comorbidities for the same period.
In Quebec, antibiotic utilisation decreased during the pandemic and remained low despite the resurgence of respiratory viruses in 2021. However, this decrease was less pronounced in individuals with multiple comorbidities.
描述2018年至2022年魁北克省社区抗生素的使用情况，并衡量新冠疫情和合并症数量对使用率的综合影响。
利用魁北克综合慢性病监测系统的数据，按合并症数量（0、1、2和≥3）和年龄组（0 - 17岁、18 - 64岁和≥65岁）分层，描述2018年至2022年抗生素使用率的月度（针对总体抗生素使用情况）和年度（针对主要抗生素类别）变化。采用泊松回归分析来衡量疫情和合并症对抗生素使用率的影响。
该研究纳入的年均儿童数量为424,792名，18 - 64岁的成年人有1,761,582名，至少65岁的成年人有1,490,081名。在每个年龄组内，随着疫情的到来，无论合并症数量多少，总体抗生素的使用率均下降，并且尽管2021年夏末呼吸道病毒卷土重来，但使用率仍维持在较低水平。除成人使用的磷霉素/呋喃妥因外，所有主要抗生素类别的使用率均出现了这种下降情况。在无合并症的成年人（≥18岁）中，疫情期间和呼吸道病毒再次流行期间，抗生素使用率与疫情前相比分别下降了25%（95%置信区间为25%至25%）和19%（18%至19%）（儿童：63%（62%至63%）和37%（36%至38%））。在患有三种或更多合并症的成年人中，使用率下降幅度较小，分别为13%（12%至14%）和7%（6%至8%）（儿童：33%（21%至43%）和23%（8%至35%））。疫情期间患有两种合并症的儿童，其抗生素使用率下降幅度也小于同期无合并症的儿童。
在魁北克省，疫情期间抗生素使用率下降，尽管2021年呼吸道病毒再次流行，但使用率仍维持在较低水平。然而，在患有多种合并症的个体中，这种下降不太明显。
