McCaig L F, Hughes J M
Ambulatory Care Statistics Branch, Centers for Disease Control and Prevention, Hyattsville, MD.
JAMA. 1995 Jan 18;273(3):214-9.
To assess changes in oral antimicrobial drug prescribing by office-based physicians from 1980 through 1992, with emphasis on the treatment of otitis media and sinusitis and on the possible impact of demographic variables on such use.
The National Ambulatory Medical Care Survey is a sample survey of office-based physicians in the United States conducted by the National Center for Health Statistics, Centers for Disease Control and Prevention.
Physicians' offices.
Physicians sampled for the 1980, 1985, 1989, and 1992 National Ambulatory Medical Care Surveys, which included groups of 2959, 5032, 2540, and 3000 physicians, respectively. Sample physicians responding in 1980, 1985, 1989, and 1992 reported data for 46,081, 71,594, 38,384, and 34,606 sample office visits, respectively, including information on antimicrobial drug prescribing.
Trends in the antimicrobial drug prescription rates.
From 1980 through 1992, increasing prescribing measured by the annual drug prescription rate per 1000 population, was found for the more expensive, broad-spectrum antimicrobial drugs, such as the cephalosporins; decreasing rates were observed for less expensive antimicrobial drugs with a narrower spectrum, such as the penicillins. No trend was found for trimethoprim-sulfamethoxazole, the erythromycins, or the tetracyclines. During the decade, an increasing trend in the visit rate to office-based physicians for otitis media was observed, while the visit rate for sinusitis among adults was found to be higher in 1992 than in each of the other study years.
The increased use of broader-spectrum and more expensive antimicrobial drugs have implications for all patients because of the impact on health care costs and the potential for the emergence of antimicrobial resistance. The data suggest that the incidence of otitis media and sinusitis is increasing.
评估1980年至1992年门诊医生开具口服抗菌药物的变化情况，重点关注中耳炎和鼻窦炎的治疗以及人口统计学变量对此类用药的可能影响。
国家门诊医疗调查是由疾病控制和预防中心的国家卫生统计中心对美国门诊医生进行的抽样调查。
医生办公室。
1980年、1985年、1989年和1992年国家门诊医疗调查抽取的医生样本，分别包括2959名、5032名、2540名和3000名医生。1980年、1985年、1989年和1992年做出回应的样本医生分别报告了46081次、71594次、38384次和34606次样本门诊的数据，包括抗菌药物处方信息。
抗菌药物处方率的趋势。
1980年至1992年期间，发现每1000人口年药物处方率衡量的更昂贵的广谱抗菌药物（如头孢菌素）的处方量在增加；而谱较窄、价格较低的抗菌药物（如青霉素）的处方率则在下降。甲氧苄啶-磺胺甲恶唑、红霉素或四环素未发现有趋势变化。在这十年间，观察到因中耳炎到门诊医生处就诊的比率呈上升趋势，而1992年成人鼻窦炎的就诊率高于其他各研究年份。
广谱和更昂贵抗菌药物的使用增加对所有患者都有影响，因为这会影响医疗成本并可能导致抗菌药物耐药性的出现。数据表明中耳炎和鼻窦炎的发病率在上升。
