Antibiotic use in ambulatory care in Europe (ESAC data 1997–2002): trends, regional differences and seasonal fluctuations

2006 ◽  
Vol 16 (1) ◽  
pp. 115-123 ◽  
Author(s):  
Monique M. Elseviers ◽  
Matus Ferech ◽  
Robert H. Vander Stichele ◽  
Herman Goossens ◽  
Keyword(s):  
Ambulatory Care ◽  
Regional Differences ◽  
Antibiotic Use ◽  
Seasonal Fluctuations

scholarly journals Antibiotic Prescriptions among China Ambulatory Care Visits of Pregnant Women: A Nationwide Cross-Sectional Study

Antibiotics ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 601
Author(s):  
Houyu Zhao ◽  
Mei Zhang ◽  
Jiaming Bian ◽  
Siyan Zhan
Keyword(s):  
Pregnant Women ◽  
Ambulatory Care ◽  
National Level ◽  
Mainland China ◽  
Antibiotic Use ◽  
First Trimester ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Fetal Safety ◽  
First Trimester Of Pregnancy

Background: Antibiotic use in pregnant women at the national level has rarely been reported in China. Objectives: We aimed to investigate antibiotic prescriptions during pregnancy in ambulatory care settings in China. Methods: Data of 4,574,961 ambulatory care visits of pregnant women from October 2014 to April 2018 were analyzed. Percentages of Antibiotic prescriptions by different subgroups and various diagnosis categories and proportions of inappropriate antibiotic prescriptions for different subgroups were estimated. Food and Drug Administration (FDA) pregnancy categories were used to describe the antibiotic prescription patterns. The 95% confidence intervals (CIs) were estimated using the Clopper––Pearson method or Goodman method. Results: Among the 4,574,961 outpatient visits during pregnancy, 2.0% (92,514 visits; 95% CI, 2.0–2.0%) were prescribed at least one antibiotic. The percentage of antibiotic prescriptions for pregnant women aged >40 years was 4.9% (95% CI, 4.7–5.0%), whereas that for pregnant women aged 26–30 years was 1.5% (95% CI, 1.4–1.5%). In addition, percentages of antibiotic prescriptions varied among different trimesters of pregnancy, which were 5.4% (95% CI, 5.3–5.4%) for the visits in the first trimester of pregnancy and 0.5% (95% CI, 0.4–0.5%) in the third trimester of pregnancy. Furthermore, the percentages of antibiotic prescriptions substantially varied among different diagnosis categories and nearly three-quarters of antibiotic prescriptions had no clear indications and thus might be inappropriate. In total, 130,308 individual antibiotics were prescribed; among these, 60.4% (95% CI, 60.0–60.8%) belonged to FDA category B, 2.7% (95% CI, 2.1–3.5%) were classified as FDA category D and 16.8% (95% CI, 16.2–17.4%) were not assigned any FDA pregnancy category. Conclusions: Antibiotic prescriptions in ambulatory care during pregnancy were not highly prevalent in mainland China. However, a substantial proportion of antibiotics might have been prescribed without adequate indications. Antibiotics whose fetal safety has not been sufficiently illustrated were widely used in pregnant women.

SEASONAL AND REGIONAL VARIATIONS IN THE UNSATURATED ACIDS OF ALBERTA BUTTERFAT

1957 ◽  
Vol 37 (1) ◽  
pp. 1-7 ◽  
Author(s):  
F. W. Wood ◽  
W. Haab
Keyword(s):  
Oleic Acid ◽  
Regional Differences ◽  
Seasonal Fluctuations ◽  
Regional Variations ◽  
Grazing Season ◽  
Polyunsaturated Acids ◽  
Iodine Values ◽  
Summer Minimum

Monthly samples of butterfat taken during 1953–54 from creameries at Edmonton and Lethbridge showed regional and seasonal fluctuations of iodine values and content of monoenoic and conjugated and non-conjugated dienoic, trienoic and tetraenoic acids. The total unsaturated acids content, as measured by iodine values, was higher in the Edmonton butterfats and reached a maximum in September at the end of the grazing season, while the lower Lethbridge maximum occurred in May with but slightly declining values throughout the summer. Minimum values were recorded during November and December for both regions. Maximum oleic acid occurrence did not coincide with the peak of the grazing season. Most of the polyunsaturated acids varied seasonally but marked regional differences were not observed. In general the latter constituents occurred in amounts comparable to those reported elsewhere. With the exception of the non-conjugated dienoic acids, summer values were high and winter values low. Conjugated tetraenoic acids were found in all butterfats but in trace amounts only.

scholarly journals 1007. A novel approach to evaluate antibiotic utilization across the spectrum of inpatient and ambulatory care and implications for prioritization of antibiotic stewardship efforts

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S354-S354
Author(s):  
Holly M Frost ◽  
Bryan C Knepper ◽  
Katherine C Shihadeh ◽  
Timothy C Jenkins
Keyword(s):  
Ambulatory Care ◽  
Healthcare System ◽  
Antibiotic Stewardship ◽  
Antibacterial Agent ◽  
Antibiotic Use ◽  
Urgent Care ◽  
Outpatient Clinics ◽  
Integrated Healthcare ◽  
Adult Outpatient ◽  
Systemic Antibacterial

Abstract Background Antibiotic overuse remains a significant problem in inpatient and outpatient settings. The objective of this study was to develop a methodology to evaluate antibiotic use across inpatient and ambulatory care sites in an integrated healthcare system in order to prioritize antibiotic stewardship efforts. Methods We conducted an epidemiologic study of antibiotic use across an integrated healthcare system on 12 randomly-selected days between October 1, 2017 and September 30, 2018. Inpatients and perioperative patients were recorded as having received an antibiotic if they were administered ≥1 dose of a systemic antibacterial agent. Outpatients were recorded as having received an antibiotic if they were prescribed ≥1 systemic antibacterial agent. Results On the study days, 10.9% (95% CI 10.6–11.3%) of patients received an antibiotic. Of all antibiotics administered or prescribed, 54.1% were from ambulatory care (95% CI 52.6–55.7%), 38.0% were from the hospital, (95% CI 36.6–39.5%), and 7.8% (95% CI 7.1–7.8%) were perioperative. The emergency department/urgent care centers, adult outpatient clinics, and adult noncritical care inpatient wards accounted for 26.4% (95% CI: 25.0–27.7%), 23.8% (95% CI: 22.6–25.2), and 23.9% (95% CI 22.7–25.3) of antibiotic use, respectively. Only 9.2% (95% CI: 8.3–10.1%) of all antibiotics were administered in critical care units. Antibiotics with a broad spectrum of Gram-negative activity accounted for 30.4% (95% CI: 29.0–31.9%) of all antibiotics prescribed. Infections of the respiratory tract were the leading indication for antibiotic use. Conclusion In an integrated healthcare system, nearly three-quarters of antibiotic use occurred in the emergency department/urgent care centers, adult outpatient clinics, and adult noncritical care inpatient wards. Antibiotics with a broad spectrum of Gram-negative activity accounted for a large portion of antibiotic use. Analysis of antibiotic utilization across the spectrum of inpatient and ambulatory care is useful to prioritize antibiotic stewardship efforts. Disclosures All authors: No reported disclosures.

scholarly journals Point-of-Care Testing for Pharyngitis in the Pharmacy

Antibiotics ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. 743
Author(s):  
Sabiha Essack ◽  
John Bell ◽  
Douglas Burgoyne ◽  
Wirat Tongrod ◽  
Martin Duerden ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Regional Differences ◽  
Point Of Care ◽  
Antibiotic Use ◽  
Community Pharmacies ◽  
Point Of Care Testing ◽  
Healthcare Settings ◽  
Group A ◽  
Limiting Condition ◽  
Opinion Article

Pharyngitis (also known as sore throat) is a common, predominately viral, self-limiting condition which can be symptomatically managed without antibiotic treatment. Inappropriate antibiotic use for pharyngitis contributes to the development and spread of antibiotic resistance. However, a small proportion of sore throats caused by group A streptococcal (GAS) infection may benefit from the provision of antibiotics. Establishing the cause of infection is therefore an important step in effective antibiotic stewardship. Point-of-care (POC) tests, where results are available within minutes, can distinguish between viral and GAS pharyngitis and can therefore guide treatment in primary healthcare settings such as community pharmacies, which are often the first point of contact with the healthcare system. In this opinion article, the evidence for the use of POC testing in the community pharmacy has been discussed. Evidence suggests that pharmacy POC testing can promote appropriate antibiotic use and reduce the need for general practitioner consultations. Challenges to implementation include cost, training and ‘who prescribes’, with country and regional differences presenting a particular issue. Despite these challenges, POC testing for pharyngitis has become widely available in pharmacies in some countries and may represent a strategy to contain antibiotic resistance and contribute to antimicrobial stewardship.

scholarly journals European Surveillance of Antimicrobial Consumption (ESAC): outpatient antibiotic use in Europe, 1998-2005

2007 ◽  
Vol 12 (41) ◽  
Author(s):  
A Muller ◽  
S Coenen ◽  
D. L. Monnet ◽  
H Goossens ◽  
Keyword(s):  
Ambulatory Care ◽  
Antibiotic Use ◽  
European Countries ◽  
Antimicrobial Consumption

The European Surveillance of Antimicrobial Consumption (ESAC) project collects data on antimicrobial consumption in ambulatory care and hospital settings from 34 European countries.

scholarly journals Significant Regional Differences in Antibiotic Use Across 576 US Hospitals and 11 701 326 Adult Admissions, 2016–2017

2020 ◽  
Author(s):  
Katherine E Goodman ◽  
Sara E Cosgrove ◽  
Lisa Pineles ◽  
Laurence S Magder ◽  
Deverick J Anderson ◽  
...  
Keyword(s):  
Regional Differences ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Antibiotic Use ◽  
Fourth Generation ◽  
Teaching Hospitals ◽  
Antibiotic Prescribing ◽  
Healthcare Database ◽  
Days Of Therapy ◽  
Adult Inpatient

Abstract Background Quantifying the amount and diversity of antibiotic use in United States hospitals assists antibiotic stewardship efforts but is hampered by limited national surveillance. Our study aimed to address this knowledge gap by examining adult antibiotic use across 576 hospitals and nearly 12 million encounters in 2016–2017. Methods We conducted a retrospective study of patients aged ≥ 18 years discharged from hospitals in the Premier Healthcare Database between 1 January 2016 and 31 December 2017. Using daily antibiotic charge data, we mapped antibiotics to mutually exclusive classes and to spectrum of activity categories. We evaluated relationships between facility and case-mix characteristics and antibiotic use in negative binomial regression models. Results The study included 11 701 326 admissions, totaling 64 064 632 patient-days, across 576 hospitals. Overall, patients received antibiotics in 65% of hospitalizations, at a crude rate of 870 days of therapy (DOT) per 1000 patient-days. By class, use was highest among β-lactam/β-lactamase inhibitor combinations, third- and fourth-generation cephalosporins, and glycopeptides. Teaching hospitals averaged lower rates of total antibiotic use than nonteaching hospitals (834 vs 957 DOT per 1000 patient-days; P < .001). In adjusted models, teaching hospitals remained associated with lower use of third- and fourth-generation cephalosporins and antipseudomonal agents (adjusted incidence rate ratio [95% confidence interval], 0.92 [.86–.97] and 0.91 [.85–.98], respectively). Significant regional differences in total and class-specific antibiotic use also persisted in adjusted models. Conclusions Adult inpatient antibiotic use remains high, driven predominantly by broad-spectrum agents. Better understanding reasons for interhospital usage differences, including by region and teaching status, may inform efforts to reduce inappropriate antibiotic prescribing.

scholarly journals Strategies to Improve Antimicrobial Utilization with a Special Focus on Developing Countries

Life ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 528
Author(s):  
Brian Godman ◽  
Abiodun Egwuenu ◽  
Mainul Haque ◽  
Oliver Ombeva Malande ◽  
Natalie Schellack ◽  
...  
Keyword(s):  
Ambulatory Care ◽  
Viral Infections ◽  
Respiratory Infections ◽  
Inappropriate Prescribing ◽  
Surgical Site Infections ◽  
Antibiotic Use ◽  
Special Focus ◽  
Antimicrobial Utilization ◽  
Improvement Programs ◽  
Current Concerns

Antimicrobial resistance (AMR) is a high priority across countries as it increases morbidity, mortality and costs. Concerns with AMR have resulted in multiple initiatives internationally, nationally and regionally to enhance appropriate antibiotic utilization across sectors to reduce AMR, with the overuse of antibiotics exacerbated by the COVID-19 pandemic. Effectively tackling AMR is crucial for all countries. Principally a narrative review of ongoing activities across sectors was undertaken to improve antimicrobial use and address issues with vaccines including COVID-19. Point prevalence surveys have been successful in hospitals to identify areas for quality improvement programs, principally centering on antimicrobial stewardship programs. These include reducing prolonged antibiotic use to prevent surgical site infections. Multiple activities centering on education have been successful in reducing inappropriate prescribing and dispensing of antimicrobials in ambulatory care for essentially viral infections such as acute respiratory infections. It is imperative to develop new quality indicators for ambulatory care given current concerns, and instigate programs with clear public health messaging to reduce misinformation, essential for pandemics. Regular access to effective treatments is needed to reduce resistance to treatments for HIV, malaria and tuberculosis. Key stakeholder groups can instigate multiple initiatives to reduce AMR. These need to be followed up.

scholarly journals Using Belgian pharmacy dispensing data to assess antibiotic use for children in ambulatory care

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Hannelore Dillen ◽  
Ruben Burvenich ◽  
Tine De Burghgraeve ◽  
Jan Y. Verbakel
Keyword(s):  
Ambulatory Care ◽  
Rural Areas ◽  
Population Data ◽  
Antibiotic Use ◽  
Relative Reduction ◽  
Antibiotic Prescribing ◽  
Prescribing Practices ◽  
Diagnostic Uncertainty ◽  
Pharmacy Dispensing Data ◽  
Dispensing Data

Abstract Background The desired effect of antibiotics is compromised by the rapid escalation of antimicrobial resistance. Children are particularly at high-risk for unnecessary antibiotic prescribing, which is owing to clinicians’ diagnostic uncertainty combined with parents’ concerns and expectations. Recent Belgian data on ambulatory antibiotic prescribing practices for children are currently lacking. Therefore, we aim to analyse different aspects of antibiotic prescriptions for children in ambulatory care. Methods Pharmacy dispensing data on antibiotics for systematic use referring from 2010 to 2019 were retrieved from Farmanet, a database of pharmaceutical dispensations in community pharmacies. Population data were obtained from the Belgian statistical office (Statbel). Descriptive statistics were performed in Microsoft Excel. The Mann-Kendall test for trend analysis and the seasplot function for seasonality testing were conducted in R. Results The past decade, paediatric antibiotic use and expenditures have relatively decreased in Belgian ambulatory care with 35.5% and 44.3%, respectively. The highest volumes of antibiotics for children are prescribed by GPs working in Walloon region and rural areas, to younger children, and during winter. The most prescribed class of antibiotics for children are the penicillins and the biggest relative reduction in number of packages is seen for the sulfonamides and trimethoprim and quinolone antibacterials. Conclusions Paediatric antibiotic use has decreased in Belgian ambulatory care. Further initiatives are needed to promote prudent antibiotic prescribing in ambulatory care.

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