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Antimicrobial-Drug Prescription in Ambulatory Care Settings, United States, 1992–2000

机译：美国，1992–2000年，门诊医疗机构中的抗菌药物处方

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During the 1990s, as antimicrobial resistance increased among pneumococci, many organizations promoted appropriate antimicrobial use to combat resistance. We analyzed data from the National Ambulatory Medical Care Survey, an annual sample survey of visits to office-based physicians, and the National Hospital Ambulatory Medical Care Survey, an annual sample survey of visits to hospital emergency and outpatient departments, to describe trends in antimicrobial prescribing from 1992 to 2000 in the United States. Approximately 1,100–1,900 physicians reported data from 21,000–37,000 visits; 200–300 outpatient departments reported data for 28,000–35,000 visits; ~400 emergency departments reported data for 21,000–36,000 visits each year. In that period, the population- and visit-based antimicrobial prescribing rates in ambulatory care settings decreased by 23% and 25%, respectively, driven largely by a decrease in prescribing by office-based physicians. Antimicrobial prescribing rates changed as follows: amoxicillin and ampicillin, –43%; cephalosporins, –28%; erythromycin, –76%; azithromycin and clarithromycin, +388%; quinolones, +78%; and amoxicillin/clavulanate, +72%. This increasing use of azithromycin, clarithromycin, and quinolones warrants concern as macrolide- and fluoroquinolone-resistant pneumococci are increasing.
机译：在1990年代，随着肺炎链球菌中抗菌药物耐药性的增加，许多组织都在推广使用适当的抗菌药物来抵抗耐药性。我们分析了国家门诊医疗调查（对办公室医生的年度访问样本调查）和国家医院门诊医疗调查（对医院急诊和门诊部门的年度访问样本调查）的数据，以描述抗菌素的趋势从1992年到2000年在美国开出处方。大约1,100–1,900名医生报告了21,000–37,000次就诊的数据; 200–300个门诊部门报告了28,000–35,000次就诊的数据;约有400个急诊科报告了每年21,000–36,000次就诊的数据。在此期间，门诊医疗机构中以人群和就诊为基础的抗菌药物处方率分别下降了23％和25％，这主要是由于办公室医生处方的减少。抗菌药物处方率变化如下：阿莫西林和氨苄青霉素，–43％;头孢菌素，–28％;红霉素–76％;阿奇霉素和克拉霉素，+ 388％;喹诺酮类药物+ 78％;阿莫西林/克拉维酸+ 72％。随着对大环内酯类和对氟喹诺酮类药物耐药的肺炎球菌的增加，对阿奇霉素，克拉霉素和喹诺酮类药物的这种增加的使用值得关注。

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