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首页> 外文期刊>Clinical microbiology and infection: European Society of Clinical Microbiology and Infectious Diseases >Antibiotic use in adult outpatients in Switzerland in relation to regions, seasonality and point of care tests.
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Antibiotic use in adult outpatients in Switzerland in relation to regions, seasonality and point of care tests.

机译：瑞士成人门诊患者的抗生素使用情况，与地区，季节性和护理点测试有关。

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摘要

The use of antibiotics is highest in primary care and directly associated with antibiotic resistance in the community. We assessed regional variations in antibiotic use in primary care in Switzerland and explored prescription patterns in relation to the use of point of care tests. Defined daily doses of antibiotics per 1000 inhabitants (DDD(1000pd) ) were calculated for the year 2007 from reimbursement data of the largest Swiss health insurer, based on the anatomic therapeutic chemical classification and the DDD methodology recommended by WHO. We present ecological associations by use of descriptive and regression analysis. We analysed data from 1 067 934 adults, representing 17.1% of the Swiss population. The rate of outpatient antibiotic prescriptions in the entire population was 8.5 DDD(1000pd) , and varied between 7.28 and 11.33 DDD(1000pd) for northwest Switzerland and the Lake Geneva region. DDD(1000pd) for the three most prescribed antibiotics were 2.90 for amoxicillin and amoxicillin-clavulanate, 1.77 for fluoroquinolones, and 1.34 for macrolides. Regions with higher DDD(1000pd) showed higher seasonal variability in antibiotic use and lower use of all point of care tests. In regression analysis for each class of antibiotics, the use of any point of care test was consistently associated with fewer antibiotic prescriptions. Prescription rates of primary care physicians showed variations between Swiss regions and were lower in northwest Switzerland and in physicians using point of care tests. Ecological studies are prone to bias and whether point of care tests reduce antibiotic use has to be investigated in pragmatic primary care trials.
机译：初级保健中抗生素的使用最高，并且与社区中的抗生素耐药性直接相关。我们评估了瑞士初级保健中抗生素使用的地区差异，并探讨了与即时检验相关的处方模式。根据最大的瑞士健康保险公司的报销数据，根据世界卫生组织建议的解剖治疗化学分类和DDD方法，计算出2007年每千名居民的每日定义抗生素剂量（DDD（1000pd））。我们通过描述性和回归分析来呈现生态联系。我们分析了1 067 934名成年人的数据，占瑞士人口的17.1％。在整个人口中，门诊抗生素处方的比例为8.5 DDD（1000pd），瑞士西北部和日内瓦湖地区的门诊抗生素处方率在7.28和11.33 DDD（1000pd）之间变化。三种处方最多的抗生素的DDD（1000pd）对阿莫西林和阿莫西林克拉维酸盐为2.90，对氟喹诺酮类药物为1.77，对大环内酯类药物为1.34。 DDD（1000pd）较高的地区在抗生素使用中表现出较高的季节性变化，而在所有即时检验中的使用均较低。在对每种抗生素进行回归分析时，使用任何即时检验均与较少的抗生素处方相关。初级保健医师的处方率在瑞士各地区之间存在差异，在瑞士西北部和使用即时检验的医师中，处方率较低。生态学研究容易产生偏差，在实用的初级保健试验中必须对即时检验是否减少抗生素使用进行调查。

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