Abstract

Despite decades of stewardship efforts to combat antimicrobial resistance and quantify changes in use, the quality of antibiotic use in British Columbia (BC) remains unknown. As the overuse and misuse of antibiotics drives antibiotic resistance, it is imperative to expand surveillance efforts to examine the quality of antibiotic prescriptions. In late 2019, Canadian expected rates of antibiotic prescribing were developed for common infections. These rates were utilized to quantify the gap between the observed rates of prescribing and Canadian expected rates for antibiotic use for the province of BC. The prescribing data were extracted and matched to physician billing systems using anonymized patient identifiers from 1 January 2000 to 31 December 2018. Outpatient prescribing was further subdivided into community and emergency department settings and stratified by the following age groups: <2 years, 2–18 years, and ≥19 years. The proportions of physician visits that received antibiotic prescription were compared against the Canadian expected rates to quantify the unnecessary use for 18 common indications. Respiratory tract infections (RTI), including acute bronchitis, acute sinusitis, and acute pharyngitis, reported significant levels of overprescribing. Across all ages and health care settings, prescribing for RTI indications occurred at rates 2–8 times higher than the expected rates recommended by a group of expert Canadian physicians. Understanding the magnitude of unnecessary prescribing is a first step in delineating the provincial prescribing quality. The quantification of antibiotic overuse offers concrete targets for provincial stewardship efforts to reduce unnecessary prescribing by an average of 30% across both outpatient and emergency care settings.

Highlights

  • The misuse of antibiotics is a global crisis

  • Over the 19-year study period, we had a total of 3,490,585 unique patients, with an average of 447,107 unique patients per year prescribed an antibiotic for one of the 18 included indications across both community and emergency care (Table 1)

  • Unnecessary antibiotic use was most pronounced in respiratory tract indications (RTI) overall, including: acute bronchitis (53%), acute sinusitis (46%), and acute pharyngitis (46%), wherein all three age categories were prescribed in excess of at least 30%

Read more

Summary

Introduction

Over 30% of the antibiotic prescriptions in the United States were deemed inappropriate, and one third of the antibiotic prescriptions for upper respiratory tract infections (URTI) in Europe had no justification for their use [1,2]. Health Authority Interior Fraser Vancouver Coastal Vancouver Island Northern Missing expected antibiotic use [4,5]. These rates offer a concrete benchmark against which to weigh indication-specific antibiotic use and characterize the quality of prescribing. The expected rates for UK primary care have been available since 2018 and have been utilized to quantify inappropriate and unnecessary antibiotic use across many common indications, including urinary tract as well as upper and lower respiratory tract infections [5]

Objectives
Methods
Results
Discussion
Conclusion
Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call