https://scholars.lib.ntu.edu.tw/handle/123456789/507945
標題: | Policy-driven revolution of prescription record in outpatient use of fluoroquinolones | 作者: | Kuo, Shu Chen Shih, Shu Man Lauderdale, Tsai Ling Yang Chang, I. Shou YEE-CHUN CHEN Hsiung, Chao A. SHAN-CHWEN CHANG |
關鍵字: | Antibiotic | Fluoroquinolone | Physician practice pattern | Policy | Prescription;Antibiotic; Fluoroquinolone; Physician practice pattern; Policy; Prescription | 公開日期: | 1-二月-2020 | 卷: | 53 | 期: | 1 | 來源出版物: | Journal of Microbiology, Immunology and Infection | 摘要: | © 2018 Objective: A policy initiated in 2001 by Taiwan's National Health Insurance (NHI) Administration has effectively reduced outpatient antibiotic use except fluoroquinolones (FQs). The influence of differential regulation policy of narrow-spectrum versus broad-spectrum FQs on the prescriptions is unknown. Methods: This study analyzed the claim records of oral FQs prescription at outpatient visits during 2000–2010 using the NHI Research Database and compared prescriptions for narrow-spectrum FQs, which are inactive against Streptococcus pneumoniae and lack formulary restriction, with those for broad-spectrum FQs. Results: Oral antibiotics were prescribed in 13.3% of visits and FQs accounted for 2.2% of them. During the study period the population-based rates of FQ prescription visits to children decreased, which was offset by increased use in the adult and geriatric populations (all p < 0.001). The most common encoded diagnoses for all FQs were urinary tract infection (19.2%) and sinusitis (10.9%), skin/bone/joint infections (7.9%), and lower respiratory tract infections (LRTI, 4.8%). Narrow-spectrum FQs accounted for 88.4% of all FQ prescriptions. Up to 95.4% of visits from patients with sinusitis and 34.3% of those with LRTI used narrow-spectrum FQs, while S. pneumoniae is an important etiology. Otorhinolaryngologists in non–hospital-based clinics prescribed most of narrow-spectrum FQs to patients with sinusitis or LRTI. Conclusions: We found debatable prescription of narrow-spectrum FQ based on claim records, particularly for LRTI and sinusitis, possibly due to the lack of formulary restriction. Additional efforts are needed to improve the appropriate selection of optimal FQs. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/507945 | ISSN: | 16841182 | DOI: | 10.1016/j.jmii.2018.05.002 | SDG/關鍵字: | ciprofloxacin; enoxacin; gemifloxacin; levofloxacin; lomefloxacin; moxifloxacin; norfloxacin; ofloxacin; pefloxacin; quinoline derived antiinfective agent; sparfloxacin; antiinfective agent; quinolone derivative; abdominal infection; adolescent; adult; aged; antibiotic therapy; Article; bacterial infection; bone infection; child; clinical audit; cystitis; drug control; gastrointestinal infection; genital tract infection; geriatric patient; health care policy; human; infectious arthritis; lower respiratory tract infection; national health insurance; otorhinolaryngology; outpatient care; pneumococcal infection; prescription; prostatitis; retrospective study; sinusitis; skin infection; urinary tract infection; clinical practice; female; health care survey; legislation and jurisprudence; male; middle aged; outpatient; prescription; respiratory tract infection; Taiwan; young adult; Adolescent; Adult; Aged; Anti-Bacterial Agents; Drug Prescriptions; Female; Fluoroquinolones; Health Care Surveys; Humans; Male; Middle Aged; Outpatients; Practice Patterns, Physicians'; Respiratory Tract Infections; Taiwan; Young Adult |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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