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Antibiotic use in a Canadian Province, 1995-1998.

https://arctichealth.org/en/permalink/ahliterature198835
Source
Ann Pharmacother. 2000 Apr;34(4):459-64
Publication Type
Article
Date
Apr-2000
Author
A G Carrie
C J Metge
G G Zhanel
Author Affiliation
Faculty of Pharmacy, University of Manitoba, Winnipeg, Canada. umcarri2@cc.umanitoba.ca
Source
Ann Pharmacother. 2000 Apr;34(4):459-64
Date
Apr-2000
Language
English
Publication Type
Article
Keywords
Anti-Bacterial Agents - economics - therapeutic use
Drug Prescriptions
Drug Resistance, Microbial
Drug Utilization Review
Humans
Manitoba
Abstract
Antibiotics are among the most commonly used classes of agents in community practice; yet, studies of antibiotic use in this setting are scarce. Data from developed countries suggest increasing use of newer broad-spectrum agents, which has implications for the development of antibiotic resistance as well as cost of therapy. In this study, we quantified changing patterns of antibiotic use in community practice in Manitoba, Canada, from 1995 to 1998.
A descriptive, population-based study of antibiotic use in Manitoba was facilitated by the Drug Programs Information Network (DPIN) of Manitoba Health; a data management system responsible for recording details of prescriptions dispensed for all Manitoba residents. Antibiotic use data, defined as numbers of prescriptions dispensed, were extracted from the DPIN from January 1, 1995, to March 31, 1998. Antibiotic use is reported as prescriptions per 1000 persons per year (Rx/1000/Yr) based on quarterly use.
Penicillins (48.3%), macrolides (16.0%), and sulfonamides (12.5%) accounted for 75% of total antibiotic use; total use decreased 19.1% between 1995 and 1998. Use of the four most commonly prescribed agents decreased over the study period (amoxicillin, -17.4%; erythromycin, -29.0%; trimethoprim/sulfamethoxazole, -18.7%; penicillins G and V, -19.2%). In contrast, use of newer and/or broad-spectrum agents increased (ciprofloxacin, 21.9%; cefuroxime, 30.7%; and azithromycin/clarithromycin, 29.5%). Use of second-line agents as a percentage of total antibiotic use increased from 14.4% to 19.3% between January 1995 and March 1998 (p
PubMed ID
10772430 View in PubMed
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Use of administrative healthcare claims to examine the effectiveness of trimethoprim-sulfamethoxazole versus fluoroquinolones in the treatment of community-acquired acute pyelonephritis in women.

https://arctichealth.org/en/permalink/ahliterature181771
Source
J Antimicrob Chemother. 2004 Mar;53(3):512-7
Publication Type
Article
Date
Mar-2004
Author
A G Carrie
C J Metge
D M Collins
G K M Harding
G G Zhanel
Author Affiliation
Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada. acarrie@pharmacy.ualberta.ca
Source
J Antimicrob Chemother. 2004 Mar;53(3):512-7
Date
Mar-2004
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Anti-Infective Agents, Urinary - therapeutic use
Cohort Studies
Community-Acquired Infections - drug therapy - microbiology
Female
Fluoroquinolones - therapeutic use
Humans
Insurance Claim Review
Kidney Papillary Necrosis - drug therapy - microbiology
Manitoba
Middle Aged
Treatment Failure
Treatment Outcome
Trimethoprim-Sulfamethoxazole Combination - therapeutic use
Abstract
To evaluate the effectiveness of trimethoprim-sulfamethoxazole and fluoroquinolones in the treatment of community-acquired acute pyelonephritis.
We identified a population-based cohort of non-pregnant women aged 18-65 years, initially treated with trimethoprim-sulfamethoxazole or a fluoroquinolone for community-acquired pyelonephritis in an ambulatory care setting. Subjects were identified from a healthcare claims database in Manitoba, Canada for the period 15 February 1996 to 31 March 1999. Subsequent treatment failure, as evidenced by the provision of additional treatment up to 42 days post-diagnosis, was compared between the two treatments.
A total of 1084 women met inclusion criteria: 653 (60.2%) treated with trimethoprim-sulfamethoxazole and 431 (39.8%) treated with a fluoroquinolone. Treatment outcomes were affected by subject age. At age 20, treatment with a fluoroquinolone resulted in a reduced probability of treatment failure compared with trimethoprim-sulfamethoxazole (odds ratio, 0.56; 95% CI, 0.33-0.97). At age 60, there was no difference in the probability of treatment failure (odds ratio, 1.61; 95% CI, 0.82-3.16). No other subject characteristics impacted comparative effectiveness; however, several characteristics increased the odds of treatment failure irrespective of the initial antibiotic. These included: recent urinary tract infection (odds ratio, 2.07; 95% CI, 1.14-3.57), recent antibiotic use (odds ratio, 1.40; 95% CI, 1.00-1.96;), and a treatment duration of less than 10 days (odds ratio, 2.18; 95% CI, 1.59-2.99).
Younger subjects ( approximately 20 years) treated with fluoroquinolones were less likely to experience treatment failure than those treated with trimethoprim-sulfamethoxazole. Treatment durations of less than 10 days resulted in a higher probability of treatment failure regardless of the initial antibiotic.
PubMed ID
14749344 View in PubMed
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