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Actinic keratosis: a cross-sectional study of disease characteristics and treatment patterns in Danish dermatology clinics.

https://arctichealth.org/en/permalink/ahliterature279478
Source
Int J Dermatol. 2016 Mar;55(3):309-16
Publication Type
Article
Date
Mar-2016
Author
Andrés M Erlendsson
Henrik Egekvist
Henrik F Lorentzen
Peter A Philipsen
Birgitte Stausbøl-Grøn
Ida M Stender
Merete Haedersdal
Source
Int J Dermatol. 2016 Mar;55(3):309-16
Date
Mar-2016
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Aged, 80 and over
Aminolevulinic Acid - analogs & derivatives - therapeutic use
Aminoquinolines - therapeutic use
Antineoplastic Agents - therapeutic use
Carcinoma, Squamous Cell - etiology - prevention & control
Cross-Sectional Studies
Cryotherapy - utilization
Denmark
Dermatology - statistics & numerical data
Female
Humans
Keratosis, Actinic - complications - therapy
Male
Middle Aged
Outpatient clinics, hospital - statistics & numerical data
Photochemotherapy - utilization
Photosensitizing Agents - therapeutic use
Practice Patterns, Physicians' - statistics & numerical data
Private Practice - statistics & numerical data
Sex Factors
Skin Neoplasms - etiology - prevention & control
Abstract
The incidence of actinic keratosis (AK) is increasing, and several treatment options are available. The aim of this study was to describe clinical characteristics and treatment patterns in patients with AK treated by Danish dermatologists.
A multicenter, non-interventional, cross-sectional study was conducted. Three dermatology hospital departments and seven private dermatology clinics enrolled eligible AK patients consecutively during one week.
A total of 312 patients were included. Non-melanoma skin cancer (NMSC) was previously reported in 51.0% of patients and currently suspected in 9.4% of AK-affected anatomical regions. Lesions of AK were located primarily on the face (38.6%), scalp (12.8%), and hands (11.2%). Actinic keratosis commonly presented with multiple AK lesions (38.6%) and field cancerization (38.5%). The treatments used most frequently were cryotherapy (57.7%) and photodynamic therapy (PDT) with methyl aminolevulinate (17.1%) and imiquimod (11.2%). The likelihood of receiving cryotherapy was higher for men (odds ratio [OR] 1.65, 95% confidence interval [CI] 1.10-2.47) and increased with age (2.2% per year, 0.4-4.0%). PDT represented the most frequently applied treatment for severe actinic damage and was more likely to be prescribed to women (OR 4.08, 95% CI 2.22-7.47) and young patients (OR 0.97 per year, 95% CI 0.95-0.99). The prevalence of severe actinic damage (17.3% versus 9.6%) and intake of immunosuppressive medication (29.0 versus 2.0) were higher among hospital patients compared with those treated in private practices (P 
PubMed ID
26276415 View in PubMed
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Adherence to guidelines on antibiotic treatment for respiratory tract infections in various categories of physicians: a retrospective cross-sectional study of data from electronic patient records.

https://arctichealth.org/en/permalink/ahliterature271494
Source
BMJ Open. 2015;5(7):e008096
Publication Type
Article
Date
2015
Author
David Tell
Sven Engström
Sigvard Mölstad
Source
BMJ Open. 2015;5(7):e008096
Date
2015
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Anti-Bacterial Agents - therapeutic use
Child
Cross-Sectional Studies
Drug Prescriptions - statistics & numerical data
Electronic Health Records
Female
General Practice - statistics & numerical data
Guideline Adherence - statistics & numerical data
Humans
Internship and Residency - statistics & numerical data
Male
Middle Aged
Practice Guidelines as Topic
Practice Patterns, Physicians' - statistics & numerical data
Professional Practice Location
Respiratory Tract Infections - drug therapy
Retrospective Studies
Sex Factors
Sweden
Young Adult
Abstract
To study how prescription patterns concerning respiratory tract infections differ between interns, residents, younger general practitioners (GPs), older GPs and locums.
Retrospective study of structured data from electronic patient records.
Data were obtained from 53 health centres and 3 out-of-hours units in Jönköping County, Sweden, through their common electronic medical record database.
All physicians working in primary care during the 2-year study period (1 November 2010 to 31 October 2012).
Physicians' adherence to current guidelines for respiratory tract infections regarding the use of antibiotics.
We found considerable differences in prescribing patterns between physician categories. The recommended antibiotic, phenoxymethylpenicillin, was more often prescribed by interns, residents and younger GPs, while older GPs and locums to a higher degree prescribed broad-spectrum antibiotics. The greatest differences were seen when the recommendation in guidelines was to refrain from antibiotics, as for acute bronchitis. Interns and residents most often followed guidelines, while compliance in descending order was: young GPs, older GPs and locums. We also noticed that male doctors were somewhat overall more restrictive with antibiotics than female doctors.
In general, primary care doctors followed national guidelines on choice of antibiotics when treating respiratory tract infections in children but to a lesser degree when treating adults. Refraining from antibiotics seems harder. Adherence to national guidelines could be improved, especially for acute bronchitis and pneumonia. This was especially true for older GPs and locums whose prescription patterns were distant from the prevailing guidelines.
Notes
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PubMed ID
26179648 View in PubMed
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Age of diagnosing physician impacts the incidence of thyroid cancer in a population.

https://arctichealth.org/en/permalink/ahliterature271219
Source
Cancer Causes Control. 2014 Dec;25(12):1627-34
Publication Type
Article
Date
Dec-2014
Author
Sapna Nagar
Briseis Aschebrook-Kilfoy
Edwin L Kaplan
Peter Angelos
Raymon H Grogan
Source
Cancer Causes Control. 2014 Dec;25(12):1627-34
Date
Dec-2014
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Biopsy, Fine-Needle
Clinical Competence
Female
Finland - epidemiology
Humans
Incidence
Male
Middle Aged
Physicians
Practice Patterns, Physicians' - statistics & numerical data
Registries
SEER Program
Thyroid Neoplasms - diagnosis - epidemiology
Abstract
Thyroid ultrasound and fine-needle aspiration (FNA) have been implicated in the overdiagnosis of thyroid cancer. To study how the use of diagnostic tools impacts thyroid cancer incidence, we propose using physician age as a surrogate. We aimed to determine whether thyroid cancer incidence is higher in areas with a high density of young physicians compared with areas with a high density of older physicians.
SEER 13 database was used to determine thyroid cancer incidence. These data were linked to the Area Resource File data (2000), containing information on physician age at a county-specific level. Cohorts were divided by age based on the concentration of physicians within a population of 1,000,000 persons. The study period was divided into two time periods (1992-1995, 2006-2009).
The incidence of thyroid cancer was stable in areas with high concentrations of young and older physicians during the 1992-1995 time period [
PubMed ID
25240802 View in PubMed
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An audit and feedback intervention study increased adherence to antibiotic prescribing guidelines at a Norwegian hospital.

https://arctichealth.org/en/permalink/ahliterature276521
Source
BMC Infect Dis. 2016;16:96
Publication Type
Article
Date
2016
Author
June Utnes Høgli
Beate Hennie Garcia
Frode Skjold
Vegard Skogen
Lars Småbrekke
Source
BMC Infect Dis. 2016;16:96
Date
2016
Language
English
Publication Type
Article
Keywords
Aged
Anti-Bacterial Agents - therapeutic use
Community-Acquired Infections - drug therapy
Disease Progression
Female
Formative Feedback
Guideline Adherence - statistics & numerical data
Hospitals, University - standards - statistics & numerical data
Humans
Inappropriate Prescribing - prevention & control - statistics & numerical data
Male
Medical Audit
Norway
Pneumonia - drug therapy
Practice Guidelines as Topic
Practice Patterns, Physicians' - statistics & numerical data
Pulmonary Disease, Chronic Obstructive - drug therapy
Retrospective Studies
Abstract
Appropriate antibiotic prescribing is associated with favourable levels of antimicrobial resistance (AMR) and clinical outcomes. Most intervention studies on antibiotic prescribing originate from settings with high level of AMR. In a Norwegian hospital setting with low level of AMR, the literature on interventions for promoting guideline-recommended antibiotic prescribing in hospital is scarce and requested. Preliminary studies have shown improvement potentials regarding antibiotic prescribing according to guidelines. We aimed to promote appropriate antibiotic prescribing in patients with community-acquired pneumonia (CAP) and acute exacerbations of chronic obstructive pulmonary disease (AECOPD) at a respiratory medicine department in a Norwegian University hospital. Our specific objectives were to increase prescribing of appropriate empirical antibiotics, reduce high-dose benzylpenicillin and reduce total treatment duration.
We performed an audit and feedback intervention study, combined with distribution of a recently published pocket version of the national clinical practice guideline. We included patients discharged with CAP or AECOPD and prescribed antibiotics during hospital stay, and excluded those presenting with aspiration, nosocomial infection and co-infections. The pre- and post-intervention period was 9 and 6 months, respectively. Feedback was provided orally to the department physicians at an internal-educational meeting. To explore the effect of the intervention on appropriate empirical antibiotics and mean total treatment duration we applied before-after analysis (Student's t-test) and interrupted time series (ITS). We used Pearson's ?2 to compare dose changes.
In the pre-and post-intervention period we included 253 and 155 patients, respectively. Following the intervention, overall mean prescribing of appropriate empirical antibiotics increased from 61.7 to 83.8 % (P
Notes
Cites: Emerg Infect Dis. 2002 Mar;8(3):278-8211927025
Cites: BMC Infect Dis. 2015;15:6425887603
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PubMed ID
26920549 View in PubMed
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Antibiotic prescribing for acute respiratory tract infections in Norwegian primary care out-of-hours service.

https://arctichealth.org/en/permalink/ahliterature290698
Source
Scand J Prim Health Care. 2017 Jun; 35(2):178-185
Publication Type
Journal Article
Date
Jun-2017
Author
Bent H Lindberg
Svein Gjelstad
Mats Foshaug
Sigurd Høye
Author Affiliation
a Hamar Out-of-hours Primary Care Centre , Hamar , Norway.
Source
Scand J Prim Health Care. 2017 Jun; 35(2):178-185
Date
Jun-2017
Language
English
Publication Type
Journal Article
Keywords
Adult
After-Hours Care - statistics & numerical data
Anti-Bacterial Agents - therapeutic use
Drug Prescriptions - statistics & numerical data
Female
Humans
Logistic Models
Male
Middle Aged
Norway
Practice Patterns, Physicians' - statistics & numerical data
Primary Health Care - statistics & numerical data
Respiratory Tract Infections - drug therapy
Retrospective Studies
Abstract
To examine factors correlating with antibiotic prescribing for acute respiratory tract infections (ARTIs) in Norwegian primary care out-of-hours service.
Retrospective data analysis for the year 2014 in two out-of-hours primary care units located in the towns of Hamar and Tønsberg in Norway, analysing type and frequency of different antibiotics prescribed by 117 medical doctors for ARTIs, and factors correlating with these.
The 117 doctors in two out-of-hours units diagnosed 6757 cases of ARTIs. 2310 (34.2%) of these resulted in an antibiotic prescription, where of 1615 (69.9%) were penicillin V (PcV). Tonsillitis and sinusitis were the two ARTI diagnoses with the highest antibiotic prescription rate. The antibiotic prescription rate increased successively with increasing activity level, measured as shorter median duration of consultations per session, from 28.7% (reference) in the least busy quintile of sessions to 36.6% (OR: 1.38 (95% CI =1.06-1.80)) in the busiest quintile of sessions. Prescribing of broad-spectrum antibiotics was not correlated with median duration of consultations per session. Female doctors had an OR of 0.61 (0.40-0.92) of a broad-spectrum antibiotic prescription compared to their male colleagues.
Antibiotic prescribing for ARTIs in the primary care out-of-hours services investigated is at the same level as in Norwegian general practice, but with a higher prescription rate of PcV. Antibiotic prescribing increases on busy sessions, measured as median duration of consultations per session. The work frame in primary care out-of-hours service might influence the quality of clinical decisions.
Notes
Cites: Scand J Prim Health Care. 2014 Dec;32(4):200-7 PMID 25350313
Cites: Tidsskr Nor Laegeforen. 2008 Oct 23;128(20):2330-4 PMID 19096489
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Cites: J Antimicrob Chemother. 2011 Oct;66(10):2425-33 PMID 21784782
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Cites: Scand J Prim Health Care. 2016 Jun;34(2):180-5 PMID 27054812
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Cites: Scand J Prim Health Care. 2009;27(4):208-15 PMID 19929185
PubMed ID
28569649 View in PubMed
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Antibiotic prescription and clinical management of common infections among general practitioners in Latvia, Lithuania, and Sweden: a pilot survey with a simple protocol.

https://arctichealth.org/en/permalink/ahliterature294307
Source
Eur J Clin Microbiol Infect Dis. 2018 Feb; 37(2):355-361
Publication Type
Journal Article
Observational Study
Date
Feb-2018
Author
Uga Dumpis
Annika Hahlin
Sonata Varvuolyte
Stephan Stenmark
Sarmite Veide
Rolanda Valinteliene
Asta Jurkeviciene
Johan Struwe
Author Affiliation
Pauls Stradins University Hospital, University of Latvia, Riga, Latvia.
Source
Eur J Clin Microbiol Infect Dis. 2018 Feb; 37(2):355-361
Date
Feb-2018
Language
English
Publication Type
Journal Article
Observational Study
Keywords
Adult
Amdinocillin Pivoxil - therapeutic use
Amoxicillin - therapeutic use
Anti-Bacterial Agents - therapeutic use
Bacterial Infections - drug therapy
Clavulanic Acid - therapeutic use
Cross-Sectional Studies
Drug Prescriptions - statistics & numerical data
Female
Floxacillin - therapeutic use
General Practitioners - statistics & numerical data
Humans
Latvia
Lithuania
Male
Penicillin V - therapeutic use
Practice Patterns, Physicians' - statistics & numerical data
Sweden
Young Adult
Abstract
Comparative information on diagnosis-related antibiotic prescribing patterns are scarce from primary care within and between countries. To describe and compare antibiotic prescription and routine management of infections in primary care in Latvia (LV), Lithuania (LT) and two study sites in Sweden (SE), a cross-sectional observational study on patients who consulted due to sypmtoms compatible with infection was undetraken. Infection and treatment was detected and recorded by physicians only. Data was collected from altogether 8786 consecutive patients with infections in the three countries. Although the overall proportion of patients receiving an antibiotic prescription was similar in all three countries (LV and LT 42%, SE 38%), there were differences in the rate of prescription between the countries depending on the respective diagnoses. While penicillins dominated among prescriptions (LV 58%, LT 67%, SE 70%), phenoxymethylpenicillin was most commonly prescribed in Sweden (57% of all penicillins), while it was amoxicillin with or without clavulanic acid in Latvia (99%) and Lithuania (85%) respectively. Pivmecillinam and flucloxacillin, which accounted for 29% of penicillins in Sweden, were available neither in Latvia nor in Lithuania. The applied methodology was simple, and provided useful information on differences in treatment of common infections in ambulatory care in the absence of available computerized diagnosis-prescription data. Despite some limitations, the method can be used for assessment of intention to treat and compliance to treatment guidelines and benchmarking locally, nationally, or internationally, just as the point prevalence surveys (PPS) protocols have been used in hospitals all over Europe.
Notes
Cites: BMC Fam Pract. 2013 Jan 12;14:9 PMID 23311389
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Cites: Emerg Infect Dis. 2002 Mar;8(3):278-82 PMID 11927025
PubMed ID
29218467 View in PubMed
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Anticholinergic drug use and its association with self-reported symptoms among older persons with and without diabetes.

https://arctichealth.org/en/permalink/ahliterature298928
Source
J Clin Pharm Ther. 2019 Apr; 44(2):229-235
Publication Type
Journal Article
Date
Apr-2019
Author
Niina-Mari Inkeri
Merja Karjalainen
Maija Haanpää
Hannu Kautiainen
Juha Saltevo
Pekka Mäntyselkä
Miia Tiihonen
Author Affiliation
School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
Source
J Clin Pharm Ther. 2019 Apr; 44(2):229-235
Date
Apr-2019
Language
English
Publication Type
Journal Article
Keywords
Aged
Aged, 80 and over
Cholinergic Antagonists - adverse effects - therapeutic use
Cohort Studies
Cross-Sectional Studies
Diabetes Mellitus - epidemiology
Female
Finland
Humans
Independent living
Male
Practice Patterns, Physicians' - statistics & numerical data
Primary Health Care
Self Report
Surveys and Questionnaires
Abstract
Anticholinergic drug use has been associated with a risk of central and peripheral adverse effects. There is a lack of information on anticholinergic drug use in persons with diabetes. The aim of this study is to investigate anticholinergic drug use and the association between anticholinergic drug use and self-reported symptoms in older community-dwelling persons with and without diabetes.
The basic population was comprised of Finnish community-dwelling primary care patients aged 65 and older. Persons with diabetes were identified according to the ICD-10 diagnostic codes from electronic patient records. Two controls adjusted by age and gender were selected for each person with diabetes. This cross-sectional study was based on electronic primary care patient records and a structured health questionnaire. The health questionnaire was returned by 430 (81.6%) persons with diabetes and 654 (73.5%) persons without diabetes. Data on prescribed drugs were obtained from the electronic patient records. Anticholinergic drug use was measured according to the Anticholinergic Risk Scale. The presence and strength of anticholinergic symptoms were asked in the health questionnaire.
The prevalence of anticholinergic drug use was 8.9% in the total study cohort. There were no significant differences in anticholinergic drug use between persons with and without diabetes. There was no consistent association between anticholinergic drug use and self-reported symptoms.
There is no difference in anticholinergic drug use in older community-dwelling persons with and without diabetes. Anticholinergic drug use should be considered individually and monitored carefully.
PubMed ID
30315583 View in PubMed
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Attitudes toward Catheter Ablation for Atrial Fibrillation: A Nationwide Survey among Danish Cardiologists.

https://arctichealth.org/en/permalink/ahliterature274490
Source
Pacing Clin Electrophysiol. 2015 Oct;38(10):1166-72
Publication Type
Article
Date
Oct-2015
Author
Henrik Vadmann
Susanne S Pedersen
Jens Cosedis Nielsen
Maria Rodrigo-Domingo
Steen Pehrson
Arne Johannessen
Peter Steen Hansen
Jens Brock Johansen
Sam Riahi
Source
Pacing Clin Electrophysiol. 2015 Oct;38(10):1166-72
Date
Oct-2015
Language
English
Publication Type
Article
Keywords
Age Distribution
Atrial Fibrillation - epidemiology - surgery
Attitude of Health Personnel
Cardiology - statistics & numerical data
Catheter Ablation
Clinical Competence - statistics & numerical data
Denmark
Female
Health Care Surveys
Humans
Male
Middle Aged
Patient Selection
Physicians - statistics & numerical data
Practice Patterns, Physicians' - statistics & numerical data
Quality of Life
Abstract
Catheter ablation for atrial fibrillation (AF) is an important but expensive procedure that is the subject of some debate. Physicians' attitudes toward catheter ablation may influence promotion and patient acceptance. This is the first study to examine the attitudes of Danish cardiologists toward catheter ablation for AF, using a nationwide survey.
We developed a purpose-designed questionnaire to evaluate attitudes toward catheter ablation for AF that was sent to all Danish cardiologists (n = 401; response n = 272 (67.8%)). There was no association between attitudes toward ablation and the experience or age of the cardiologist with respect to patients with recurrent AF episodes with a duration of 7 days and/or need for cardioversion. The majority (69%) expected a recurrence of AF after catheter ablation in more than 30% of the cases. For patients with persistent longstanding AF with a duration of >1 year, the attitude toward ablation for longstanding AF was more likely to be positive with increasing age (P 7 days, or those who needed medical/electrical conversion, but a more negative attitude toward treating longstanding AF patients.
PubMed ID
26096979 View in PubMed
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Benzodiazepine prescribing for children, adolescents, and young adults from 2006 through 2013: A total population register-linkage study.

https://arctichealth.org/en/permalink/ahliterature299334
Source
PLoS Med. 2018 08; 15(8):e1002635
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
08-2018
Author
Anna Sidorchuk
Kayoko Isomura
Yasmina Molero
Clara Hellner
Paul Lichtenstein
Zheng Chang
Johan Franck
Lorena Fernández de la Cruz
David Mataix-Cols
Author Affiliation
Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Source
PLoS Med. 2018 08; 15(8):e1002635
Date
08-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adolescent
Benzodiazepines - therapeutic use
Child
Child, Preschool
Female
Humans
Infant
Infant, Newborn
Male
Odds Ratio
Pharmacoepidemiology
Practice Patterns, Physicians' - statistics & numerical data
Registries
Regression Analysis
Sex Factors
Sweden
Young Adult
Abstract
Pharmacoepidemiological studies have long raised concerns on widespread use of benzodiazepines and benzodiazepine-related drugs (BZDs), in particular long-term use, among adults and the elderly. In contrast, evidence pertaining to the rates of BZD use at younger ages is still scarce, and the factors that influence BZD utilisation and shape the different prescribing patterns in youths remain largely unexplored. We examined the prevalence rates, relative changes in rates over time, and prescribing patterns for BZD dispensation in young people aged 0-24 years in Sweden during the period January 1, 2006-December 31, 2013, and explored demographic, clinical, pharmacological, and prescriber-related attributes of BZD prescribing in this group.
Through the linkage of 3 nationwide Swedish health and administrative registers, we collected data on 17,500 children (0-11 years), 15,039 adolescents (12-17 years), and 85,200 young adults (18-24 years) with at least 1 dispensed prescription for a BZD during 2006-2013, out of 3,726,818 Swedish inhabitants aged 0-24 years. Age-specific annual prevalence rates of BZD dispensations were adjusted for population growth, and relative changes in rates were calculated between 2006 and 2013. We analysed how BZD dispensation varied by sex, psychiatric morbidity and epilepsy, concurrent dispensation of psychotropic medication, type of dispensed BZD, and type of healthcare provider prescribing the BZD. Prescribing patterns were established in relation to duration (3 months, >3 to =6 months, or >6 months), dosage ( 6 months). The study limitations included lack of information on actual consumption of the dispensed BZDs and unavailability of data on the indications for BZD prescriptions.
The overall increase in prevalence rates of BZD dispensations during the study period and the unexpectedly high proportion of individuals who were prescribed a BZD on a long-term basis at a young age indicate a lack of congruence with international and national guidelines. These findings highlight the need for close monitoring of prescribing practices, particularly in non-psychiatric settings, in order to build an evidence base for safe and efficient BZD treatment in young persons.
PubMed ID
30086134 View in PubMed
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Characterisation of antibiotic prescriptions for acute respiratory tract infections in Danish general practice: a retrospective registry based cohort study.

https://arctichealth.org/en/permalink/ahliterature291469
Source
NPJ Prim Care Respir Med. 2017 May 19; 27(1):37
Publication Type
Journal Article
Date
May-19-2017
Author
Rune Aabenhus
Malene Plejdrup Hansen
Laura Trolle Saust
Lars Bjerrum
Author Affiliation
Section of General Practice and Research Unit for General Practice, Department of public Health, University of Copenhagen, Copenhagen, Denmark. runeaa@sund.ku.dk.
Source
NPJ Prim Care Respir Med. 2017 May 19; 27(1):37
Date
May-19-2017
Language
English
Publication Type
Journal Article
Keywords
Acute Disease
Adolescent
Adult
Aged
Anti-Bacterial Agents - therapeutic use
Child
Child, Preschool
Denmark
Female
General practice
Humans
Infant
Infant, Newborn
Male
Middle Aged
Practice Patterns, Physicians' - statistics & numerical data
Registries
Respiratory Tract Infections - diagnosis - drug therapy - etiology
Retrospective Studies
Young Adult
Abstract
Inappropriate use of antibiotics is contributing to the increasing rates of antimicrobial resistance. Several Danish guidelines on antibiotic prescribing for acute respiratory tract infections in general practice have been issued to promote rational prescribing of antibiotics, however it is unclear if these recommendations are followed. We aimed to characterise the pattern of antibiotic prescriptions for patients diagnosed with acute respiratory tract infections, by means of electronic prescriptions, labeled with clinical indications, from Danish general practice. Acute respiratory tract infections accounted for 456,532 antibiotic prescriptions issued between July 2012 and June 2013. Pneumonia was the most common indication with 178,354 prescriptions (39%), followed by acute tonsillitis (21%) and acute otitis media (19%). In total, penicillin V accounted for 58% of all prescriptions, followed by macrolides (18%) and amoxicillin (15%). The use of second-line agents increased with age for all indications, and comprised more than 40% of the prescriptions in patients aged?>75 years. Women were more often prescribed antibiotics regardless of clinical indication. This is the first Danish study to characterise antibiotic prescription patterns for acute respiratory tract infections by data linkage of clinical indications. The findings confirm that penicillin V is the most commonly prescribed antibiotic agent for treatment of patients with an acute respiratory tract infection in Danish general practice. However, second-line agents like macrolides and amoxicillin with or without clavulanic acid are overused. Strategies to improve the quality of antibiotic prescribing especially for pneumonia, acute otitis media and acute rhinosinusitis are warranted.
TRACKING THE OVERUSE OF ANTIBIOTICS: Better adherence to guidelines for prescribing antibiotics for different respiratory tract infections are warranted in Danish general practice. The over-use of antibiotics, particularly so-called 'second-line' agents such as amoxicillin, increases resistance and may lead to a potentially catastrophic scenario where antibiotics are no longer effective. Exactly how widespread the over-use of antibiotics is for different infections, however, is not clear. Rune Aabenhus at the University of Copenhagen and co-workers analyzed primary care data regarding antibiotic prescriptions for acute respiratory tract infections including pneumonia and ear infections in Denmark. They found that penicillin V-the current recommended first-line drug in Scandinavian countries-accounted for 58 per cent of prescriptions, a figure which should be improved. Amoxicillin and macrolides were over-prescribed, particularly in elderly patients. The team also call for further analysis of prescriptions given by out-of-hours clinics.
Notes
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PubMed ID
28526836 View in PubMed
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