Quantifying the Gap between Expected and Actual Rates of Antibiotic Prescribing in British Columbia, Canada

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 exa...

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Autores principales:	Ariana Saatchi, Ji-Won Yoo, Kevin L. Schwartz, Michael Silverman, Andrew M. Morris, David M. Patrick, James McCormack, Fawziah Marra
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	antibiotics epidemiology antimicrobial resistance (AMR) prescription respiratory tract infections outpatient care Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/89b5e957b19b49a89428fd529bd913cf
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spelling	oai:doaj.org-article:89b5e957b19b49a89428fd529bd913cf2021-11-25T16:25:15ZQuantifying the Gap between Expected and Actual Rates of Antibiotic Prescribing in British Columbia, Canada10.3390/antibiotics101114282079-6382https://doaj.org/article/89b5e957b19b49a89428fd529bd913cf2021-11-01T00:00:00Zhttps://www.mdpi.com/2079-6382/10/11/1428https://doaj.org/toc/2079-6382Despite 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.Ariana SaatchiJi-Won YooKevin L. SchwartzMichael SilvermanAndrew M. MorrisDavid M. PatrickJames McCormackFawziah MarraMDPI AGarticleantibioticsepidemiologyantimicrobial resistance (AMR)prescriptionrespiratory tract infectionsoutpatient careTherapeutics. PharmacologyRM1-950ENAntibiotics, Vol 10, Iss 1428, p 1428 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	antibiotics epidemiology antimicrobial resistance (AMR) prescription respiratory tract infections outpatient care Therapeutics. Pharmacology RM1-950
spellingShingle	antibiotics epidemiology antimicrobial resistance (AMR) prescription respiratory tract infections outpatient care Therapeutics. Pharmacology RM1-950 Ariana Saatchi Ji-Won Yoo Kevin L. Schwartz Michael Silverman Andrew M. Morris David M. Patrick James McCormack Fawziah Marra Quantifying the Gap between Expected and Actual Rates of Antibiotic Prescribing in British Columbia, Canada
description	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.
format	article
author	Ariana Saatchi Ji-Won Yoo Kevin L. Schwartz Michael Silverman Andrew M. Morris David M. Patrick James McCormack Fawziah Marra
author_facet	Ariana Saatchi Ji-Won Yoo Kevin L. Schwartz Michael Silverman Andrew M. Morris David M. Patrick James McCormack Fawziah Marra
author_sort	Ariana Saatchi
title	Quantifying the Gap between Expected and Actual Rates of Antibiotic Prescribing in British Columbia, Canada
title_short	Quantifying the Gap between Expected and Actual Rates of Antibiotic Prescribing in British Columbia, Canada
title_full	Quantifying the Gap between Expected and Actual Rates of Antibiotic Prescribing in British Columbia, Canada
title_fullStr	Quantifying the Gap between Expected and Actual Rates of Antibiotic Prescribing in British Columbia, Canada
title_full_unstemmed	Quantifying the Gap between Expected and Actual Rates of Antibiotic Prescribing in British Columbia, Canada
title_sort	quantifying the gap between expected and actual rates of antibiotic prescribing in british columbia, canada
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/89b5e957b19b49a89428fd529bd913cf
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Quantifying the Gap between Expected and Actual Rates of Antibiotic Prescribing in British Columbia, Canada

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