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Temporal trends in ambulatory antibiotic prescription rates in South Carolina: Impact of age, gender, and resident location

Published online by Cambridge University Press:  05 June 2020

Hana R. Winders*
Affiliation:
Department of Clinical Pharmacy and Outcomes Sciences, University of South Carolina College of Pharmacy, Columbia, South Carolina
Julie Royer
Affiliation:
Health and Demographics Division, South Carolina Revenue and Fiscal Affairs Office, Columbia, South Carolina
Mariam Younas
Affiliation:
University of South Carolina School of Medicine, Columbia, South Carolina Department of Medicine, Palmetto Health University of South Carolina Medical Group, Columbia, South Carolina
Julie Ann Justo
Affiliation:
Department of Clinical Pharmacy and Outcomes Sciences, University of South Carolina College of Pharmacy, Columbia, South Carolina Department of Pharmacy, Prisma Health Richland, Columbia, South Carolina
P. Brandon Bookstaver
Affiliation:
Department of Clinical Pharmacy and Outcomes Sciences, University of South Carolina College of Pharmacy, Columbia, South Carolina Department of Pharmacy, Prisma Health Richland, Columbia, South Carolina
Sharon B. Weissman
Affiliation:
University of South Carolina School of Medicine, Columbia, South Carolina Department of Medicine, Palmetto Health University of South Carolina Medical Group, Columbia, South Carolina
Linda Bell
Affiliation:
South Carolina Department of Health and Environmental Control, Columbia, South Carolina
Katie S. Waites
Affiliation:
South Carolina Department of Health and Environmental Control, Columbia, South Carolina
John Plante
Affiliation:
University of South Carolina School of Medicine, Columbia, South Carolina
Majdi N. Al-Hasan
Affiliation:
University of South Carolina School of Medicine, Columbia, South Carolina Department of Medicine, Palmetto Health University of South Carolina Medical Group, Columbia, South Carolina
*
Author for correspondence: Hana R. Winders, E-mail: hwinders@cop.sc.edu

Abstract

Objective:

To examine the temporal trends in ambulatory antibiotic prescription fill rates and to determine the influences of age, gender, and location.

Design:

Population-based cohort study.

Setting:

Ambulatory setting in South Carolina.

Patients:

Patients ≤64 years of age from January 2012 to December 2017.

Methods:

Aggregated pharmacy claims data for oral antibiotic prescriptions were utilized to estimate community antibiotic prescription rates. Poisson regression or Student t tests were used to examine overall temporal trend in antibiotic prescription rates, seasonal variation, and the trends across age group, gender, and rural versus urban location.

Results:

Overall antibiotic prescription rates decrease from 1,127 to 897 per 1,000 person years (P < .001). The decrease was more noticeable in persons aged <18 years (26%) and 18–39 years (20%) than in those aged 40–64 years (5%; P < .001 for all). Prescription rates were higher among females than males in all age groups, although this finding was the most pronounced in group aged 18–39 years (1,232 vs 585 per 1,000 person years; P < .0001). Annualized antibiotic prescription rates were higher during the winter months (December–March) than the rest of the year (1,145 vs 885 per 1,000 person years; P < .0001), and rates were higher in rural areas than in urban areas (1,032 vs 941 per 1,000 person years; P < .0001).

Conclusions:

The decline in ambulatory antibiotic prescription rates is encouraging. Ongoing ambulatory antibiotic stewardship efforts across South Carolina should focus on older adults, rural areas, and during the winter season when antibiotic prescriptions peak.

Type
Original Article
Copyright
© 2020 by The Society for Healthcare Epidemiology of America. All rights reserved.

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Footnotes

PREVIOUS PRESENTATION: This work was presented in part as a poster presentation at the SHEA Spring 2019 conference on April 25, 2019, in Boston, Massachusetts, and as an oral presentation at the ASM Microbe 2019 conference on June 21, 2019, in San Francisco, California.

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