Hostname: page-component-76fb5796d-2lccl Total loading time: 0 Render date: 2024-04-26T14:12:46.530Z Has data issue: false hasContentIssue false
  • English
  • Français

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 Open the ORCID record for Hana R. Winders [Opens in a new window] ,
Julie Royer ,
Mariam Younas ,
Julie Ann Justo ,
P. Brandon Bookstaver ,
Sharon B. Weissman ,
Linda Bell ,
Katie S. Waites ,
John Plante  and
Majdi N. Al-Hasan
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
Get access Rights & Permissions [Opens in a new window]

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
Information
Infection Control & Hospital Epidemiology , Volume 41 , Issue 8 , August 2020 , pp. 879 - 882
Check for updates
Copyright
© 2020 by The Society for Healthcare Epidemiology of America. All rights reserved.

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

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.

References

Younas, M, Royer, J, Weissman, S, et al.Burden of Clostridioides difficile infection in southeastern United States: a population-based study. Infection 2020;48:129–132.CrossRefGoogle ScholarPubMed
Lessa, FC, Mu, Y, Bamberg, WM, et al.Burden of Clostridium difficile infection in the United States. N Engl J Med 2015;372:825–834.CrossRefGoogle ScholarPubMed
Suda, KJ, Hicks, LA, Roberts, RM, Hunkler, RJ, Danziger, LH.A national evaluation of antibiotic expenditures by healthcare setting in the United States, 2009. J Antimicrob Chemother 2013;68:715–718.CrossRefGoogle Scholar
Fleming-Dutra, KE, Hersh, AL, Shapiro, DJ, et al.Prevalence of inappropriate antibiotic prescriptions among US ambulatory care visits, 2010–2011. JAMA 2016;315:1864–1873.CrossRefGoogle ScholarPubMed
Sanchez, GV, Fleming-Dura, KE, Roberts, RM, Hicks, LA.Core elements of outpatient antibiotic stewardship. MMWR Recomm Rep 2016;65:1–12.CrossRefGoogle ScholarPubMed
Outpatient antibiotic prescriptions—United States, 2014. Centers for disease Control and Prevention website. https://www.cdc.gov/antibiotic-use/community/pdfs/annualreportsummary_2014.pdf. Accessed July 23, 2019.Google Scholar
Durkin, MJ, Jafarzadeh, SR, Hsueh, K, et al.Outpatient antibiotic prescription trends in the United States: a national cohort study. Infect Control Hosp Epidemiol 2018;39:584–589.CrossRefGoogle ScholarPubMed
Suda, KJ, Hicks, LA, Roberts, RM, Hunkler, RJ, Taylor, TH.Trends and seasonal variation in outpatient antibiotic prescription rates in the United States, 2006 to 2010. Antimicrob Agents Chemother 2014;58:2763–2766.CrossRefGoogle ScholarPubMed
NPI registry. Centers for Medicare & Medicaid Services website. https://www.cms.gov/Regulations-and-Guidance/AdministrativeSimplification/NationalProvIdentStand/DataDissemination.html. Accessed September 11, 2019.Google Scholar
SAS Software. Version 9.4. Cary, NC, USA: SAS Institute.Google Scholar
Zhang, Z, Chen, M, Yu, Y, Pan, S, Liu, Y.Antimicrobial susceptibility among Streptococcus pneumoniae and Haemophilus influenzae collected globally between 2015 and 2017 as part of the Tigecycline Evaluation and Surveillance Trial (TEST). Infect Drug Resist 2019;12:1209–1220.CrossRefGoogle Scholar
Yarrington, ME, Anderson, DJ, Dodds Ashley, E, et al.Impact of FDA black box warning on fluoroquinolone and alternative antibiotic use in southeastern US hospitals. Infect Control Hosp Epidemiol 2019;40:1297–1300.CrossRefGoogle ScholarPubMed
Patrick, DM, Marra, F, Hutchinson, J, Monnet, DL, Ng, H, Bowie, WR.Per capita antibiotic consumption: how does a North American jurisdiction compare with Europe? Clin Infect Dis 2004;39:11–17.CrossRefGoogle ScholarPubMed
Kristensen, PK, Johnsen, SP, Thomsen, RW.Decreasing trends, and geographical variation in outpatient antibiotic use: a population-based study in central Denmark. BMC Infect Dis 2019;19:337.CrossRefGoogle ScholarPubMed
Younas, M, Royer, J, Rac, H, et al.Clostridium difficile infection and antibiotic prescription rates in the community: explaining the gender gap. Open Forum Infect Dis 2018;5:S39.CrossRefGoogle Scholar
Finkelstein, JA, Raebel, MA, Nordin, JD, Lakoma, M, Young, JG.Trends in outpatient antibiotic use in 3 health plans. Pediatrics 2019;143(1). pii: e20181259.CrossRefGoogle ScholarPubMed
Lieberthal, AS, Carroll, AE, Chonmaitree, T, et al.The diagnosis and management of acute otitis media. Pediatrics 2013;131:e964–e999.CrossRefGoogle ScholarPubMed
Deniz, Y, van Uum, RT, de Hoog, MLA, Schilder, AGM, Damoiseaux, RAMJ, Venekamp, RP.Impact of otitis media clinical guidelines on antibiotic and analgesic prescriptions: a systematic review. Arch Dis Child 2018;103:597–602.CrossRefGoogle ScholarPubMed
Morris, SK, Moss, WJ, Halsey, N.Haemophilus influenzae type B conjugate vaccine use and effectiveness. Lancet Infect Dis 2008;8:435–443.CrossRefGoogle ScholarPubMed
Lewnard, JA, Givon-Lavi, N, Weinberger, DM, Lipsitch, M, Dagan, R.Pan-serotype reduction in progression of Streptococcus pneumoniae to otitis media after rollout of pneumococcal conjugate vaccines. Clin Infect Dis 2017;65:1853–1861.CrossRefGoogle ScholarPubMed
Younas, M, Royer, J, Weissman, SB, et al. Association between influenza vaccination coverage and ambulatory antibiotic prescription rates in children in South Carolina. In: Program and abstracts of IDWeek 2019; October 2–6, 2019; Washington, DC. Abstract 2733.CrossRefGoogle Scholar
Elseviers, MM, Ferech, M, Vander Stichele, RH, Goossens, H, group Ep. Antibiotic use in ambulatory care in Europe (ESAC data 1997–2002): trends, regional differences and seasonal fluctuations. Pharmacoepidemiol Drug Saf 2007;16:115–123.CrossRefGoogle Scholar
Curtis, HJ, Walker, AJ, Mahtani, KR, Goldacre, B.Time trends and geographical variation in prescribing of antibiotics in England, 1998–2017. J Antimicrob Chemother 2019;74:242–250.Google Scholar
Cals, JW, Butler, CC, Hopstaken, RM, Hood, K, Dinant, GJ.Effect of point of care testing for C reactive protein and training in communication skills on antibiotic use in lower respiratory tract infections: cluster randomised trial. BMJ 2009;338:b1374.CrossRefGoogle ScholarPubMed
Andreeva, E, Melbye, H.Usefulness of C-reactive protein testing in acute cough/respiratory tract infection: an open cluster-randomized clinical trial with C-reactive protein testing in the intervention group. BMC Fam Pract 2014;15:80.CrossRefGoogle ScholarPubMed
Hoberman, A, Paradise, JL, Greenberg, DP, Wald, ER, Kearney, DH, Colborn, DK.Penicillin susceptibility of pneumococcal isolates causing acute otitis media in children: seasonal variation. Pediatr Infect Dis J 2005;24:115–120.CrossRefGoogle ScholarPubMed
Ramsey, EG, Royer, J, Bookstaver, PB, et al.Seasonal variation in antimicrobial resistance rates of community-acquired Escherichia coli bloodstream isolates. Int J Antimicrob Agents 2019;54:1–7.CrossRefGoogle ScholarPubMed
Gonzales, R, Steiner, JF, Sande, MA.Antibiotic prescribing for adults with colds, upper respiratory tract infections, and bronchitis by ambulatory care physicians. JAMA 1997;278:901904.CrossRefGoogle ScholarPubMed
Vázquez Fernández, ME, Bachiller Luque, MR, Vázquez Fernández, MJ, Pastor García, E, Eiros Bouza, JM.Variability in antibiotic prescription in the pediatric population of Castile and Leon (Spain) from 2001 to 2005 in relation to urban or rural setting. An Pediatr (Barc) 2007;67:139–144.CrossRefGoogle ScholarPubMed
Barlam, TF, Soria-Saucedo, R, Cabral, HJ, Kazis, LE.Unnecessary antibiotics for acute respiratory tract infections: association with care setting and patient demographics. Open Forum Infect Dis 2016;3:ofw045.CrossRefGoogle ScholarPubMed
Chow, AW, Benninger, MS, Brook, I, et al.IDSA clinical practice guideline for acute bacterial rhinosinusitis in children and adults. Clin Infect Dis 2012;54:e72–e112.CrossRefGoogle ScholarPubMed
Suda, KJ, Roberts, RM, Hunkler, RJ, Taylor, TH.Antibiotic prescriptions in the community by type of provider in the United States, 2005–2010. J Am Pharm Assoc (2003) 2016;56:621–626.CrossRefGoogle ScholarPubMed
Palms, DL, Hicks, LA, Hersh, AL, et al.Comparison of antibiotic prescribing in retail clinics, urgent care centers, emergency departments, and traditional ambulatory care settings in the United States. JAMA Intern Med 2018;178:1267–1269.CrossRefGoogle ScholarPubMed
Deshpande, A, Pasupuleti, V, Thota, P, et al.Community-associated Clostridium difficile infection and antibiotics: a meta-analysis. J Antimicrob Chemother 2013;68:1951–1961.CrossRefGoogle ScholarPubMed
Gross, AE, Hanna, D, Rowan, SA, Bleasdale, SC, Suda, KJ.Successful implementation of an antibiotic stewardship program in an academic dental practice. Open Forum Infect Dis 2019;6(3):ofz067.CrossRefGoogle Scholar
Supplementary material: Image

Winders et al. Supplementary Materials

Winders et al. Supplementary Materials 1

Download Winders et al. Supplementary Materials(Image)
Image 112.2 KB
Supplementary material: Image

Winders et al. Supplementary Materials

Winders et al. Supplementary Materials 2

Download Winders et al. Supplementary Materials(Image)
Image 85.5 KB
Supplementary material: PDF

Winders et al. Supplementary Materials

Winders et al. Supplementary Materials 3

Download Winders et al. Supplementary Materials(PDF)
PDF 87.5 KB