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Prescriber-level surveillance of outpatient antimicrobial consumption to enable targeted antimicrobial stewardship: a nationwide observational study, Switzerland, 2015 to 2022.
Graber, Sereina M; Stollberg, Sabrina M; Plüss-Suard, Catherine; Huber, Carola A; Kronenberg, Andreas; Senn, Oliver; Neuner-Jehle, Stefan; Plate, Andreas.
Afiliación
  • Graber SM; Department of Health Sciences, Helsana Group, Zurich, Switzerland.
  • Stollberg SM; Department of Health Sciences, Helsana Group, Zurich, Switzerland.
  • Plüss-Suard C; Swiss Centre for Antibiotic Resistance (ANRESIS), Institute for Infectious Diseases, University of Bern, Bern, Switzerland.
  • Huber CA; Department of Health Sciences, Helsana Group, Zurich, Switzerland.
  • Kronenberg A; Swiss Centre for Antibiotic Resistance (ANRESIS), Institute for Infectious Diseases, University of Bern, Bern, Switzerland.
  • Senn O; Institute of Primary Care, University of Zurich and University Hospital Zurich, Zurich, Switzerland.
  • Neuner-Jehle S; Institute of Primary Care, University of Zurich and University Hospital Zurich, Zurich, Switzerland.
  • Plate A; Institute of Primary Care, University of Zurich and University Hospital Zurich, Zurich, Switzerland.
Euro Surveill ; 29(37)2024 Sep.
Article en En | MEDLINE | ID: mdl-39268651
ABSTRACT
BackgroundIn Europe and other high-income countries, antibiotics are mainly prescribed in the outpatient setting, which consists of primary, specialist and hospital-affiliated outpatient care. Established surveillance platforms report antimicrobial consumption (AMC) on aggregated levels and the contribution of the different prescriber groups is unknown.AimTo determine the contribution of different prescribers to the overall outpatient AMC in Switzerland.MethodsWe conducted a retrospective observational study using claims data from one large Swiss health insurance company, covering the period from 2015 to 2022. We analysed antibiotic prescriptions (ATC code J01) prescribed in the Swiss outpatient setting. Results were reported as defined daily doses per 1,000 inhabitants per day (DID) and weighted according to the total population of Switzerland based on census data.ResultsWe analysed 3,663,590 antibiotic prescriptions from 49 prescriber groups. Overall, AMC ranged from 9.12 DID (2015) to 7.99 DID (2022). General internal medicine (40.1% of all prescribed DID in 2022), hospital-affiliated outpatient care (20.6%), group practices (17.3%), paediatrics (5.4%) and gynaecology (3.7%) were the largest prescriber groups. Primary care accounted for two-thirds of the prescribed DID. Quantity and type of antibiotics prescribed varied between the prescriber groups. Broad-spectrum penicillins, tetracyclines and macrolides were the most prescribed antibiotic classes.ConclusionPrimary care contributed considerably less to AMC than anticipated, and hospital-affiliated outpatient care emerged as an important prescriber. Surveillance at the prescriber level enables the identification of prescribing patterns within all prescriber groups, offering unprecedented visibility and allowing a more targeted antibiotic stewardship according to prescriber groups.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pacientes Ambulatorios / Pautas de la Práctica en Medicina / Programas de Optimización del Uso de los Antimicrobianos / Antibacterianos Límite: Female / Humans / Male País/Región como asunto: Europa Idioma: En Revista: Euro Surveill Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2024 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Suecia
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pacientes Ambulatorios / Pautas de la Práctica en Medicina / Programas de Optimización del Uso de los Antimicrobianos / Antibacterianos Límite: Female / Humans / Male País/Región como asunto: Europa Idioma: En Revista: Euro Surveill Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2024 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Suecia