Antibiotic use in adult outpatients in Switzerland in relation to regions, seasonality and point of care tests

Achermann, R; Suter, K; Kronenberg, Andreas Oskar; Gyger, P; Mühlemann, K; Zimmerli, W; Bucher, H C (2011). Antibiotic use in adult outpatients in Switzerland in relation to regions, seasonality and point of care tests. Clinical microbiology and infection, 17(6), pp. 855-861. Oxford: Blackwell Publishing 10.1111/j.1469-0691.2010.03348.x

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The use of antibiotics is highest in primary care and directly associated with antibiotic resistance in the community. We assessed regional variations in antibiotic use in primary care in Switzerland and explored prescription patterns in relation to the use of point of care tests. Defined daily doses of antibiotics per 1000 inhabitants (DDD(1000pd) ) were calculated for the year 2007 from reimbursement data of the largest Swiss health insurer, based on the anatomic therapeutic chemical classification and the DDD methodology recommended by WHO. We present ecological associations by use of descriptive and regression analysis. We analysed data from 1 067 934 adults, representing 17.1% of the Swiss population. The rate of outpatient antibiotic prescriptions in the entire population was 8.5 DDD(1000pd) , and varied between 7.28 and 11.33 DDD(1000pd) for northwest Switzerland and the Lake Geneva region. DDD(1000pd) for the three most prescribed antibiotics were 2.90 for amoxicillin and amoxicillin-clavulanate, 1.77 for fluoroquinolones, and 1.34 for macrolides. Regions with higher DDD(1000pd) showed higher seasonal variability in antibiotic use and lower use of all point of care tests. In regression analysis for each class of antibiotics, the use of any point of care test was consistently associated with fewer antibiotic prescriptions. Prescription rates of primary care physicians showed variations between Swiss regions and were lower in northwest Switzerland and in physicians using point of care tests. Ecological studies are prone to bias and whether point of care tests reduce antibiotic use has to be investigated in pragmatic primary care trials.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Service Sector > Institute for Infectious Diseases

UniBE Contributor:

Kronenberg, Andreas Oskar and Mühlemann, Kathrin

Subjects:

500 Science > 570 Life sciences; biology
600 Technology > 610 Medicine & health

ISSN:

1198-743X

Publisher:

Blackwell Publishing

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:12

Last Modified:

28 Jan 2019 16:36

Publisher DOI:

10.1111/j.1469-0691.2010.03348.x

PubMed ID:

20731682

Web of Science ID:

000292385300013

BORIS DOI:

10.7892/boris.2689

URI:

https://boris.unibe.ch/id/eprint/2689 (FactScience: 205556)

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