Antibiotic Use in Ontario Facilities That Provide Chronic Care
OBJECTIVE: To determine the incidence and variability of antibiotic use in facilities which provide chronic care and to determine how often clinical criteria for infection are met when antibiotics are prescribed in these facilities. DESIGN: A prospective, 12‐month, observational cohort study. SETTIN...
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| Veröffentlicht in: | Journal of general internal medicine : JGIM 2001-06, Vol.16 (6), p.376-383 |
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| container_title | Journal of general internal medicine : JGIM |
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| creator | Loeb, Mark Simor, Andrew E. Landry, Lisa Walter, Stephen McArthur, Margaret Duffy, JoAnn Kwan, Debora McGeer, Allison |
| description | OBJECTIVE: To determine the incidence and variability of antibiotic use in facilities which provide chronic care and to determine how often clinical criteria for infection are met when antibiotics are prescribed in these facilities.
DESIGN: A prospective, 12‐month, observational cohort study.
SETTING: Twenty‐two facilities which provide chronic care in southwestern Ontario.
PARTICIPANTS: Patients who were treated with systemic antibiotics over the study period.
MEASUREMENTS: Characteristics of antibiotic prescriptions (name, dose, duration, and indication) and clinical features of randomly selected patients who were treated with antibiotics.
RESULTS: A total of 9,373 courses of antibiotics were prescribed for 2,408 patients (66% of all patients in study facilities). The incidence of antibiotic prescriptions in the facilities ranged from 2.9 to 13.9 antibiotic courses per 1,000 patient‐days. Thirty‐six percent of antibiotics were prescribed for respiratory tract infections, 33% for urinary infections, and 13% for skin and soft tissue infections. Standardized surveillance definitions of infection were met in 49% of the 1,602 randomly selected patients who were prescribed antibiotics. Diagnostic criteria for respiratory, urinary, and skin infection were met in 58%, 28%, and 65% of prescriptions, respectively. One third of antibiotic prescriptions for a urinary indication were for asymptomatic bacteriuria. Adverse reactions were noted in 6% of prescriptions for respiratory and urinary infections and 4% of prescriptions for skin infection.
CONCLUSIONS: Antibiotic use is frequent and highly variable amongst patients who receive chronic care. Reducing antibiotic prescriptions for asymptomatic bacteriuria represents an important way to optimize antibiotic use in this population. |
| doi_str_mv | 10.1046/j.1525-1497.2001.016006376.x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_1495221</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>70952852</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5432-8108c04a69f5c110a55844303b683507dc5047a5accede6a679f3898e6f2605d3</originalsourceid><addsrcrecordid>eNqVkU9PGzEQxS3UClLar4BWFeptt-P_XqlCgqhQKiR6gLPleL2No41N7Q2Fb1-vEgXaW09zmN-8eTMPoVMMDQYmPq8azAmvMWtlQwBwA1gACCpF83SAZvvmGzQDpVitJGVH6F3OqwJTQtQhOsKYESIom6Gz8zD6hY-jt9V9dpUP1W0YTfKxujTWD370Lld3SzNWP1J89J2r5ssUQ8HnJrn36G1vhuw-7Ooxur_8ejf_Vt_cXl3Pz29qyxkltcKgLDAj2p5bjMFwrhijQBdCUQ6ysxyYNNxY6zonjJBtT1WrnOiJAN7RY3S21X3YLNausy6MyQz6Ifm1Sc86Gq__7gS_1D_joy6f4ITgIvBpJ5Dir43Lo177bN0wmODiJmsJhVOcFPDjP-AqblIox2kleTv9kBfoyxayKeacXL93gkFPKemVnoKY1ks9paT3KemnMn7y-pqX4V0sBTjdASZbM_TJBOvzqyWU0HbyerHFfvvBPf-XB_396hqgxYT-AbKPrNc</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>875900135</pqid></control><display><type>article</type><title>Antibiotic Use in Ontario Facilities That Provide Chronic Care</title><source>MEDLINE</source><source>SpringerNature Journals</source><source>Access via Wiley Online Library</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>Alma/SFX Local Collection</source><creator>Loeb, Mark ; Simor, Andrew E. ; Landry, Lisa ; Walter, Stephen ; McArthur, Margaret ; Duffy, JoAnn ; Kwan, Debora ; McGeer, Allison</creator><creatorcontrib>Loeb, Mark ; Simor, Andrew E. ; Landry, Lisa ; Walter, Stephen ; McArthur, Margaret ; Duffy, JoAnn ; Kwan, Debora ; McGeer, Allison</creatorcontrib><description>OBJECTIVE: To determine the incidence and variability of antibiotic use in facilities which provide chronic care and to determine how often clinical criteria for infection are met when antibiotics are prescribed in these facilities.
DESIGN: A prospective, 12‐month, observational cohort study.
SETTING: Twenty‐two facilities which provide chronic care in southwestern Ontario.
PARTICIPANTS: Patients who were treated with systemic antibiotics over the study period.
MEASUREMENTS: Characteristics of antibiotic prescriptions (name, dose, duration, and indication) and clinical features of randomly selected patients who were treated with antibiotics.
RESULTS: A total of 9,373 courses of antibiotics were prescribed for 2,408 patients (66% of all patients in study facilities). The incidence of antibiotic prescriptions in the facilities ranged from 2.9 to 13.9 antibiotic courses per 1,000 patient‐days. Thirty‐six percent of antibiotics were prescribed for respiratory tract infections, 33% for urinary infections, and 13% for skin and soft tissue infections. Standardized surveillance definitions of infection were met in 49% of the 1,602 randomly selected patients who were prescribed antibiotics. Diagnostic criteria for respiratory, urinary, and skin infection were met in 58%, 28%, and 65% of prescriptions, respectively. One third of antibiotic prescriptions for a urinary indication were for asymptomatic bacteriuria. Adverse reactions were noted in 6% of prescriptions for respiratory and urinary infections and 4% of prescriptions for skin infection.
CONCLUSIONS: Antibiotic use is frequent and highly variable amongst patients who receive chronic care. Reducing antibiotic prescriptions for asymptomatic bacteriuria represents an important way to optimize antibiotic use in this population.</description><identifier>ISSN: 0884-8734</identifier><identifier>EISSN: 1525-1497</identifier><identifier>DOI: 10.1046/j.1525-1497.2001.016006376.x</identifier><identifier>PMID: 11422634</identifier><language>eng</language><publisher>Boston, MA, USA: Blackwell Science Inc</publisher><subject>Aged ; Anti-Bacterial Agents - therapeutic use ; antibiotic use ; Antibiotics ; Asymptomatic ; Bacteriuria ; Biological and medical sciences ; chronic care facilities ; Chronic Disease - drug therapy ; Chronic Disease - epidemiology ; Chronic infection ; Cohort Studies ; Criteria ; General aspects ; Human infectious diseases. Experimental studies and models ; Humans ; Indication ; infection ; Infection - drug therapy ; Infection - epidemiology ; Infections ; Infectious diseases ; Internal medicine ; Medical sciences ; Ontario - epidemiology ; Original ; Patients ; Prospective Studies ; Respiratory tract ; Respiratory tract diseases ; Skin ; Soft tissues ; Urinary tract infections</subject><ispartof>Journal of general internal medicine : JGIM, 2001-06, Vol.16 (6), p.376-383</ispartof><rights>2001 INIST-CNRS</rights><rights>Blackwell Science Inc 2001.</rights><rights>2001 by the Society of General Internal Medicine 2001</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5432-8108c04a69f5c110a55844303b683507dc5047a5accede6a679f3898e6f2605d3</citedby><cites>FETCH-LOGICAL-c5432-8108c04a69f5c110a55844303b683507dc5047a5accede6a679f3898e6f2605d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1495221/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1495221/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,1417,27924,27925,45574,45575,53791,53793</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1032392$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11422634$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Loeb, Mark</creatorcontrib><creatorcontrib>Simor, Andrew E.</creatorcontrib><creatorcontrib>Landry, Lisa</creatorcontrib><creatorcontrib>Walter, Stephen</creatorcontrib><creatorcontrib>McArthur, Margaret</creatorcontrib><creatorcontrib>Duffy, JoAnn</creatorcontrib><creatorcontrib>Kwan, Debora</creatorcontrib><creatorcontrib>McGeer, Allison</creatorcontrib><title>Antibiotic Use in Ontario Facilities That Provide Chronic Care</title><title>Journal of general internal medicine : JGIM</title><addtitle>J Gen Intern Med</addtitle><description>OBJECTIVE: To determine the incidence and variability of antibiotic use in facilities which provide chronic care and to determine how often clinical criteria for infection are met when antibiotics are prescribed in these facilities.
DESIGN: A prospective, 12‐month, observational cohort study.
SETTING: Twenty‐two facilities which provide chronic care in southwestern Ontario.
PARTICIPANTS: Patients who were treated with systemic antibiotics over the study period.
MEASUREMENTS: Characteristics of antibiotic prescriptions (name, dose, duration, and indication) and clinical features of randomly selected patients who were treated with antibiotics.
RESULTS: A total of 9,373 courses of antibiotics were prescribed for 2,408 patients (66% of all patients in study facilities). The incidence of antibiotic prescriptions in the facilities ranged from 2.9 to 13.9 antibiotic courses per 1,000 patient‐days. Thirty‐six percent of antibiotics were prescribed for respiratory tract infections, 33% for urinary infections, and 13% for skin and soft tissue infections. Standardized surveillance definitions of infection were met in 49% of the 1,602 randomly selected patients who were prescribed antibiotics. Diagnostic criteria for respiratory, urinary, and skin infection were met in 58%, 28%, and 65% of prescriptions, respectively. One third of antibiotic prescriptions for a urinary indication were for asymptomatic bacteriuria. Adverse reactions were noted in 6% of prescriptions for respiratory and urinary infections and 4% of prescriptions for skin infection.
CONCLUSIONS: Antibiotic use is frequent and highly variable amongst patients who receive chronic care. Reducing antibiotic prescriptions for asymptomatic bacteriuria represents an important way to optimize antibiotic use in this population.</description><subject>Aged</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>antibiotic use</subject><subject>Antibiotics</subject><subject>Asymptomatic</subject><subject>Bacteriuria</subject><subject>Biological and medical sciences</subject><subject>chronic care facilities</subject><subject>Chronic Disease - drug therapy</subject><subject>Chronic Disease - epidemiology</subject><subject>Chronic infection</subject><subject>Cohort Studies</subject><subject>Criteria</subject><subject>General aspects</subject><subject>Human infectious diseases. Experimental studies and models</subject><subject>Humans</subject><subject>Indication</subject><subject>infection</subject><subject>Infection - drug therapy</subject><subject>Infection - epidemiology</subject><subject>Infections</subject><subject>Infectious diseases</subject><subject>Internal medicine</subject><subject>Medical sciences</subject><subject>Ontario - epidemiology</subject><subject>Original</subject><subject>Patients</subject><subject>Prospective Studies</subject><subject>Respiratory tract</subject><subject>Respiratory tract diseases</subject><subject>Skin</subject><subject>Soft tissues</subject><subject>Urinary tract infections</subject><issn>0884-8734</issn><issn>1525-1497</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqVkU9PGzEQxS3UClLar4BWFeptt-P_XqlCgqhQKiR6gLPleL2No41N7Q2Fb1-vEgXaW09zmN-8eTMPoVMMDQYmPq8azAmvMWtlQwBwA1gACCpF83SAZvvmGzQDpVitJGVH6F3OqwJTQtQhOsKYESIom6Gz8zD6hY-jt9V9dpUP1W0YTfKxujTWD370Lld3SzNWP1J89J2r5ssUQ8HnJrn36G1vhuw-7Ooxur_8ejf_Vt_cXl3Pz29qyxkltcKgLDAj2p5bjMFwrhijQBdCUQ6ysxyYNNxY6zonjJBtT1WrnOiJAN7RY3S21X3YLNausy6MyQz6Ifm1Sc86Gq__7gS_1D_joy6f4ITgIvBpJ5Dir43Lo177bN0wmODiJmsJhVOcFPDjP-AqblIox2kleTv9kBfoyxayKeacXL93gkFPKemVnoKY1ks9paT3KemnMn7y-pqX4V0sBTjdASZbM_TJBOvzqyWU0HbyerHFfvvBPf-XB_396hqgxYT-AbKPrNc</recordid><startdate>200106</startdate><enddate>200106</enddate><creator>Loeb, Mark</creator><creator>Simor, Andrew E.</creator><creator>Landry, Lisa</creator><creator>Walter, Stephen</creator><creator>McArthur, Margaret</creator><creator>Duffy, JoAnn</creator><creator>Kwan, Debora</creator><creator>McGeer, Allison</creator><general>Blackwell Science Inc</general><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7RV</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>M7N</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>200106</creationdate><title>Antibiotic Use in Ontario Facilities That Provide Chronic Care</title><author>Loeb, Mark ; Simor, Andrew E. ; Landry, Lisa ; Walter, Stephen ; McArthur, Margaret ; Duffy, JoAnn ; Kwan, Debora ; McGeer, Allison</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5432-8108c04a69f5c110a55844303b683507dc5047a5accede6a679f3898e6f2605d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Aged</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>antibiotic use</topic><topic>Antibiotics</topic><topic>Asymptomatic</topic><topic>Bacteriuria</topic><topic>Biological and medical sciences</topic><topic>chronic care facilities</topic><topic>Chronic Disease - drug therapy</topic><topic>Chronic Disease - epidemiology</topic><topic>Chronic infection</topic><topic>Cohort Studies</topic><topic>Criteria</topic><topic>General aspects</topic><topic>Human infectious diseases. Experimental studies and models</topic><topic>Humans</topic><topic>Indication</topic><topic>infection</topic><topic>Infection - drug therapy</topic><topic>Infection - epidemiology</topic><topic>Infections</topic><topic>Infectious diseases</topic><topic>Internal medicine</topic><topic>Medical sciences</topic><topic>Ontario - epidemiology</topic><topic>Original</topic><topic>Patients</topic><topic>Prospective Studies</topic><topic>Respiratory tract</topic><topic>Respiratory tract diseases</topic><topic>Skin</topic><topic>Soft tissues</topic><topic>Urinary tract infections</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Loeb, Mark</creatorcontrib><creatorcontrib>Simor, Andrew E.</creatorcontrib><creatorcontrib>Landry, Lisa</creatorcontrib><creatorcontrib>Walter, Stephen</creatorcontrib><creatorcontrib>McArthur, Margaret</creatorcontrib><creatorcontrib>Duffy, JoAnn</creatorcontrib><creatorcontrib>Kwan, Debora</creatorcontrib><creatorcontrib>McGeer, Allison</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Nursing & Allied Health Database</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of general internal medicine : JGIM</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Loeb, Mark</au><au>Simor, Andrew E.</au><au>Landry, Lisa</au><au>Walter, Stephen</au><au>McArthur, Margaret</au><au>Duffy, JoAnn</au><au>Kwan, Debora</au><au>McGeer, Allison</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Antibiotic Use in Ontario Facilities That Provide Chronic Care</atitle><jtitle>Journal of general internal medicine : JGIM</jtitle><addtitle>J Gen Intern Med</addtitle><date>2001-06</date><risdate>2001</risdate><volume>16</volume><issue>6</issue><spage>376</spage><epage>383</epage><pages>376-383</pages><issn>0884-8734</issn><eissn>1525-1497</eissn><abstract>OBJECTIVE: To determine the incidence and variability of antibiotic use in facilities which provide chronic care and to determine how often clinical criteria for infection are met when antibiotics are prescribed in these facilities.
DESIGN: A prospective, 12‐month, observational cohort study.
SETTING: Twenty‐two facilities which provide chronic care in southwestern Ontario.
PARTICIPANTS: Patients who were treated with systemic antibiotics over the study period.
MEASUREMENTS: Characteristics of antibiotic prescriptions (name, dose, duration, and indication) and clinical features of randomly selected patients who were treated with antibiotics.
RESULTS: A total of 9,373 courses of antibiotics were prescribed for 2,408 patients (66% of all patients in study facilities). The incidence of antibiotic prescriptions in the facilities ranged from 2.9 to 13.9 antibiotic courses per 1,000 patient‐days. Thirty‐six percent of antibiotics were prescribed for respiratory tract infections, 33% for urinary infections, and 13% for skin and soft tissue infections. Standardized surveillance definitions of infection were met in 49% of the 1,602 randomly selected patients who were prescribed antibiotics. Diagnostic criteria for respiratory, urinary, and skin infection were met in 58%, 28%, and 65% of prescriptions, respectively. One third of antibiotic prescriptions for a urinary indication were for asymptomatic bacteriuria. Adverse reactions were noted in 6% of prescriptions for respiratory and urinary infections and 4% of prescriptions for skin infection.
CONCLUSIONS: Antibiotic use is frequent and highly variable amongst patients who receive chronic care. Reducing antibiotic prescriptions for asymptomatic bacteriuria represents an important way to optimize antibiotic use in this population.</abstract><cop>Boston, MA, USA</cop><pub>Blackwell Science Inc</pub><pmid>11422634</pmid><doi>10.1046/j.1525-1497.2001.016006376.x</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Anti-Bacterial Agents - therapeutic use antibiotic use Antibiotics Asymptomatic Bacteriuria Biological and medical sciences chronic care facilities Chronic Disease - drug therapy Chronic Disease - epidemiology Chronic infection Cohort Studies Criteria General aspects Human infectious diseases. Experimental studies and models Humans Indication infection Infection - drug therapy Infection - epidemiology Infections Infectious diseases Internal medicine Medical sciences Ontario - epidemiology Original Patients Prospective Studies Respiratory tract Respiratory tract diseases Skin Soft tissues Urinary tract infections |
| title | Antibiotic Use in Ontario Facilities That Provide Chronic Care |
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