Discrepancies in national time trends of outpatient antibiotic utilization using different measures: a population-based study in France

Trinh, Nhung T H; Chahwakilian, Pierre; Bruckner, Tim A.; Sclison, S.; Lévy, Corinne; Milic, Dejan; Cohen, Robert; Cohen, Jérémie F.

doi:10.1093/jac/dky018

Cited by 9 publications

(3 citation statements)

References 20 publications

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“…The prevalence rate of psychotropic drug use according to socio‐professional characteristics was only reported in the 2010 survey, showing an annual prevalence rate of 16.7% for the active adult population, with a higher prevalence rate in women compared to men, whatever the socio‐professional category 15 . Some studies performed on health care databases or with sales data have already identified a decrease in the use of antibiotics, 16,17 or of benzodiazepines and z drugs, 18 confirming the strong tendency observed in our study (and confirmed again between 2006 and 2016). The study by Airagnes et al used the data of the CONSTANCE cohort, a national population‐based cohort of randomly recruited participants, including volunteers aged 18–69 years at baseline in 22 selected health screening centers from the principal regions of France 6 .…”

Section: Discussionsupporting

confidence: 91%

Evolution of medication consumption in a working environment in France: Results of the four waves of the “Drugs and Work” study (1986–2016)

Hérin

Othenin

Jouanjus

et al. 2021

Pharmacoepidemiology and Drug

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Objectives Previous studies in the working environment have underlined the high prevalence of drug consumption. The aim of this study was to present the main characteristics of this consumption in French workers and to identify changes from the 1986, 1996, 2006 and 2016 surveys. Methods The design was a repeated cross‐sectional study in 1986, 1996, 2006 and 2016. At each wave, demographic and socio‐professional characteristics, self‐reported consumption of medications during the week before the occupational medical visit, and perceived difficult working conditions and extraprofessional problems were collected among a sample of workers. Factors associated with consumption of any drug and of main therapeutic classes were investigated through multivariate logistic regression models, using 2016 as the reference for investigating temporal trends. Results Prevalence of use of any drug was significantly higher in 2016, with marked changes observed in comparison with 1986: absolute decrease of psychotropic (−5.1%, p < 0.0001), antibiotics (−2.7%, p < 0.0001) and cardiovascular drug use (−3.8%, p < 0.0001), increase of analgesic use (+8.3%, p < 0.0001). Difficult working conditions, age and female gender were independently associated with analgesic drug use, and extraprofessional problems and female gender associated with psychotropic drug use. Conclusions This analysis of self‐reported drug use in the working environment illustrates the global patterns of medication use in a French active population over 3 decades. The favorable development in the level of consumption of psychotropic drugs should not underestimate the attention to be paid to the determinants of chronic consumption, or possible transfers to less stigmatized medications.

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Section: Discussionsupporting

confidence: 91%

Evolution of medication consumption in a working environment in France: Results of the four waves of the “Drugs and Work” study (1986–2016)

Hérin

Othenin

Jouanjus

et al. 2021

Pharmacoepidemiology and Drug

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“…They all had a high training in diagnoses of infectious diseases and they rigorously followed the guidelines for ATB prescriptions or RDT use. 36 In the coming months, other diagnostic tools must be deployed to improve the quality of diagnosis. These tools allow for adapted children management as well as improvement of the surveillance system.…”

Section: Discussionmentioning

confidence: 99%

New Approach to the Surveillance of Pediatric Infectious Diseases From Ambulatory Pediatricians in the Digital Era

Cohen

Béchet

Gelbert

et al. 2021

Pediatric Infectious Disease Journal

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Background: Many ambulatory networks in several countries have established syndromic surveillance systems to detect outbreaks of different illnesses. Here, we describe a new Pediatric and Ambulatory Research in Infectious diseases network that combined automated data extraction from the computers of primary care pediatricians. Methods: Pediatricians who used the same software, AxiSanté 5-Infansoft for electronic medical records were specially trained in infectious diseases, encouraged to comply with French treatments' recommendations, use of point-of-care tests and vaccination guidelines. Infectious disease diagnoses in children <16 years old in the records triggered automatic data extraction of complete records. A quality control process and external validation were developed.Results: From September 2017 to February 2020, 107 pediatricians enrolled 57,806 children (mean age 2.9 ± 2.6 years at diagnosis) with at least one infectious disease diagnosis among those followed by the network. Among the 118,193 diagnoses, the most frequent were acute otitis media (n = 44,924, 38.0%), tonsillopharyngitis (n = 13,334, 11.3%), gastroenteritis (n = 12,367, 10.5%), influenza (n = 11,062, 9.4%), bronchiolitis (n = 10,531, 8.9%), enteroviral infections (n = 8474, 7.2%) and chickenpox (n = 6857, 5.8%). A rapid diagnostic test was performed in 84.7% of cases of tonsillopharyngitis and was positive in 44%. The antibiotic recommendations from French guidelines were strictly followed: amoxicillin was the most prescribed antibiotic and less than 10% of presumed viral infections were treated. Conclusions: This "tailor-made" network set up with quality controls and external validation represents a new approach to the surveillance of pediatric infectious diseases in the digital era and could highly optimize pediatric practices.

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“…The irrational use of antibiotics is a public health problem and has an impact on people’s health and economic development [ 1 – 3 ]. In the 1990 s, many countries, such as the United States, launched antimicrobial stewardship programmes [ 4 , 5 ] to promote the rational use of antibiotics.…”

Section: Introductionmentioning

confidence: 99%

Cross-sectional study on the drug utilization and evaluation indicator of antibiotics used in pediatric population

Zhang

Wang

et al. 2021

BMC Health Serv Res

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Background The lack of medication standards is a serious problem in paediatrics mainly because of age-related differences in organ development and physiological functions in children. Consequently, dosage measurement becomes inaccurate. For this reason, methods for evaluating and monitoring rational paediatric medications should be developed. Drug use indicators, such as those similar to the drug utilisation index (DUI) based on the Anatomical Therapeutic Chemical/Defined Daily Dose (DDD) and widely used for the assessment of appropriate dosage in adults, should be explored in terms of their applicability to children. Methods A total of 5,538 prescriptions of antibiotics selected from a general teaching hospital were included. Drug, dose, frequency and treatment duration were obtained from each prescription. The prescription daily dose (PDD) of each antibiotic drug was calculated as the average of the daily doses. Underdose and overdose were determined in terms of the PDD/DDD ratio for each prescription. Children’s DUI (cDUI) was explored in terms of the appropriate dosage for children as follows: the meaning of children’s DDD (cDDD) and the evaluation of paediatric drug dosage. Results The top five antibiotics and their utilisation rates were as follows: cefmetazole sodium injection (18.47 %), erythromycin lactobionate injection (15.07 %), amoxicillin/clavulanate potassium injection (10.72 %), ceftriaxone sodium injection (9.50 %) and azithromycin dry suspension (8.02 %). The ratio of cDUI and PDD/cDDD was mostly not close to 1. Conclusions The establishment of a cDUI system is an effective means of paediatric dosage evaluation. In addition to DDDs, cDUI and PDD/cDDD should be used to analyse the utilisation of antibiotics in children.

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Discrepancies in national time trends of outpatient antibiotic utilization using different measures: a population-based study in France

Cited by 9 publications

References 20 publications

Evolution of medication consumption in a working environment in France: Results of the four waves of the “Drugs and Work” study (1986–2016)

Evolution of medication consumption in a working environment in France: Results of the four waves of the “Drugs and Work” study (1986–2016)

New Approach to the Surveillance of Pediatric Infectious Diseases From Ambulatory Pediatricians in the Digital Era

Cross-sectional study on the drug utilization and evaluation indicator of antibiotics used in pediatric population

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