Ocular Antibiotic Utilisation across Aotearoa/New Zealand

Abstract

Ocular antibiotics are integral to the prevention and treatment of bacterial ocular infections. This study aimed to describe their utilisation across New Zealand according to patient and healthcare factors. Every subsidy-eligible community dispensing of ocular chloramphenicol, fusidic acid and ciprofloxacin in New Zealand, between 2010 and 2019, was included in this analysis. Number of dispensings/1000 population/year was quantified, stratified by patient age and urban/non-urban health districts. Dispensing rates by ethnicity were determined and were age adjusted. The proportion of dispensings by socioeconomic deprivation quintile was also determined. Chloramphenicol was the most commonly dispensed antibiotic; however, its utilisation decreased over time. Ciprofloxacin use was higher in children, while chloramphenicol use was higher in older patients. Ciprofloxacin usage was higher among Māori and Pasifika ethnicities, while fusidic acid use was lower. Chloramphenicol usage was higher among Pasifika. Antibiotic utilisation was higher in urban health districts, and in the most deprived quintile; both were most marked with ciprofloxacin. The utilisation of publicly funded ocular antibiotics across New Zealand varied between patient subgroups. These findings will help improve the prevention, management and outcomes of bacterial ocular infections, and support wider initiatives in antibiotic stewardship and medicine access equity.

Ocular Chloramphenicol Exposure in Early Childhood in Aotearoa/New Zealand

“…The use of ophthalmic antibiotics in the paediatric population is relatively high [1]. Although evidence of substantial clinical benefit is limited, topical antimicrobials are often prescribed in the management of acute bacterial conjunctivitis [2,3].…”

“…With chloramphenicol, although there is no strong evidence linking topical use with haematotoxicity, topical chloramphenicol is not in use in the United States, due to concerns around this rare adverse effect being linked to systemic administration [12]. Topical chloramphenicol is widely used in many other countries, including the United Kingdom, Australia, and Aotearoa/New Zealand (NZ) [1,3].…”