Assessment of the quality of antibiotics prescription in a regional health system

  1. Rojas García, P.
  2. Antoñanzas Villar, F.
  1. 1 Universidad de La Rioja
    info

    Universidad de La Rioja

    Logroño, España

    ROR https://ror.org/0553yr311

Journal:
Revista Clínica Española

ISSN: 0014-2565

Year of publication: 2020

Type: Article

beta Ver similares en nube de resultados
DOI: 10.1016/J.RCE.2020.04.015 PMID: 34752261 SCOPUS: 2-s2.0-85086178912 GOOGLE SCHOLAR lock_openOpen access editor

More publications in: Revista Clínica Española

Institutional repository: lockOpen access Editor

Abstract

ObjectivesThe inappropriate and indiscriminate use of antibiotics is one of the main factors contributing to the onset of antimicrobial resistance. In 2007, the European Surveillance of Antimicrobial Consumption (ESAC) project established certain indicators to assess the quality of antibiotic use. We analysed the quality of antibiotic prescription in La Rioja (Spain) in 2017, using epidemiological (age, sex, seasonal nature) and financial variables (price of the antibiotic and income level).Material and methodsUsing data on monthly distributions of antibiotics (J01) through official prescriptions and prescriptions from medical insurance companies, we calculated the population rates for the number of prescriptions per 1000 inhabitants, as well as the values of 9 quality indicators (by antibiotic family, age group, sex and income), defined by ESAC, classifying the prescription quality as “very high”, “high”, “low” and “very low”.ResultsThe quality of antibiotic prescriptions in La Rioja in 2017 was “high” for antibiotics dispensed through official prescriptions (18.55 daily defined doses per 1000 inhabitants [DID]) and “low” for those dispensed through medical insurance companies (21.79 DID). When we included private prescriptions (26.02 DID), the quality was “very low”, taking into account the margins indicated by ESAC. We detected high rates of prescription for broad-spectrum antibiotics for men older than 45 years, penicillins for women aged 25 to 39 years, quinolones for pensioners and cephalosporins for high-income patients.ConclusionsThe quality of antibiotic prescription is determined not only by epidemiological variables, such as age and sex, but also by financial variables, such as patient income and antibiotic price.

Bibliographic References

  • Comisión Europea. Día europeo para el uso prudente de los antibióticos, 2017. Declaración de Vytenis Andriukaitis, comisario de salud y seguridad alimentaria, y Carlos Moedas, comisario de investigación, ciencia e innovación [consultado 7 Abr 2020]. Disponible en: https://ec.europa.eu/commission/presscorner/detail/es/STATEMENT_17_4607; 2017
  • Agencia española de medicamentos y productos sanitarios. Strategic action plan to reduce the risk of selection and dissemination of antibiotic resistance [consultado 10 Dic 2018]. Disponible en: http://www.resistenciaantibioticos.es/es/system/files/field/files/action_plan_on_amr_spain.pdf?file=1&type=node&id=388&force=0; 2015
  • European Centre for Disease Prevention and Control (ECDC). Campañas en Europa [consultado 8 Abr 2020]. Disponible en: https://antibiotic.ecdc.europa.eu/es/campanas-en-europa; 2020
  • Ministerio de sanidad, consumo y bienestar social. Plan nacional frente a la resistencia a los antibióticos [consultado 5 Nov 2018]. Disponible en: http://www.resistenciaantibioticos.es/es/system/files/field/files/informe_anual_pran_2016-2017.pdf?file=1&type=node&id=441&force=0; 2017
  • Lázaro, (2002), Med Clin (Barc), 118, pp. 561, 10.1016/S0025-7753(02)72453-6
  • Ripoll, (2007), Rev Esp Quimioter, 20, pp. 44
  • Vázquez, (2008), Rev Pediatr Aten Primaria, 10, pp. 55
  • Serna, (2011), Aten Primaria, 43, pp. 236, 10.1016/j.aprim.2010.04.015
  • Lallana-Alvarez, (2012), Enferm Infecc Microbiol Clin, 30, pp. 591, 10.1016/j.eimc.2012.03.004
  • Sánchez-Núñez, (2018), Rev Esp Quimioter, 31, pp. 27
  • Coenen, (2007), Qual Saf Health Care, 16, pp. 440, 10.1136/qshc.2006.021121
  • EUR-Lex: Derecho de la UE. Plan de acción europeo «Una sola salud» para luchar contra la resistencia a los antimicrobianos [consultado 7 Abr 2020]. Disponible en: https://eur-lex.europa.eu/legal-content/ES/TXT/?uri=legissum:4304077; 2017
  • Adriaenssens, (2011), J Antimicrob Chemother, 66, pp. vi47, 10.1093/jac/dkr457
  • Klein, (2018), Proc Natl Acad Sci USA, 115, pp. E3463, 10.1073/pnas.1717295115
  • El Global. La implementación, el gran reto del Plan nacional frente a la resistencia a los antibióticos [consultado 8 Abr 2020]. Disponible en: https://elglobal.es/politica/la-implementacion-el-gran-reto-del-plan-nacional-frente-a-la-resistencia-a-los-antibioticos-ig1967596/; 2019
  • Plan nacional frente a la resistencia a los antibióticos. Consumos antibióticos sector comunitario [consultada el 7 de abril de 2020]. Disponible en: http://www.resistenciaantibioticos.es/es/profesionales/vigilancia/mapas-de-consumo/consumos-antibioticos-en-atencion-primaria; 2020
  • Organización Mundial de la Salud. ATC /DDD Index 2020 [consultado 8 Abr 2020]. Disponible en: https://www.whocc.no/atc_ddd_index/; 2020
  • Real Decreto Ley 16/2012, de 20 de abril, de Medidas Urgentes para Garantizar la Sostenibilidad del Sistema Nacional de Salud y mejorar la calidad y seguridad de sus prestaciones. Boletín Oficial del Estado, núm. 98, de 24 de abril de 2012, páginas 31.278-312 [consultado 2 Dic 2018]. Disponible en: https://www.boe.es/buscar/act.php?id=BOE-A-2012-5403; 2012
  • Powell, (2003), Qual Saf Health Care, 12, pp. 122, 10.1136/qhc.12.2.122
  • Seddon, (2001), Qual Health Care, 10, pp. 152, 10.1136/qhc.0100152
  • Coenen, (2009), J Antimicrob Chemother, 64, pp. 200, 10.1093/jac/dkp135
  • Antoñanzas, (2019), Eur J Health Econ, 20, pp. 483, 10.1007/s10198-018-1021-z
  • Organización Mundial de la Salud. Resistencia a los antibióticos. Datos y cifras [consultado 21 Dic 2018]. Disponible en: https://www.who.int/es/news-room/fact-sheets/detail/resistencia-a-los-antibi%C3%B3ticos; 2018
  • Adriaenssens, (2011), BMJ Qual Saf, 20, pp. 764, 10.1136/bmjqs.2010.049049
  • Adriaenssens, (2011), J Antimicrob Chemother, 66, pp. vi71, 10.1093/jac/dkr459
  • Alsan, (2015), Lancet Infect Dis, 15, pp. 1203, 10.1016/S1473-3099(15)00149-8
  • Vera, (2012), Rev Med La Paz, 8, pp. 73
  • Blix, (2007), J Antimicrob Chemother, 59, pp. 971, 10.1093/jac/dkm032
  • Campos, (2012), Enferm Infecc Microbiol Clin, 30, pp. 589, 10.1016/j.eimc.2012.07.003
  • Campos, (2007), J Antimicrob Chemother, 60, pp. 698, 10.1093/jac/dkm248
  • El Global. España se acerca más a la media europea en consumo de antibióticos [consultado 5 Feb 2019]. Disponible en: https://elglobal.es/politica/espana-se-acerca-mas-a-la-media-europea-en-consumo-de-antibioticos-ch1911026/; 2019
  • European Commission. Public Opinion. Antimicrobial Resistance (in the EU) [consultado 7 Abr 2020]. Disponible en: https://ec.europa.eu/COMMFrontOffice/publicopinion/index.cfm/Survey/getSurveyDetail/instruments/SPECIAL/surveyKy/2107; 2016
  • Ministerio de sanidad, consumo y bienestar social. Nota de prensa. Los antibióticos NO valen para todo [consultado 8 Abr 2020]. Disponible en: https://www.mscbs.gob.es/gabinete/notasPrensa.do?id=4713; 2019
  • Carbajal, (2019), Semergen, piiS1138-3593, pp. 30363
  • Zapata-Cachafeiro, (2019), J Antimicrob Chemother, 74, pp. 511, 10.1093/jac/dky440
  • Servia-Dopazo, (2018), J Antimicrob Chemother, 73, pp. 3244, 10.1093/jac/dky319
  • European Centre for Disease Prevention and Control. Infectious diseases & public health. Rates by country [consultado 16 Dic 2018]. Disponible en: https://www.ecdc.europa.eu/en/antimicrobial-consumption/database/rates-country; 2018
  • Rodríguez-Baño, (2020), Clin Microbiol Infect, 26, pp. 358, 10.1016/j.cmi.2019.07.009
  • Peñalva, (2019), Lancet Infect Dis, 20, pp. 199, 10.1016/S1473-3099(19)30573-0