Antibiotic Utilization Among People With Multiple Sclerosis in the Netherlands, 2018-2020.

IF 2.4 4区医学 Q3 PHARMACOLOGY & PHARMACY Pharmacoepidemiology and Drug Safety Pub Date : 2024-12-01 DOI:10.1002/pds.70070

Melissa W Y Leung, Marloes T Bazelier, Bernard M J Uitdehaag, Hilda J I De Jong, Olaf H Klungel, Ewoudt M W van de Garde

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Abstract

Purpose: The purpose of this study was to describe the intensity and patterns of antibiotic drug use among people with multiple sclerosis (pwMS) in the Netherlands.

Methods: People with prevalent MS between 1 January 2018 and 31 December 2020 were identified using ambulatory hospital records from the PHARMO Database Network that contains routinely collected healthcare data from the Netherlands. Out-patient pharmacy dispensing data were used to assess type of antibiotic, dosage, and amounts dispensed. Antibiotic intensity in defined daily doses (DDD)/1000 patient-days (PD) was calculated together with frequency of dispensing of the same (prolongation) or different (switch) antibiotic up to 3 days after the end of the last antibiotic prescription; and stratified by sex, age, polypharmacy (use of > 4 out-patient prescription drugs for > 29 days), type of disease-modifying treatment, and Sars-CoV-2-related lockdown.

Results: A total of 1960 (37.8%) out of 5179 pwMS were dispensed ≥ 1 antibiotic. Of the 8762 dispensing events, 27.6%% were part of a prolongation, and 16.3% of a switch. Overall antibiotic use among pwMS was 18.8 DDD/1000 PD (95% confidence interval [95% CI]: 18.7-19.0) compared to 7.77-8.90 DDD/1000 PD in the general out-patient population, as reported by the Dutch Working Party on Antibiotic Policy. Antibiotic use was higher among women, increased with age, and was higher in people with polypharmacy and lower during lockdown. Nitrofurantoin was the most commonly dispensed antibiotic (41.7%).

Conclusions: The intensity of antibiotic use is considerably higher among pwMS than the general population. This reflects the burden of infection in this susceptible population.

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2018-2020年荷兰多发性硬化症患者抗生素使用情况

目的：本研究的目的是描述荷兰多发性硬化症（pwMS）患者抗生素药物使用的强度和模式。方法：使用PHARMO数据库网络中的门诊医院记录确定2018年1月1日至2020年12月31日期间流行的MS患者，该数据库网络包含来自荷兰的常规收集的医疗保健数据。门诊药房配药数据用于评估抗生素类型、剂量和配药量。计算限定日剂量(DDD)/1000患者日（PD）的抗生素强度，以及在最后一次抗生素处方结束后3天内使用相同（延长）或不同（切换）抗生素的频率；并按性别、年龄、多药（使用门诊处方药40天，持续29天）、改善疾病的治疗类型和与sars - cov相关的封锁进行分层。结果：5179名pwMS中有1960名（37.8%）使用了≥1种抗生素。在8762起配药事件中，27.6%是延长配药的一部分，16.3%是转换配药的一部分。根据荷兰抗生素政策工作组的报告，pwMS患者的总体抗生素使用为18.8 DDD/1000 PD(95%置信区间[95% CI]: 18.7-19.0)，而普通门诊患者的总体抗生素使用为7.77-8.90 DDD/1000 PD。抗生素的使用在女性中更高，随着年龄的增长而增加，在使用多种药物的人群中更高，在封锁期间更低。呋喃妥因是最常用的抗生素（41.7%）。结论：pwMS患者的抗生素使用强度明显高于普通人群。这反映了易感人群的感染负担。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pharmacoepidemiology and Drug Safety 医学-药学

CiteScore

4.80

自引率

7.70%

发文量

173

审稿时长

3 months

期刊介绍： The aim of Pharmacoepidemiology and Drug Safety is to provide an international forum for the communication and evaluation of data, methods and opinion in the discipline of pharmacoepidemiology. The Journal publishes peer-reviewed reports of original research, invited reviews and a variety of guest editorials and commentaries embracing scientific, medical, statistical, legal and economic aspects of pharmacoepidemiology and post-marketing surveillance of drug safety. Appropriate material in these categories may also be considered for publication as a Brief Report. Particular areas of interest include: design, analysis, results, and interpretation of studies looking at the benefit or safety of specific pharmaceuticals, biologics, or medical devices, including studies in pharmacovigilance, postmarketing surveillance, pharmacoeconomics, patient safety, molecular pharmacoepidemiology, or any other study within the broad field of pharmacoepidemiology; comparative effectiveness research relating to pharmaceuticals, biologics, and medical devices. Comparative effectiveness research is the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition, as these methods are truly used in the real world; methodologic contributions of relevance to pharmacoepidemiology, whether original contributions, reviews of existing methods, or tutorials for how to apply the methods of pharmacoepidemiology; assessments of harm versus benefit in drug therapy; patterns of drug utilization; relationships between pharmacoepidemiology and the formulation and interpretation of regulatory guidelines; evaluations of risk management plans and programmes relating to pharmaceuticals, biologics and medical devices.