Prescribing Antibiotics in Public Primary Care Clinics in Singapore: A Retrospective Cohort Study.
Autor: | Koh SWC; National University Polyclinics, National University Health System, Singapore 609606, Singapore.; Division of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore., Lee VME; National University Polyclinics, National University Health System, Singapore 609606, Singapore.; Division of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore., Low SH; National University Polyclinics, National University Health System, Singapore 609606, Singapore., Tan WZ; National University Polyclinics, National University Health System, Singapore 609606, Singapore.; School of Biological Sciences, Nanyang Technological University, Singapore 637551, Singapore., Valderas JM; Division of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore., Loh VWK; Division of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore., Sundram M; National University Polyclinics, National University Health System, Singapore 609606, Singapore., Hsu LY; Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore. |
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Jazyk: | angličtina |
Zdroj: | Antibiotics (Basel, Switzerland) [Antibiotics (Basel)] 2023 Apr 16; Vol. 12 (4). Date of Electronic Publication: 2023 Apr 16. |
DOI: | 10.3390/antibiotics12040762 |
Abstrakt: | Background: Antibiotic prescription practices in primary care in Singapore have received little scholarly attention. In this study, we ascertained prescription prevalence and identified care gaps and predisposing factors. Methods: A retrospective study was conducted on adults (>21 years old) at six public primary care clinics in Singapore. Prescriptions >14 days were excluded. Descriptive statistics were used to showcase the prevalence data. We used chi-square and logistic regression analyses to identify the factors affecting care gaps. Results: A total of 141,944 (4.33%) oral and 108,357 (3.31%) topical antibiotics were prescribed for 3,278,562 visits from 2018 to 2021. There was a significant reduction in prescriptions ( p < 0.01) before and after the pandemic, which was attributed to the 84% reduction in prescriptions for respiratory conditions. In 2020 to 2021, oral antibiotics were most prescribed for skin (37.7%), genitourinary (20.2%), and respiratory conditions (10.8%). Antibiotic use in the "Access" group (WHO AWaRe classification) improved from 85.6% (2018) to 92.1% (2021). Areas of improvement included a lack of documentation of reasons for antibiotic use, as well as inappropriate antibiotic prescription for skin conditions. Conclusion: There was a marked reduction in antibiotic prescriptions associated with the onset of the COVID-19 pandemic. Further studies could address the gaps identified here and evaluate private-sector primary care to inform antibiotic guidelines and the local development of stewardship programs. |
Databáze: | MEDLINE |
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