Study design

A retrospective cross-sectional study.

Objective

To identify who prescribes outpatient antibiotics among a primary care spinal cord injury (SCI) cohort.

Setting

ICES databases in Ontario, Canada.

Methods

A cohort of individuals with SCI were retrospectively identified using a tested-algorithm and chart reviews in a primary care electronic medical records database. The cohort was linked to a drug dispensing database to obtain outpatient antibiotic prescribing information, and prescriber details were obtained from a physician database.

Results

Final cohort included three hundred and twenty individuals with SCI. The average annual number of antibiotic courses dispensed for the SCI cohort was 2.0 ± 6.2. For dispensed antibiotics, 58.9% were prescribed by rostered-primary care practice physicians, compared to 17.9% by emergency and non-rostered primary care physicians, 17.4% by specialists and 6.1% by non-physician prescribers. Those who lived in urban areas and rural areas, compared to those who lived in suburban areas, were more likely to receive antibiotics from emergency and non-rostered primary care physicians than from rostered-primary care practice physicians.

Conclusion

Although individuals with SCI received outpatient antibiotic prescriptions from multiple sources, physicians from an individual’s rostered-primary care practice were the main antibiotic prescribers. As such, interventions to optimize antibiotics use in the SCI population should target the primary care practice.

中文翻译：

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确定初级保健脊髓损伤队列中抗生素的处方者

学习规划

一项回顾性横断面研究。

客观的

旨在确定初级保健脊髓损伤 (SCI) 队列中谁为门诊患者开抗生素。

环境

加拿大安大略省的 ICES 数据库。

方法

使用初级保健电子病历数据库中经过测试的算法和图表审查来回顾性识别一组 SCI 患者。该队列与药物配药数据库相关联，以获取门诊抗生素处方信息，并从医生数据库中获取处方者详细信息。

结果

最终队列包括 320 名 SCI 患者。 SCI 队列的平均每年抗生素疗程数为 2.0 ± 6.2。对于配发的抗生素，58.9%是由登记初级保健执业医生开出的，相比之下，17.9%是由急诊和非登记初级保健医生开出的，17.4%是由专科医生开出的，6.1%是由非医生开出的。与居住在郊区的人相比，居住在城市和农村地区的人更有可能从急诊和非名册初级保健医生那里获得抗生素，而不是从名册初级保健执业医生那里获得抗生素。

结论

尽管 SCI 患者从多个来源获得门诊抗生素处方，但个人名册初级保健诊所的医生是主要的抗生素处方者。因此，优化 SCI 人群抗生素使用的干预措施应针对初级保健实践。