Élise Fortin1,2, Sonia Jean3,4, Caroline Sirois3,5,6, Marc Simard3, Alejandra Irace-Cima7, Valérie Émond3, Marc Dionne3. 1. Institut national de santé publique du Québec, Québec, Canada. elise.fortin@inspq.qc.ca. 2. Department of Microbiology, Infectious Diseases and Immunology, Faculty of Medicine, University of Montreal, Québec, Canada. elise.fortin@inspq.qc.ca. 3. Institut national de santé publique du Québec, Québec, Canada. 4. Department of Medicine, Faculty of Medicine, Laval University, Québec, Canada. 5. Department of Social and Preventive Medicine, Faculty of Medicine, Laval University, Québec, Canada. 6. Centre d'excellence sur le vieillissement de Québec, Centre de recherche du CHU de Québec, Québec, Canada. 7. Institut national de santé publique du Québec, Montréal, Canada.
Abstract
OBJECTIVES: Chronic respiratory diseases (CRD) put patients at increased risk of respiratory infection and antimicrobial use, but surveillance results on community antimicrobial use are generally not adjusted for this risk factor. The objective of this study was to demonstrate the importance of accounting for CRD when interpreting indicators of community antimicrobial use in people over 65 years old, in Québec, Canada. METHODS: Retrospective cohort study of antimicrobial use according to CRD status in individuals over 65 years old covered by Québec's public drug insurance plan between 2010 and 2015. Defined daily doses per 1000 person-days (DID) were computed per antimicrobial class and were further stratified according to chronic disease group, fiscal year, gender and age group. RESULTS: Antimicrobial use was 2.3 times higher in the CRD group (29.7 DID) compared with the other chronic disease group (13.1 DID) and 3.1 times higher than in the no chronic disease group (9.6 DID). The same gradient was reflected as well in use per antimicrobial class, per age group, per gender, and in time. Antimicrobial use increased throughout the study period and was higher in older age groups and in women. CONCLUSIONS: Interpretation of results of antimicrobial use surveillance should consider the prevalence of CRD in populations. In order to identify opportunities for adapted interventions targeting inappropriate use, finer analyses are necessary.
OBJECTIVES: Chronic respiratory diseases (CRD) put patients at increased risk of respiratory infection and antimicrobial use, but surveillance results on community antimicrobial use are generally not adjusted for this risk factor. The objective of this study was to demonstrate the importance of accounting for CRD when interpreting indicators of community antimicrobial use in people over 65 years old, in Québec, Canada. METHODS: Retrospective cohort study of antimicrobial use according to CRD status in individuals over 65 years old covered by Québec's public drug insurance plan between 2010 and 2015. Defined daily doses per 1000 person-days (DID) were computed per antimicrobial class and were further stratified according to chronic disease group, fiscal year, gender and age group. RESULTS: Antimicrobial use was 2.3 times higher in the CRD group (29.7 DID) compared with the other chronic disease group (13.1 DID) and 3.1 times higher than in the no chronic disease group (9.6 DID). The same gradient was reflected as well in use per antimicrobial class, per age group, per gender, and in time. Antimicrobial use increased throughout the study period and was higher in older age groups and in women. CONCLUSIONS: Interpretation of results of antimicrobial use surveillance should consider the prevalence of CRD in populations. In order to identify opportunities for adapted interventions targeting inappropriate use, finer analyses are necessary.
Entities:
Keywords:
Antimicrobial use; COPD; Chronic respiratory diseases; Public health; Surveillance
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