門診上呼吸道感染抗生素使用及介入措施成效評估

Surveillance of Antibiotics Prescription for Patients with Upper Respiratory Tract Infection in Outpatient Clinics and Evaluation the Outcome of Intervention

林淑惠(Shu-Hui Lin) ； 陳惇杰(Tun-Chieh Chen) ； 盧柏樑(Po-Liang Lu) ； 蔡季君(Jih-Jin Tsai) ； 林俊祐(Chun-Yu Lin) ； 洪靖慈(Ching-Tzu Hung) ； 林蔚如(Wei-Ru Lin) ； 陳彥旭(Yen-Hsu Chen)

《感染控制雜誌》 20卷1期 (2010/02) Pp. 1-12

https://doi.org/10.6526/ICJ.201002_20(1).0001

摘要

Inappropriate use of antibiotic for treatment of upper respiratory tract infections (URI) can lead to bacterial resistance. The Bureau of National Health Insurance (NHI) has prohibited inappropriate antibiotic use in URI patients since 2001. We conducted a research to understand the physicians' compliance to the regulation of NHI and analyzed the outcome of our intervention by education, monitoring antibiotics consumption and feedback. We focused on patients' diagnosis with ICD-9 numbers of 460, 465.8, 465.9, 487.1 and 487.8 in our out-patient department (OPD) between January 2004 and December 2007. We surveyed the prescription rate of antibiotics for URI in OPDs of pediatric, pulmonary medicine, ENT, general medicine and family medicine departments and save feedback of the results of surveillance quarter1y. We found the antibiotic prescription rates for URI in OPD patients declined significantly (12.8% to 7.7%, P＜0.01). Physicians tended to prescribe broad-spectrum antibiotics in recent 2 years of our survey. Surveillance and feedback have efficient outcome on control antibiotic use in OPD. However, physicians did not follow the regulation of NHI completely. Therefore, stronger restrictions and implements should be considered to improve antibiotics policy of prescription for patients with URI.

關鍵字

上呼吸道感染 ； 抗生素

並列摘要

Inappropriate use of antibiotic for treatment of upper respiratory tract infections (URI) can lead to bacterial resistance. The Bureau of National Health Insurance (NHI) has prohibited inappropriate antibiotic use in URI patients since 2001. We conducted a research to understand the physicians' compliance to the regulation of NHI and analyzed the outcome of our intervention by education, monitoring antibiotics consumption and feedback. We focused on patients' diagnosis with ICD-9 numbers of 460, 465.8, 465.9, 487.1 and 487.8 in our out-patient department (OPD) between January 2004 and December 2007. We surveyed the prescription rate of antibiotics for URI in OPDs of pediatric, pulmonary medicine, ENT, general medicine and family medicine departments and save feedback of the results of surveillance quarter1y. We found the antibiotic prescription rates for URI in OPD patients declined significantly (12.8% to 7.7%, P＜0.01). Physicians tended to prescribe broad-spectrum antibiotics in recent 2 years of our survey. Surveillance and feedback have efficient outcome on control antibiotic use in OPD. However, physicians did not follow the regulation of NHI completely. Therefore, stronger restrictions and implements should be considered to improve antibiotics policy of prescription for patients with URI.

並列關鍵字

Upper respiratory tract infection ； antibiotic