國家衛生研究院 NHRI:Item 3990099045/11232
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    Please use this identifier to cite or link to this item: http://ir.nhri.org.tw/handle/3990099045/11232


    Title: Policy-driven revolution of prescription record in outpatient use of fluoroquinolones
    Authors: Kuo, SC;Shih, SM;Lauderdale, TLY;Chang, IS;Chen, YC;Hsiung, CA;Chang, SC
    Contributors: Institute of Population Health Sciences;National Institute of Cancer Research;National Institute of Infectious Diseases and Vaccinology
    Abstract: Objective: A policy initiated in 2001 by Taiwan's National Health Insurance (NHI) Administration has effectively reduced outpatient antibiotic use except fluoroquinolones (FQs). The influence of differential regulation policy of narrow-spectrum versus broad-spectrum FQs on the prescriptions is unknown. Methods: This study analyzed the claim records of oral FQs prescription at outpatient visits during 2000–2010 using the NHI Research Database and compared prescriptions for narrow-spectrum FQs, which are inactive against Streptococcus pneumoniae and lack formulary restriction, with those for broad-spectrum FQs. Results: Oral antibiotics were prescribed in 13.3% of visits and FQs accounted for 2.2% of them. During the study period the population-based rates of FQ prescription visits to children decreased, which was offset by increased use in the adult and geriatric populations (all p < 0.001). The most common encoded diagnoses for all FQs were urinary tract infection (19.2%) and sinusitis (10.9%), skin/bone/joint infections (7.9%), and lower respiratory tract infections (LRTI, 4.8%). Narrow-spectrum FQs accounted for 88.4% of all FQ prescriptions. Up to 95.4% of visits from patients with sinusitis and 34.3% of those with LRTI used narrow-spectrum FQs, while S. pneumoniae is an important etiology. Otorhinolaryngologists in non–hospital-based clinics prescribed most of narrow-spectrum FQs to patients with sinusitis or LRTI. Conclusions: We found debatable prescription of narrow-spectrum FQ based on claim records, particularly for LRTI and sinusitis, possibly due to the lack of formulary restriction. Additional efforts are needed to improve the appropriate selection of optimal FQs.
    Date: 2020-02
    Relation: Journal of Microbiology, Immunology and Infection. 2020 Feb;53(1):133-140.
    Link to: http://dx.doi.org/10.1016/j.jmii.2018.05.002
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=1684-1182&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000516797400016
    Cited Times(Scopus): https://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85048001247
    Appears in Collections:[Chao A. Hsiung] Periodical Articles
    [I-Shou Chang] Periodical Articles
    [Yee-Chun Chen] Periodical Articles
    [Tsai-Ling Yang Lauderdale] Periodical Articles
    [Shu-Chen Kuo] Periodical Articles

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