Microbiology testing associated with antibiotic dispensing in older community-dwelling adults

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dc.contributor.authorPeng, Zhuoxin
dc.contributor.authorHayen, Andrew
dc.contributor.authorKirk, Martyn
dc.contributor.authorPearson, Sallie
dc.contributor.authorCheng, A.C.
dc.contributor.authorLiu, Bette
dc.date.accessioned2021-02-22T22:50:42Z
dc.date.available2021-02-22T22:50:42Z
dc.date.issued2020
dc.date.updated2020-11-15T07:18:07Z
dc.description.abstractBackground: It is commonly recommended that microbiological assessment should accompany the use of antibiotics prone to resistance. We sought to estimate the rate of microbiology testing and compare this to dispensing of the World Health Organization classified “watch” group antibiotics in primary care. Methods: Data from a cohort of older adults (mean age 69 years) were linked to Australian national health insurance (Pharmaceutical Benefits Scheme & Medicare Benefits Schedule) records of community-based antibiotic dispensing and microbiology testing in 2015. Participant characteristics associated with greater watch group antibiotic dispensing and microbiology testing were estimated using adjusted incidence rate ratios (aIRR) and 95% confidence intervals (CI) in multivariable zero-inflated negative binomial regression models. Results: In 2015, among 244,299 participants, there were 63,306 watch group antibiotic prescriptions dispensed and 149,182 microbiology tests conducted; the incidence rate was 0.26 per person-year for watch group antibiotic dispensing and 0.62 for microbiology testing. Of those antibiotic prescriptions, only 19% were accompanied by microbiology testing within − 14 to + 7 days. After adjusting for socio-demographic factors and co-morbidities, individuals with chronic respiratory diseases were more likely to receive watch group antibiotics than those without, e.g. asthma (aIRR:1.59, 95%CI:1.52–1.66) and chronic obstructive pulmonary disease (COPD) (aIRR:2.71, 95%CI:2.48– 2.95). However, the rate of microbiology testing was not comparably higher among them (with asthma aIRR:1.03, 95%CI:1.00–1.05; with COPD aIRR:1.00, 95%CI:0.94–1.06). Conclusions: Priority antibiotics with high resistance risk are commonly dispensed among community-dwelling older adults. The discord between the rate of microbiology testing and antibiotic dispensing in adults with chronic respiratory diseases suggests the potential for excessive empirical prescribing.en_AU
dc.description.sponsorshipThis project was supported by the Australian National Health and Medical Research Council (NHMRC) (grant number 1048180). BL and MK are supported by NHMRC research fellowships. ZP is supported by a Commonwealth Australian Government Research Training Program Scholarshipen_AU
dc.format.mimetypeapplication/pdfen_AU
dc.identifier.issn1471-2334en_AU
dc.identifier.urihttp://hdl.handle.net/1885/224125
dc.language.isoen_AUen_AU
dc.provenance© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.en_AU
dc.publisherBioMed Centralen_AU
dc.relationhttp://purl.org/au-research/grants/nhmrc/1048180en_AU
dc.rights© The Author(s).en_AU
dc.rights.licenseCreative Commons Attribution 4.0 International Licenseen_AU
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_AU
dc.sourceBMC Infectious Diseasesen_AU
dc.subjectWatch group antibioticsen_AU
dc.subjectMicrobiology testingen_AU
dc.subjectCommunityen_AU
dc.subjectStewardshipen_AU
dc.titleMicrobiology testing associated with antibiotic dispensing in older community-dwelling adultsen_AU
dc.typeJournal articleen_AU
dcterms.accessRightsOpen Accessen_AU
local.bibliographicCitation.issue306en_AU
local.bibliographicCitation.lastpage9en_AU
local.bibliographicCitation.startpage1en_AU
local.contributor.affiliationPeng, Zhuoxin, University of New South Walesen_AU
local.contributor.affiliationHayen, Andrew, University of Technology Sydneyen_AU
local.contributor.affiliationKirk, Martyn, College of Health and Medicine, ANUen_AU
local.contributor.affiliationPearson, Sallie, University of New South Walesen_AU
local.contributor.affiliationCheng, A.C., Department of Epidemiology and Preventive Medicineen_AU
local.contributor.affiliationLiu, Bette, University of New South Walesen_AU
local.contributor.authoremailu3853379@anu.edu.auen_AU
local.contributor.authoruidKirk, Martyn, u3853379en_AU
local.description.notesImported from ARIESen_AU
local.identifier.absfor111702 - Aged Health Careen_AU
local.identifier.absseo920502 - Health Related to Ageingen_AU
local.identifier.ariespublicationa383154xPUB13175en_AU
local.identifier.citationvolume20en_AU
local.identifier.doi10.1186/s12879-020-05029-zen_AU
local.identifier.uidSubmittedBya383154en_AU
local.publisher.urlhttp://www.biomedcentral.com/bmcinfectdis/en_AU
local.type.statusPublished Versionen_AU

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