Population-based assessment of factors influencing antibiotic prescribing for adults with dengue infection in Taiwan
Background Antibiotic treatment for dengue is likely considerable and potentially avoidable but has not been well characterized. This study aimed to assess antibiotic prescribing for confirmed dengue cases in outpatient and inpatient settings and to identify associated patient, physician and context...
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ftdoajarticles:oai:doaj.org/article:4bb9f6f60b644ec991611c5ba2c48f4d 2023-05-15T15:13:21+02:00 Population-based assessment of factors influencing antibiotic prescribing for adults with dengue infection in Taiwan Chia-En Lien Yiing-Jenq Chou Yi-Jung Shen Theodore Tsai Nicole Huang 2022-02-01T00:00:00Z https://doaj.org/article/4bb9f6f60b644ec991611c5ba2c48f4d EN eng Public Library of Science (PLoS) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8884547/?tool=EBI https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 https://doaj.org/article/4bb9f6f60b644ec991611c5ba2c48f4d PLoS Neglected Tropical Diseases, Vol 16, Iss 2 (2022) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2022 ftdoajarticles 2022-12-30T19:37:37Z Background Antibiotic treatment for dengue is likely considerable and potentially avoidable but has not been well characterized. This study aimed to assess antibiotic prescribing for confirmed dengue cases in outpatient and inpatient settings and to identify associated patient, physician and contextual factors. Methods 57,301 adult dengue cases reported in Taiwan between 2008–2015 were analyzed. We assessed both outpatient and inpatient claims data of dengue patients from a week before to a week after their dengue infections were confirmed under Taiwan’s National Health Insurance program. A multivariable logistic regression with generalized estimating equations was used to estimate the probability of antibiotic prescribing in dengue patients. Results Overall, 24.6% of dengue patients were prescribed an antibiotic during the 14 day-assessment period. Antibiotics were prescribed in 6.1% and 30.1% of outpatient visits and inpatient admissions, respectively. Antibiotic prescriptions were reduced by ~50% in epidemic years. Among inpatients, advanced age, females, and major comorbidities were risk factors for receipt of an antibiotic; antibiotics were used in 26.0% of inpatients after dengue was diagnosed. Significant differences in antibiotic prescribing practices were observed among physicians in outpatient settings but not in inpatient settings. Conclusions In addition to patient and physician demographic characteristics, contextual factors such as care setting and during epidemics significantly influenced prescription of antibiotics. Characterization of prescribing patterns should help direct programs to curb antibiotic prescribing. Author summary Antimicrobial resistance is a growing global public health threat. The non-specific clinical manifestations of dengue overlap with signs and symptoms of other febrile illnesses common to tropical and subtropical zones making differential diagnosis between dengue and bacterial infections difficult, hence, leading to potentially unnecessary antibiotic prescribing. However, ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic |
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Directory of Open Access Journals: DOAJ Articles |
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English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Chia-En Lien Yiing-Jenq Chou Yi-Jung Shen Theodore Tsai Nicole Huang Population-based assessment of factors influencing antibiotic prescribing for adults with dengue infection in Taiwan |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Background Antibiotic treatment for dengue is likely considerable and potentially avoidable but has not been well characterized. This study aimed to assess antibiotic prescribing for confirmed dengue cases in outpatient and inpatient settings and to identify associated patient, physician and contextual factors. Methods 57,301 adult dengue cases reported in Taiwan between 2008–2015 were analyzed. We assessed both outpatient and inpatient claims data of dengue patients from a week before to a week after their dengue infections were confirmed under Taiwan’s National Health Insurance program. A multivariable logistic regression with generalized estimating equations was used to estimate the probability of antibiotic prescribing in dengue patients. Results Overall, 24.6% of dengue patients were prescribed an antibiotic during the 14 day-assessment period. Antibiotics were prescribed in 6.1% and 30.1% of outpatient visits and inpatient admissions, respectively. Antibiotic prescriptions were reduced by ~50% in epidemic years. Among inpatients, advanced age, females, and major comorbidities were risk factors for receipt of an antibiotic; antibiotics were used in 26.0% of inpatients after dengue was diagnosed. Significant differences in antibiotic prescribing practices were observed among physicians in outpatient settings but not in inpatient settings. Conclusions In addition to patient and physician demographic characteristics, contextual factors such as care setting and during epidemics significantly influenced prescription of antibiotics. Characterization of prescribing patterns should help direct programs to curb antibiotic prescribing. Author summary Antimicrobial resistance is a growing global public health threat. The non-specific clinical manifestations of dengue overlap with signs and symptoms of other febrile illnesses common to tropical and subtropical zones making differential diagnosis between dengue and bacterial infections difficult, hence, leading to potentially unnecessary antibiotic prescribing. However, ... |
format |
Article in Journal/Newspaper |
author |
Chia-En Lien Yiing-Jenq Chou Yi-Jung Shen Theodore Tsai Nicole Huang |
author_facet |
Chia-En Lien Yiing-Jenq Chou Yi-Jung Shen Theodore Tsai Nicole Huang |
author_sort |
Chia-En Lien |
title |
Population-based assessment of factors influencing antibiotic prescribing for adults with dengue infection in Taiwan |
title_short |
Population-based assessment of factors influencing antibiotic prescribing for adults with dengue infection in Taiwan |
title_full |
Population-based assessment of factors influencing antibiotic prescribing for adults with dengue infection in Taiwan |
title_fullStr |
Population-based assessment of factors influencing antibiotic prescribing for adults with dengue infection in Taiwan |
title_full_unstemmed |
Population-based assessment of factors influencing antibiotic prescribing for adults with dengue infection in Taiwan |
title_sort |
population-based assessment of factors influencing antibiotic prescribing for adults with dengue infection in taiwan |
publisher |
Public Library of Science (PLoS) |
publishDate |
2022 |
url |
https://doaj.org/article/4bb9f6f60b644ec991611c5ba2c48f4d |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 16, Iss 2 (2022) |
op_relation |
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8884547/?tool=EBI https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 https://doaj.org/article/4bb9f6f60b644ec991611c5ba2c48f4d |
_version_ |
1766343917561708544 |