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背景欧洲抗生素处方质量指标(APQI)是针对7种急性适应证(支气管炎、上呼吸道感染、膀胱炎、扁桃体炎、鼻窦炎、中耳炎和肺炎)而言:(1)为患者开具抗生素处方的百分比;(2)患者接受指南推荐的抗生素治疗的百分比;(3)患者接受喹诺酮类抗菌药治疗的百分比。目的评估利用初级卫生保健数据库的数据,得出21个APQI值的可行性;并评价全科医疗在办公和非办公时间开具的抗生素处方质量。方法数据源自佛兰德斯发病登记网络(http://www.intego.be)及非办公时间服务中心。根据修订的基层医疗国际分类第2版(ICPC-2-R)为两个数据库的诊断进行标记,根据解剖治疗化学分类系统(ATC)对抗生素处方分类。结果两个数据库均可计算出APQI值且结果相似。仅膀胱炎患者开具抗生素处方的百分比在可接受范围内。就所有适应证而言,接受指南推荐的抗生素治疗的百分比均低于可接受的范围(80%~100%)。对中耳炎、上呼吸道感染和扁桃体炎患者,采用喹诺酮类抗菌药治疗的百分比也在可接受范围内(0~5%)。结论初级保健数据库可得出APQI值。这些值表明,佛兰德全科医学在办公时间和非办公时间开具的抗生素处方质量有很大的可改善的空间,特别是采用指南推荐的抗生素方面。
Background The European Antibiotic Prescription Quality Index (APQI) is for seven acute indications (bronchitis, upper respiratory tract infection, cystitis, tonsillitis, sinusitis, otitis media and pneumonia): (1) Percentage of prescriptions prescribed for antibiotics ; (2) the percentage of patients receiving recommended guidelines for antibiotic treatment; and (3) the percentage of patients treated with quinolone antibacterials. Objective To assess the feasibility of using 21 primary health care databases for 21 APQI values and to evaluate the quality of prescribing antibiotic prescriptions during general and non-office hours. Method data were sourced from the Flemish Disease Register Network (http://www.intego.be) and non-office hours service centers. The two databases were diagnosed according to the revised International Classification of Primary Care, Second Edition (ICPC-2-R), and antibiotic prescriptions were classified according to the Anatomical and Chemotherapy Classification System (ATC). Results Both databases calculate APQI values and the results are similar. Only patients with cystitis prescribed antibiotic prescription percentage was within acceptable range. For all indications, the percentage of antibiotics recommended in the guidelines was below the acceptable range (80% -100%). For otitis media, upper respiratory tract infections and tonsillitis, the percentage of quinolone antibacterials was also acceptable (0-5%). Conclusion The primary care database yields APQI values. These values indicate that there is significant room for improvement in the quality of prescribing antibiotics prescribed by Flanders GPO during office hours and non-office hours, particularly with regard to the recommended antibiotics.