Chronic diseases and compliance with provincial guidelines for outpatient antibiotic prescription in cases of otitis media and respiratory infections: a population-based study of linked data in Quebec, Canada, 2010–2017

Abstract

A ntimicrobial resistance is of concern to public health authorities worldwide. [1][2][3][4][5] As the frequency of multidrug resistant bacteria increases, with very few new antimicrobials developed, therapeutic options become more limited. This has led the World Health Organization to place antimicrobial resistance among its top 10 list of global health issues. 6 Antimicrobial use, especially inappropriate use, is the main modifiable determinant of resistance because of how it selects resistant strains. 6 Although exposure to antibiotics is higher in hospitals, most antimicrobial prescriptions are provided in the community. 7 In Quebec, hospitals are expected to have an antimicrobial stewardship program; 8,9 however, in the community, the main tools to support adequate use of antimicrobials are the provincial clinical guidelines developed by the Institut national d'excellence en santé et services sociaux (INESSS) for the treatment of the most common infections. 10 Quebec's rates of antimicrobial use in the community are among the lowest in Canada and are lower than those of most European countries. 7,11 It is unclear whether antibiotic use Chronic diseases and compliance with provincial guidelines for outpatient antibiotic prescription in cases of otitis media and respiratory infections: a population-based study of linked data

Evaluating Antibiotic Treatment Guideline Adherence to Ongoing Antibiotic Stewardship in a Tertiary Care Setting: A Retrospective Observational Study

“…The findings suggest that the overall adherence to standard treatment guidelines for antibiotic prescribing in terms of drug selection, dosage, and duration in the studied hospital was suboptimal at only 37.9%. The observation of the suboptimal-level adherence rate was congruent with that observed by previous studies in other European countries [ 37 , 38 ], but contrasted with some studies reporting higher levels of antimicrobial treatment guideline adherence rates: 53% observed in Denmark [ 39 ], 56% in the Netherlands [ 40 ], 57% in the Republic of Korea [ 41 ], and 59% in Canada [ 42 ]. In addition, Ekman et al [ 43 ] reported high adherence to treatment guidelines in Nepal in infants.…”