scholarly journals 975. Clostridium difficile Infection and Antibiotic Prescription Rates in the Community: Explaining the Gender Gap

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S39-S39 ◽  
Author(s):  
Mariam Younas ◽  
Julie Royer ◽  
Hana Rac ◽  
Julie Ann Justo ◽  
P Brandon Bookstaver ◽  
...  
Keyword(s):  
South Carolina ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Antibiotic Prescription ◽  
Age Groups ◽  
Incidence Rates ◽  
Age Group ◽  
Significant Difference ◽  
Prescription Rates ◽  
Carolina Population

Abstract Background Previous studies have reported higher incidence rates of community-associated Clostridium difficile infection (CA-CDI) in women than in men. This cross-sectional population-based study examines whether this difference in CA-CDI rates across genders is driven by or independent of antibiotic use. Methods Medicaid and State Employee Health Plan pharmacy claims for outpatient oral antibiotics and associated medical claims were utilized for estimation of community antibiotic prescription rates in South Carolina population 18 to 64 years of age from January 1, 2015 to December 31, 2015. CA-CDI cases were identified from National Healthcare Safety Network (NHSN) and South Carolina Infectious Disease and Outbreak Network (SCION) through complete enumeration of South Carolina population of the same age and study period as above. Incidence rates of CA-CDI were reported in both men and women 18–39 and 40–64 years of age before and after adjustments for antibiotic prescription rates in the same gender and age group. The 95% confidence intervals (CI) were calculated to examine statistical difference in incidence rates across genders within the same age group. Results During the calendar year 2015, a total of 1,564 CA-CDI cases were identified in South Carolina residents 18–64 years of age. The incidence rate of CA-CDI per 100,000 person-years was higher in women than in men in age groups 18–39 years (37.3 [95% CI: 32.8–41.8] vs. 21.0 [95% CI: 17.6–24.4]) and 40–64 years (86.4 [95% CI: 80.1–92.8] vs. 56.6 [95% CI: 51.2–61.9]. Similarly, antibiotic prescription rates per 100 person-years were higher in women than men in the 2 respective age groups (118.8 [95% CI: 118.3–119.3] vs. 54.3 [95% CI: 53.9–54.8] and 130.4 [95% CI: 129.8–130.9] vs. 83.8 [95% CI: 83.3–84.4]. After adjustments for antibiotic prescriptions, there was no significant difference in the incidence rates of CA-CDI per 100,000 prescriptions between women and men 18–39 years of age (31.4 [95% CI: 27.6–35.2] vs. 38.6 [95% CI: 32.4–44.8] and 40–64 years old (66.3 [95% CI 61.5–71.2] vs. 67.5 [95% CI: 61.1–73.8]). Conclusion Higher crude incidence rates of CA-CDI in women are likely due to higher outpatient antibiotic prescription rates in women when compared with men. Disclosures P. B. Bookstaver, CutisPharma: Scientific Advisor, <$1,000. Melinta Therapeutics: Speaker’s Bureau, <$1,000.

Temporal trends in ambulatory antibiotic prescription rates in South Carolina: Impact of age, gender, and resident location

2020 ◽  
Vol 41 (8) ◽  
pp. 879-882
Author(s):  
Hana R. Winders ◽  
Julie Royer ◽  
Mariam Younas ◽  
Julie Ann Justo ◽  
P. Brandon Bookstaver ◽  
...  
Keyword(s):  
South Carolina ◽  
Rural Areas ◽  
Urban Areas ◽  
Antibiotic Prescription ◽  
Temporal Trends ◽  
Age Groups ◽  
Winter Season ◽  
Ambulatory Setting ◽  
Oral Antibiotic ◽  
Prescription Rates

AbstractObjective:To examine the temporal trends in ambulatory antibiotic prescription fill rates and to determine the influences of age, gender, and location.Design:Population-based cohort study.Setting:Ambulatory setting in South Carolina.Patients:Patients ≤64 years of age from January 2012 to December 2017.Methods:Aggregated pharmacy claims data for oral antibiotic prescriptions were utilized to estimate community antibiotic prescription rates. Poisson regression or Student t tests were used to examine overall temporal trend in antibiotic prescription rates, seasonal variation, and the trends across age group, gender, and rural versus urban location.Results:Overall antibiotic prescription rates decrease from 1,127 to 897 per 1,000 person years (P < .001). The decrease was more noticeable in persons aged <18 years (26%) and 18–39 years (20%) than in those aged 40–64 years (5%; P < .001 for all). Prescription rates were higher among females than males in all age groups, although this finding was the most pronounced in group aged 18–39 years (1,232 vs 585 per 1,000 person years; P < .0001). Annualized antibiotic prescription rates were higher during the winter months (December–March) than the rest of the year (1,145 vs 885 per 1,000 person years; P < .0001), and rates were higher in rural areas than in urban areas (1,032 vs 941 per 1,000 person years; P < .0001).Conclusions:The decline in ambulatory antibiotic prescription rates is encouraging. Ongoing ambulatory antibiotic stewardship efforts across South Carolina should focus on older adults, rural areas, and during the winter season when antibiotic prescriptions peak.

Clostridioides difficile infection and antibiotic prescription rates in the community: Explaining the gender gap

2020 ◽  
pp. 1-3
Author(s):  
Mariam Younas ◽  
Julie Royer ◽  
Sharon B. Weissman ◽  
Hana R. Winders ◽  
Sangita Dash ◽  
...  
Keyword(s):  
South Carolina ◽  
Gender Gap ◽  
Antibiotic Prescription ◽  
Population Based ◽  
Incidence Rates ◽  
Cross Sectional ◽  
Crude Incidence ◽  
Clostridioides Difficile ◽  
Clostridioides Difficile Infection ◽  
Prescription Rates

Abstract In this cross-sectional population-based study, women had significantly higher crude incidence rates of both community-associated Clostridioides difficile infection (CA-CDI) and ambulatory antibiotic prescriptions compared to men in South Carolina in 2015. After adjustments for antibiotic prescription rates, there was no difference in the incidence rates of CA-CDI between the genders.

Trends in Oral Antibiotic, Proton Pump Inhibitor, and Histamine 2 Receptor Blocker Prescription Patterns for Children Compared With Adults

2015 ◽  
Vol 55 (8) ◽  
pp. 712-716 ◽  
Author(s):  
Howard S. Faden ◽  
Chan-Xing Ma
Keyword(s):  
Clostridium Difficile ◽  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Clostridium Difficile Infection ◽  
Antibiotic Prescription ◽  
Receptor Blocker ◽  
Oral Antibiotic ◽  
Oral Antibiotics ◽  
Prescription Patterns ◽  
Prescription Rates

The use of antibiotics, proton pump inhibitor (PPI), and histamine 2 receptor blocker (H2B) was compared between children and adults in the community from 2005 through 2011. Antibiotic prescription rates remained stable for children, but increased significantly for adults, P = .03. PPI prescription rates increased for children, P = .02 and for adults, P = .009. H2B prescription rates increased for children, P = .03, but not for adults. Antibiotic prescription rates were significantly higher in children than adults in all 7 years, P < .0001. In contrast, PPI prescription rates were significantly higher in adults than children in all 7 years, P < .0001. H2B prescription rates were significantly higher in adults than children 1 to 18 years old P < .0001; however, H2B prescription rates were highest in children <1 year old, P = .0001. The high use of oral antibiotics, PPI, and H2B among outpatients may be a contributing factor to the rise of Clostridium difficile infection in the community.

scholarly journals Incidence of Pediatric Community Associated Clostridium Difficile Infection Following Common Antibotics

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S392-S392 ◽  
Author(s):  
Margot Miranda Katz ◽  
Deepika Parmar ◽  
Rebecca Dang ◽  
Amy Alabaster ◽  
Tara Greenhow
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Clinical Symptoms ◽  
Antibiotic Prescription ◽  
Antibiotic Use ◽  
Incidence Rates ◽  
Kaiser Permanente ◽  
Health Records ◽  
Stool Specimens ◽  
Third Generation Cephalosporins

Abstract Background As rates of pediatric community-associated (CA) Clostridium difficile infection (CDI) increase, additional research is needed to address rates of infection following common antibiotics. Methods This study was a retrospective review of the electronic health records of all children with stool specimens sent for C difficile from January first 2012 – December 31st2016 at Kaiser Permanente Northern California. Children with clinical symptoms consistent with CDI, confirmatory laboratory testing, no other identified causes of diarrhea, and community associated disease were defined as cases. Using outpatient and ED antibiotic prescription records for children, incidence rates were calculated for subsequent CA CDI for the most commonly prescribed antibiotics. Results Of 507 primary CDI cases in our cohort, 327 had any antibiotic use 2012–2015. There were 205 primary CDI cases that were preceded by an antibiotic in the previous 1–365 days. Many of these patients had more than 1 antibiotic in the preceding year. Of those, rates of CA CDI were uncommon following common antibiotics. (Table) The highest rate of CA CDI followed ceftriaxone, cefdinir, ciprofloxacin and augmentin. The lowest rates were seen following penicillin, doxycycline and azithromycin. Ninety-three percent of the antibiotic prescriptions were in outpatients, 7% in inpatients. Conclusion As rates of CA CDI increase, clinicians should be aware of rates of infection following administration of common antibiotics. The most common antibiotics to cause CA CDI were third-generation cephalosporins (ceftriaxone and cefdinir) and ciprofloxacin. Disclosures All authors: No reported disclosures.

scholarly journals Marked reductions in outpatient antibiotic prescriptions for children and adolescents – a population-based study covering 83% of the paediatric population, Germany, 2010 to 2018

2020 ◽  
Vol 25 (31) ◽  
Author(s):  
Jakob Holstiege ◽  
Maike Schulz ◽  
Manas K Akmatov ◽  
Annika Steffen ◽  
Jörg Bätzing
Keyword(s):  
Antibiotic Prescription ◽  
Age Groups ◽  
European Countries ◽  
Antibiotic Prescribing ◽  
Third Generation ◽  
Prescription Rate ◽  
Age Group ◽  
Cross Sectional ◽  
Targeted Interventions ◽  
Prescription Rates

Background Prescribing of systemic antibiotics in general and of cephalosporins in particular in German paediatric outpatients has previously been reported to be higher than in other European countries. Aim Our objective was to assess recent trends in antibiotic prescribing in German children. Methods This study was conducted as consecutive annual cross-sectional analyses and included all children aged 0–14 years (n = 9,389,183 in 2018) covered by statutory health insurance in Germany. Annual antibiotic prescription rates from 2010 to 2018 were calculated for the age groups 0–1, 2–5, 6–9 and 10–14 years. Poisson regression was used to estimate trends of prescription rates by age group and antibiotic subgroup. Results Overall, the age-standardised antibiotic prescription rate decreased significantly by 43% from 746 prescriptions per 1,000 persons in 2010 to 428 per 1,000 in 2018 (p < 0.001). Reductions were most pronounced in the age groups 0–1 year (−50%) and 2–5 years (−44%). The age group 2–5 years exhibited the highest prescription rate with 683 per 1,000 in 2018 (0–1 year: 320/1,000; 6–9 years: 417/1,000; 10–14 years: 273/1,000). Cephalosporins (second and third generation) accounted for 32% of prescribed antibiotics. Conclusions Marked reductions in antibiotic prescribing during the last decade indicate a change towards more judicious paediatric prescribing habits. Compared with other European countries, however, prescribing of second- and third-generation cephalosporins remains high in Germany, suggesting frequent first-line use of these substances for common respiratory infections. Considerable regional variations underline the need for regionally targeted interventions.

scholarly journals 2733. Association Between Influenza Vaccination Coverage and Ambulatory Antibiotic Prescription Rates in Children in South Carolina

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S962-S962 ◽  
Author(s):  
Mariam Younas ◽  
Julie Royer ◽  
Hana Rac ◽  
Sharon Weissman ◽  
Katie Waites ◽  
...  
Keyword(s):  
South Carolina ◽  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
Vaccination Coverage ◽  
Influenza Season ◽  
Antibiotic Prescription ◽  
Vaccine Coverage ◽  
Prescription Rate ◽  
Prescription Rates ◽  
Carolina Population

Abstract Background Prior studies demonstrated an increase in ambulatory antibiotic prescription rates during the peak of Influenza virus activity, which often occurs during the first 4 months of the year in Southeastern United States. However, the impact of Influenza vaccination coverage on antibiotic prescription rates remains undefined. The purpose of this retrospective cohort study is to examine the association between Influenza vaccination coverage and ambulatory antibiotic prescription rates in children in South Carolina from 2012 to 2017. Methods Medicaid and State Employee Health Plan pharmacy claims for outpatient oral antibiotics were utilized for estimation of community antibiotic prescription rates in South Carolina population 6 months to 17 years of age from January 1, 2012 to December 31, 2017, which represents approximately 60% of the South Carolina population in this age group. Linear regression was used to examine the association between antibiotic prescription rates in January to April of each year and Influenza vaccine coverage in children 6 months to 17 years old after adjustments for Influenza vaccine effectiveness in that season as obtained from Centers for Disease Control and Prevention (CDC). Results During the 6-year study period, the mean antimicrobial prescription rate in children in South Carolina declined from 103 to 79 per 1000 person-months for the months January through April indicating a 26% decline (P < 0.0001). Influenza vaccine coverage also increased from 50.6% during the first Influenza season of the study and peaked at 60.7% in 2014–2015 Influenza season (Figure 1). After adjusting for the vaccine effectiveness, the decline in antibiotic prescription rate was significantly associated with an increase in vaccine coverage in children (P-value < 0.01). Antibiotic prescription rates declined by 3 per 1,000 person-months for each 1% increase in Influenza vaccine coverage in children. Conclusion There is a temporal association between the increase in Influenza vaccination coverage and the decline in ambulatory antibiotic prescription rates in children in South Carolina. Achieving the CDC’s set target Influenza vaccination coverage of 70% of the population may be associated with greater decline in ambulatory antibiotic prescription rates in children in the future. Disclosures All authors: No reported disclosures.

scholarly journals The incidence of pneumonia in the paediatric population in Poland in light of the maps of health needs

2021 ◽  
Author(s):  
Joanna Lange ◽  
Jerzy Kozielski ◽  
Kinga Bartolik ◽  
Paweł Kabicz ◽  
Tomasz Targowski
Keyword(s):  
Average Length ◽  
Age Groups ◽  
Paediatric Population ◽  
Incidence Rates ◽  
Education Development ◽  
Average Length Of Stay ◽  
Significant Difference ◽  
Social Fund ◽  
Hospital Deaths ◽  
Reported Data

Abstract In Poland, no statistical data are available concerning the analysis of the incidence of pneumonia in inpatient children. The requirement for these data results mainly from the need to prepare systemic and economic solutions. Aim This study aimed to use reported data for evaluating pneumonia incidence rates among hospitalised children and other parameters in various age groups. Subject and methods A detailed analysis was performed as part of the Operational Programme Knowledge Education Development co-financed by the European Social Fund. Services reported to the National Health Fund in 2014 were considered, including pneumonia incidence among hospitalised children and mortality in specific age groups. Results In 2014, a total of 68,543 children were hospitalised for pneumonia (68% of all hospitalisations for acute respiratory diseases). Within each of the analysed age groups, boys were hospitalised more frequently. Irrespective of the place of residence, infants were most commonly hospitalised. It was observed that there was a significant difference between the incidence rate of pneumonia among hospitalised children in all analysed groups depending on the province. The average length of stay was 7.29 days, with infants requiring the longest stays (7.96 days), and 1.8% of children were rehospitalised within 30 days due to recurrence of pneumonia. The most commonly coded pathogens responsible for pneumonia included Mycoplasma pneumoniae, Streptococcus pneumoniae and Chlamydia spp. A total of 19 inpatient hospital deaths in the course of pneumonia were reported. Conclusions Based on our findings, it is warranted to utilize epidemiological knowledge for the planning of an appropriate level of service commissioned both in outpatient and inpatient facilities as well as for the estimation of institutional and staff needs necessary to secure these services.

scholarly journals Vaccine impact and effectiveness of meningococcal serogroup ACWY conjugate vaccine implementation in the Netherlands: a nationwide surveillance study

2021 ◽  
Author(s):  
Milou Ohm ◽  
Susan J M Hahné ◽  
Arie van der Ende ◽  
Elizabeth A M Sanders ◽  
Guy A M Berbers ◽  
...  
Keyword(s):  
The Netherlands ◽  
Incidence Rate ◽  
Vaccination Programme ◽  
Screening Method ◽  
Age Groups ◽  
Incidence Rates ◽  
Age Group ◽  
Mass Campaign ◽  
Conjugate Vaccination ◽  
The Impact

Abstract Background In response to the recent serogroup W invasive meningococcal disease (IMD-W) epidemic in the Netherlands, meningococcal serogroup C (MenC) conjugate vaccination for 14-month-olds was replaced with a MenACWY conjugate vaccination, and a mass campaign targeting 14-18 year-olds was executed. We investigated the impact of MenACWY vaccination implementation in 2018-2020 on incidence rates and estimated vaccine effectiveness (VE). Methods We extracted all IMD cases diagnosed between July 2014 and December 2020 from the national surveillance system. We calculated age group-specific incidence rate ratios by comparing incidence rates before (July 2017-March 2018) and after (July 2019-March 2020) MenACWY vaccination implementation. We estimated VE in vaccine-eligible cases using the screening method. Results Overall, IMD-W incidence rate lowered by 61% (95%CI 40-74). It declined by 82% (95%CI 18-96) in vaccine-eligible age group (15-36 month-olds and 14-18 year-olds) and by 57% (95%CI 34-72) in vaccine non-eligible age groups. VE was 92% (95%CI -20-99.5) against IMD-W vaccine-eligible toddlers. No IMD-W cases were reported in vaccine-eligible teenagers after the campaign. Conclusions The MenACWY vaccination programme was effective in preventing IMD-W in the target population. The IMD-W incidence reduction in vaccine non-eligible age groups may be caused by indirect effects of the vaccination programme. However, disentangling natural fluctuation from vaccine-effect was not possible. Our findings encourage the use of toddler- and teenager MenACWY vaccination in national immunization programmes especially when implemented together with a teenager mass campaign during an epidemic.

scholarly journals Characteristics of Helicobacter pylori infection in a National Referral Hospital in Bhutan

2020 ◽  
Vol 6 (1) ◽  
pp. 6-10
Author(s):  
Chhabi Lal Adhikari ◽  
Guru Prasad Dhakal ◽  
Nongluck Suwisith ◽  
Sonam Dargay ◽  
Krishna P Sharma
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
Age Groups ◽  
Referral Hospital ◽  
Upper Gastrointestinal Endoscopy ◽  
Age Group ◽  
Exact Test ◽  
Significant Difference ◽  
H Pylori ◽  
National Referral Hospital

Introduction: Helicobacter pylori (H. pylori) is a bacterium causing chronic gastric infection and may cause gastric cancer. It was necessary to see the trend of infection, especially in symptomatic patients. This retrospective descriptive study was aimed to describe the characteristics of H. pylori infection in Bhutanese patients referred for an endoscopy to the National Referral Hospital, Thimphu. Methods: The sample of the study was randomized 380 medical records of the patients who underwent upper gastrointestinal endoscopy and Rapid Urea Test for symptomatic dyspepsia and peptic ulcer. Data was collected using a survey form designed by the researchers. Data analysis was done using descriptive statistics and either Chi-square or Fisher’s exact test. Results: The prevalence of H. pylori infection was very high (76.6%). The mean age of the infection was 42 with a range from 15 to 84 years. The highest prevalence of infection was observed in the age group 20-29 years (82.7%) and lowest in the oldest age group 70-84 years (66.7%). The analysis showed no significant difference in infection amongst age groups, gender, and endoscopic findings to the positive results at 5% significant level except for monthly prevalence (p<0.001). Gastritis was the commonest endoscopy finding (153/380) and gastro-duodenitis had the highest positivity rate (88.9%). Conclusion: The prevalence of infection was relatively high compared with previous studies. Young and middle-aged adults had a high prevalence and this group needs to be given priority for screening and eradication treatment considering limited resources to prevent associated gastric cancer in Bhutan.

scholarly journals The Dynamics of Cullin-1 Expression in Preeclamptic Placenta and its Association with Pregnancy Termination Time

2020 ◽  
Vol 8 (B) ◽  
pp. 210-215
Author(s):  
Makbruri Makbruri ◽  
Isabella Kurnia Liem ◽  
Ahmad Aulia Jusuf ◽  
Tantri Hellyanti
Keyword(s):  
Gestational Age ◽  
Pregnancy Termination ◽  
Age Groups ◽  
Trophoblast Invasion ◽  
Age Group ◽  
Placental Development ◽  
Very Preterm ◽  
Significant Difference ◽  
Cellular Factors ◽  
Termination Time

BACKGROUND: Preeclampsia is a systemic syndrome occurring in 3–5% of pregnancies, caused by disorders of cellular factors resulting in the disruption of trophoblast differentiation and invasion which is important for the placental development and maintaining pregnancy. Cullin-1 is a protein that plays a role in the process of maintaining pregnancy, development, and trophoblast invasion in the placenta. Until now, there have been no studies linking the expression of cullin-1 in preeclamptic patients with the timing of pregnancy termination. AIM: This study analyzed cullin-1 expression in preeclamptic patients and their relationship to the timing of pregnancy termination was carried out. METHODS: Placental samples were taken from preeclampsia patients consisting of three gestational age groups, then immunohistochemical staining was performed to see the dynamics of expression and distribution in each age group of pregnancy and to find out their relationship with the timing of pregnancy termination. RESULTS: Cullin-1 was expressed in syncytiotrophoblasts and cytotrophoblasts. The lowest cullin-1 level was obtained in the very preterm age group, and the highest was found in the moderate preterm gestational age group. There was a significant difference between cullin-1 optical density (OD) expression and termination time of pregnancy, and there was a significant difference (OD) in cullin-1 preeclamptic patients with very preterm gestational age with moderate preterm gestational age. CONCLUSION: Cullin-1 was expressed both in syncytiotrophoblasts and cytotrophoblasts and was associated with the timing of pregnancy termination.

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