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    題名: Doctor characteristics and prescribing antibiotics for urinary tract infections: the experience of an Asian country
    作者: Lin,Yi-Chun;Lin,Herng-Ching;林秀真
    貢獻者: 台北醫學大學附設醫院小兒學科
    關鍵詞: broad-spectrum antibiotics;prescribing;behaviour;urinary tract infections
    日期: 2010
    上傳時間: 2012-01-16 16:08:26 (UTC+8)
    摘要: Abstract
    Rationale, aims and objectives This study aims to explore the relationship between
    doctor characteristics and prescribing behaviour for patients with urinary tract infections
    (UTIs) using a 2-year population-based data set in Taiwan.
    Methods This study used data from the Taiwan National Health Insurance Research
    Database. Our study sample consists of first-time ambulatory care visits for treatment of
    UTIs among female patients between 2005 and 2006 (n = 45 934). The primary outcome
    studied was ‘whether a broad-spectrum antibiotic was prescribed’, and the key independent
    variables were ‘doctor characteristics’. Doctor characteristics included gender, age (<41,
    41–50, >50), specialty, type (hospital-based vs. office-based) and practice location. Multivariate
    logistic regression analysis using generalized estimated equations was performed
    to assess the adjusted odds ratio of the doctors using broad-spectrum antibiotics.
    Results Among the sampled patients, 13.5% were prescribed broad-spectrum antibiotics
    at their first visit for treatment of UTIs. The adjusted odds of prescribing second-line
    antibiotics for doctors aged between 41–50 years and >50 years were 0.80 (P < 0.001) and
    0.90 (P = 0.007) times, respectively, that of doctors aged <41 years. Doctors specializing in
    family medicine were 1.10 (P = 0.006) times more likely than doctors specializing in
    obstetrics and gynaecology to prescribe broad-spectrum, and office-based doctors were
    1.41 (P < 0.001) times more likely than hospital-based doctors to do so.
    Conclusions We conclude that there is variation in doctor prescribing behaviour of antimicrobial
    therapy for UTIs, after adjusting for possible confounding factors. Continuing
    medical education and intervention should be designed for doctor groups with undesirable
    performance in prescribing antibiotics.
    關聯: Journal of evaluation in clinical practice. 16(6): 1221–1226.
    顯示於類別:[小兒學科] 期刊論文

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