Risk Factors Associated with Antibiotic Prescriptions for Cases of Enteric Pathogens in Canada, 2015-2019

Overview

Journal Epidemiol Infect

Publisher Cambridge University Press

Specialties Infectious Diseases
Public Health

Date 2024 Oct 23

PMID 39440529

Authors

Brendan Dougherty

Rita Finley

Danielle Dumoulin

J Scott Weese

Sherilee Harper

E Jane Parmley

Andrew Papadopoulos

Affiliations

Soon will be listed here.

Abstract

Inappropriate antibiotic use is a key driver of antibiotic resistance and one that can be mitigated through stewardship. A better understanding of current prescribing practices is needed to develop successful stewardship efforts. This study aims to identify factors that are associated with human cases of enteric illness receiving an antibiotic prescription. Cases of laboratory-confirmed enteric illness reported to the FoodNet Canada surveillance system between 2015 and 2019 were the subjects of this study. Laboratory data were combined with self-reported data collected from an enhanced case questionnaire that included demographic data, illness duration and symptoms, and antibiotic prescribing. The data were used to build univariable logistic regression models and a multivariable logistic regression model to explore what factors were associated with a case receiving an antibiotic prescription. The final multivariable model identified several factors as being significantly associated with cases being prescribed an antibiotic. Some of the identified associations indicate that current antibiotic prescribing practices include a substantial level of inappropriate use. This study provides evidence that antibiotic stewardship initiatives targeting infectious diarrhoea are needed to optimize antibiotic use and combat the rise of antibiotic resistance.

References

van Lunzen J, Altfeld M . Sex differences in infectious diseases-common but neglected. J Infect Dis. 2014; 209 Suppl 3:S79-80. DOI: 10.1093/infdis/jiu159. View

Goossens H, Ferech M, Vander Stichele R, Elseviers M . Outpatient antibiotic use in Europe and association with resistance: a cross-national database study. Lancet. 2005; 365(9459):579-87. DOI: 10.1016/S0140-6736(05)17907-0. View

Herikstad H, Yang S, Van Gilder T, Vugia D, Hadler J, Blake P . A population-based estimate of the burden of diarrhoeal illness in the United States: FoodNet, 1996-7. Epidemiol Infect. 2002; 129(1):9-17. PMC: 2869879. DOI: 10.1017/s0950268801006628. View

Dougherty B, Forrest R, Smith C, Morton V, Sherk L, Avery B . Impact of the COVID-19 Pandemic on the Reported Incidence of Select Bacterial Enteric Diseases in Canada, 2020. Foodborne Pathog Dis. 2023; 20(3):81-89. PMC: 9997028. DOI: 10.1089/fpd.2022.0064. View

Hatchette T, Farina D . Infectious diarrhea: when to test and when to treat. CMAJ. 2010; 183(3):339-44. PMC: 3042443. DOI: 10.1503/cmaj.091495. View

Thomas M, Murray R, Flockhart L, Pintar K, Fazil A, Nesbitt A . Estimates of foodborne illness-related hospitalizations and deaths in Canada for 30 specified pathogens and unspecified agents. Foodborne Pathog Dis. 2015; 12(10):820-7. PMC: 4601674. DOI: 10.1089/fpd.2015.1966. View

Bell B, Schellevis F, Stobberingh E, Goossens H, Pringle M . A systematic review and meta-analysis of the effects of antibiotic consumption on antibiotic resistance. BMC Infect Dis. 2014; 14:13. PMC: 3897982. DOI: 10.1186/1471-2334-14-13. View

Hulscher M, Grol R, van der Meer J . Antibiotic prescribing in hospitals: a social and behavioural scientific approach. Lancet Infect Dis. 2010; 10(3):167-75. DOI: 10.1016/S1473-3099(10)70027-X. View

Bartlett J . Clinical practice. Antibiotic-associated diarrhea. N Engl J Med. 2002; 346(5):334-9. DOI: 10.1056/NEJMcp011603. View

10.

Linder J . Editorial commentary: antibiotics for treatment of acute respiratory tract infections: decreasing benefit, increasing risk, and the irrelevance of antimicrobial resistance. Clin Infect Dis. 2008; 47(6):744-6. DOI: 10.1086/591149. View

11.

Thomas M, Murray R, Flockhart L, Pintar K, Pollari F, Fazil A . Estimates of the burden of foodborne illness in Canada for 30 specified pathogens and unspecified agents, circa 2006. Foodborne Pathog Dis. 2013; 10(7):639-48. PMC: 3696931. DOI: 10.1089/fpd.2012.1389. View

12.

Hohmann E . Nontyphoidal salmonellosis. Clin Infect Dis. 2001; 32(2):263-9. DOI: 10.1086/318457. View

13.

Dougherty B, Finley R, Marshall B, Dumoulin D, Pavletic A, Dow J . An analysis of antibiotic prescribing practices for enteric bacterial infections within FoodNet Canada sentinel sites. J Antimicrob Chemother. 2020; 75(4):1061-1067. DOI: 10.1093/jac/dkz525. View

14.

Nelson J, Kusmiesz H, Jackson L, Woodman E . Treatment of Salmonella gastroenteritis with ampicillin, amoxicillin, or placebo. Pediatrics. 1980; 65(6):1125-30. View

15.

Ong S, Nakase J, Moran G, Karras D, Kuehnert M, Talan D . Antibiotic use for emergency department patients with upper respiratory infections: prescribing practices, patient expectations, and patient satisfaction. Ann Emerg Med. 2007; 50(3):213-20. DOI: 10.1016/j.annemergmed.2007.03.026. View

16.

Pinkhasov R, Wong J, Kashanian J, Lee M, Samadi D, Pinkhasov M . Are men shortchanged on health? Perspective on health care utilization and health risk behavior in men and women in the United States. Int J Clin Pract. 2010; 64(4):475-87. DOI: 10.1111/j.1742-1241.2009.02290.x. View

17.

Proulx F, Turgeon J, Delage G, Lafleur L, Chicoine L . Randomized, controlled trial of antibiotic therapy for Escherichia coli O157:H7 enteritis. J Pediatr. 1992; 121(2):299-303. DOI: 10.1016/s0022-3476(05)81209-0. View

18.

Schroder W, Sommer H, Gladstone B, Foschi F, Hellman J, Evengard B . Gender differences in antibiotic prescribing in the community: a systematic review and meta-analysis. J Antimicrob Chemother. 2016; 71(7):1800-6. DOI: 10.1093/jac/dkw054. View

19.

Smits W, Lyras D, Lacy D, Wilcox M, Kuijper E . Clostridium difficile infection. Nat Rev Dis Primers. 2016; 2:16020. PMC: 5453186. DOI: 10.1038/nrdp.2016.20. View