Cargando…

Antibiotic Prescribing in New York State Medicare Part B Beneficiaries Diagnosed With Cystitis Between 2016 and 2017

BACKGROUND: Statewide tracking and reporting is an outpatient antimicrobial stewardship tool that may be useful for many stakeholders. However, to date, these evaluations have been limited. This study aimed to track and report outpatient antibiotic prescribing in Medicare Part B enrollees diagnosed...

Descripción completa

Detalles Bibliográficos
Autores principales: Yu, Joyce Y, McKenna, Valerie A, Dumyati, Ghinwa K, Lubowski, Teresa J, Carreno, Joseph J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6975250/
https://www.ncbi.nlm.nih.gov/pubmed/31988975
http://dx.doi.org/10.1093/ofid/ofz544
_version_ 1783490257720705024
author Yu, Joyce Y
McKenna, Valerie A
Dumyati, Ghinwa K
Lubowski, Teresa J
Carreno, Joseph J
author_facet Yu, Joyce Y
McKenna, Valerie A
Dumyati, Ghinwa K
Lubowski, Teresa J
Carreno, Joseph J
author_sort Yu, Joyce Y
collection PubMed
description BACKGROUND: Statewide tracking and reporting is an outpatient antimicrobial stewardship tool that may be useful for many stakeholders. However, to date, these evaluations have been limited. This study aimed to track and report outpatient antibiotic prescribing in Medicare Part B enrollees diagnosed with cystitis in the outpatient setting. METHODS: This was a retrospective, cohort study of Medicare Part B enrollees in New York State. Inclusion criteria include outpatient visit in 2016 or 2017, cystitis diagnosis code, and oral antibiotic prescription ≤3 days after diagnosis of cystitis. Antibiotics were categorized as first-line, oral β-lactams, fluoroquinolones, or other per Infectious Diseases Society of America acute uncomplicated cystitis guidelines. Data were stratified by sex. Annual prescriptions proportions were compared using χ (2) test or Fisher’s exact test as appropriate. RESULTS: A total of 50 658 prescriptions were included. For females’ prescriptions, first line increased (41.5% vs 43.8%, P < .0001), oral β-lactams increased (17.8% vs 20.5%, P < .0001), fluoroquinolones decreased (34.1% vs 29.1%, P < .0001), and other increased (6.5% vs 6.6%, P = .76) in 2017. For males’ prescriptions, first line increased (25.2% vs 26.7%, P = .11), oral β-lactams increased (23.1% vs 26.2%, P = .0003), fluoroquinolones decreased (44.0% vs 39.3%, P < .0001), and other remained unchanged (7.8% vs 7.8%, P = .92) in 2017. CONCLUSIONS: Guideline concordant therapy prescribing for cystitis increased among Medicare Part B beneficiaries in New York State between 2016 and 2017. However, there was still a high prevalence of fluoroquinolone prescribing. These data highlight the need for additional outpatient antimicrobial stewardship efforts in New York State.
format Online
Article
Text
id pubmed-6975250
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-69752502020-01-27 Antibiotic Prescribing in New York State Medicare Part B Beneficiaries Diagnosed With Cystitis Between 2016 and 2017 Yu, Joyce Y McKenna, Valerie A Dumyati, Ghinwa K Lubowski, Teresa J Carreno, Joseph J Open Forum Infect Dis Major Article BACKGROUND: Statewide tracking and reporting is an outpatient antimicrobial stewardship tool that may be useful for many stakeholders. However, to date, these evaluations have been limited. This study aimed to track and report outpatient antibiotic prescribing in Medicare Part B enrollees diagnosed with cystitis in the outpatient setting. METHODS: This was a retrospective, cohort study of Medicare Part B enrollees in New York State. Inclusion criteria include outpatient visit in 2016 or 2017, cystitis diagnosis code, and oral antibiotic prescription ≤3 days after diagnosis of cystitis. Antibiotics were categorized as first-line, oral β-lactams, fluoroquinolones, or other per Infectious Diseases Society of America acute uncomplicated cystitis guidelines. Data were stratified by sex. Annual prescriptions proportions were compared using χ (2) test or Fisher’s exact test as appropriate. RESULTS: A total of 50 658 prescriptions were included. For females’ prescriptions, first line increased (41.5% vs 43.8%, P < .0001), oral β-lactams increased (17.8% vs 20.5%, P < .0001), fluoroquinolones decreased (34.1% vs 29.1%, P < .0001), and other increased (6.5% vs 6.6%, P = .76) in 2017. For males’ prescriptions, first line increased (25.2% vs 26.7%, P = .11), oral β-lactams increased (23.1% vs 26.2%, P = .0003), fluoroquinolones decreased (44.0% vs 39.3%, P < .0001), and other remained unchanged (7.8% vs 7.8%, P = .92) in 2017. CONCLUSIONS: Guideline concordant therapy prescribing for cystitis increased among Medicare Part B beneficiaries in New York State between 2016 and 2017. However, there was still a high prevalence of fluoroquinolone prescribing. These data highlight the need for additional outpatient antimicrobial stewardship efforts in New York State. Oxford University Press 2020-01-04 /pmc/articles/PMC6975250/ /pubmed/31988975 http://dx.doi.org/10.1093/ofid/ofz544 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Major Article
Yu, Joyce Y
McKenna, Valerie A
Dumyati, Ghinwa K
Lubowski, Teresa J
Carreno, Joseph J
Antibiotic Prescribing in New York State Medicare Part B Beneficiaries Diagnosed With Cystitis Between 2016 and 2017
title Antibiotic Prescribing in New York State Medicare Part B Beneficiaries Diagnosed With Cystitis Between 2016 and 2017
title_full Antibiotic Prescribing in New York State Medicare Part B Beneficiaries Diagnosed With Cystitis Between 2016 and 2017
title_fullStr Antibiotic Prescribing in New York State Medicare Part B Beneficiaries Diagnosed With Cystitis Between 2016 and 2017
title_full_unstemmed Antibiotic Prescribing in New York State Medicare Part B Beneficiaries Diagnosed With Cystitis Between 2016 and 2017
title_short Antibiotic Prescribing in New York State Medicare Part B Beneficiaries Diagnosed With Cystitis Between 2016 and 2017
title_sort antibiotic prescribing in new york state medicare part b beneficiaries diagnosed with cystitis between 2016 and 2017
topic Major Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6975250/
https://www.ncbi.nlm.nih.gov/pubmed/31988975
http://dx.doi.org/10.1093/ofid/ofz544
work_keys_str_mv AT yujoycey antibioticprescribinginnewyorkstatemedicarepartbbeneficiariesdiagnosedwithcystitisbetween2016and2017
AT mckennavaleriea antibioticprescribinginnewyorkstatemedicarepartbbeneficiariesdiagnosedwithcystitisbetween2016and2017
AT dumyatighinwak antibioticprescribinginnewyorkstatemedicarepartbbeneficiariesdiagnosedwithcystitisbetween2016and2017
AT lubowskiteresaj antibioticprescribinginnewyorkstatemedicarepartbbeneficiariesdiagnosedwithcystitisbetween2016and2017
AT carrenojosephj antibioticprescribinginnewyorkstatemedicarepartbbeneficiariesdiagnosedwithcystitisbetween2016and2017