142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Geographic and Temporal Variations in Community Antibiotic Use, Florida, 2010-2012

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014

Taj Azarian, MPH , Epidemiology Department, University of Florida, Gainesville, FL
Robert L. Cook, MD, MPH , Department of Epidemiology, University of Florida College of Public Health and Health Professions, Gainesville, FL
Marco Salemi, PhD , Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL
Glenn Morris Jr., MD, MPH , Emerging Pathogens Institute, University of Florida, Gainesville, FL
Background: Antimicrobial resistance is a worldwide problem posing a serious threat to human health, with an estimated two million illnesses and 23,000 deaths in the US alone. Antibiotic use is the most important contributing factor to the development of antibiotic resistance; half of all antibiotics prescribed are unwarranted or improperly prescribed.  

Methods: To understand trends in antibiotic prescribing, we conducted a temporospatial analysis of 24 months of community antibiotic prescription data in Florida obtained from IMS Health Xponent database, which represent 100% projection of all outpatient prescription activity. We conducted a spatial regression of healthcare and demographic factors on county-level antibiotic prescriptions using ArcGIS and SaTScan. 

Results: Between 2010 and 2012, an average 15 million antibiotic prescriptions were prescribed in Florida annually, equating to 0.81 prescriptions per person.  We observed the highest prescription rates for B-lactam antibiotics; however, prescribing patterns varied across Florida counties by healthcare provider composition and demographics.  Children aged 1-4 years old received the greatest proportion of antibiotics and general practitioners were the highest prescribers. B-lactams, macrolides, cephalosporins, and fluoroquinolones demonstrated seasonality, while tetracycline and trimethoprim-sulfamethoxazole did not.  Among those demonstrating seasonality, prescriptions peaked in winter months, coinciding with seasonal peaks in the incidence of viral respiratory infections. 

Conclusions: These data demonstrate variations in healthcare provider prescribing practices and highlight communities as well as provider groups in which direct public health messaging should be aimed.  Understanding current trends in community antibiotic use may lead to targeted public health messaging aimed at high-prescribing provider groups or high-consuming patient populations.

Learning Areas:

Public health biology

Learning Objectives:
Describe the temporal and spatial variations in community antibiotic prescribing in Florida from 2010 to 2012 for six major antibiotic classes.

Keyword(s): Epidemiology, Surveillance

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am currently a doctoral candidate in the Department of Epidemiology at the University of Florida. My current work with the UF Emerging Pathogens Institute regards the investigation of antibiotic resistance, specifically among Staphylococcus aureus bacteria. Additionally, we are investigating the community factors driving the emergence of antibiotic resistance, focusing on hidden reservoirs of transmission and antibiotic use/misuse.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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