PDF(Pubmed)
Abstract：
We performed a scoping review of articles published from 1 January 2000 to 4 January 2022 to characterize inequities in antibiotic prescribing and use across healthcare settings in the United States to inform antibiotic stewardship interventions and research. We included 34 observational studies, 21 cross-sectional survey studies, 4 intervention studies, and 2 systematic reviews. Most studies (55 of 61 [90%]) described the outpatient setting, 3 articles were from dentistry, 2 were from long-term care, and 1 was from acute care. Differences in antibiotic prescribing were found by patient\'s race and ethnicity, sex, age, socioeconomic factors, geography, clinician\'s age and specialty, and healthcare setting, with an emphasis on outpatient settings. Few studies assessed stewardship interventions. Clinicians, antibiotic stewardship experts, and health systems should be aware that prescribing behavior varies according to both clinician- and patient-level markers. Prescribing differences likely represent structural inequities; however, no studies reported underlying drivers of inequities in antibiotic prescribing.
摘要：
我们对2000年1月1日至2022年1月4日发表的文章进行了范围审查，以描述美国医疗保健环境中抗生素处方和使用的不平等，以告知抗生素管理干预和研究。我们纳入了34项观察性研究，21项横断面调查研究，4项干预研究，和2个系统评价。大多数研究(61项研究中的55项[90%])描述了门诊设置，3篇文章来自牙科，2来自长期护理，1来自急性护理。抗生素处方的差异是由患者的种族和种族发现的，性别,年龄,社会经济因素,地理,临床医生的年龄和专业，和医疗保健环境，强调门诊设置。很少有研究评估管理干预措施。临床医生,抗生素管理专家,和卫生系统应该意识到，处方行为根据临床和患者水平的标志物而有所不同。处方差异可能代表结构性不平等；然而，没有研究报告抗生素处方不公平的潜在驱动因素.
