■调查covid-19大流行对A组链球菌感染患者人数和相关抗生素处方的影响。
■在英国使用OpenSAFELY-TPP进行回顾性队列研究。
■使用TPPSystmOne软件的英格兰初级保健实践,2018年1月1日至2023年3月31日,经英国NHS批准。
■在研究期的每个月开始时在TPP实践中注册的患者。性别或年龄数据缺失的患者被排除在外,2018年1月人口为23816470,到2023年3月增加到25541940。
■A组链球菌感染(喉咙痛或扁桃体炎,猩红热,和侵袭性A组链球菌感染),并推荐第一线,另类,以及之前(2020年4月之前)与A组链球菌感染相关的保留抗生素处方,during,以及(2021年4月后)covid-19限制之后。每个感染季节(9月至8月)的最高和最低计数和费率,以及2022-23赛季与上一个相对较高的赛季(2017-18)相比的比率。
■A组链球菌感染的患者人数,以及与A组链球菌感染迹象相关的抗生素处方,在2022年12月达到峰值,高于2017-18年的峰值。每月喉咙痛或扁桃体炎(可能是A组链球菌咽喉感染)的发生率,猩红热,2022-23年侵袭性A组链球菌感染相对于2017-18年为1.39(95%置信区间(CI)1.38至1.40),2.68(2.59至2.77),和4.37(2.94至6.48),分别。一线处方的费率比率,另类,2022-23年与2017-18年相比,对A组链球菌感染患者的保留抗生素为1.37(95%CI1.35至1.38),2.30(2.26至2.34),和2.42(2.24至2.61),分别。对于2022-23年的个别抗生素处方,与2017-18年相比,阿奇霉素显示出最大的相对增长,比率为7.37(6.22至8.74)。这一发现是在covid-19限制期间,A组链球菌感染和相关处方患者的记录显着减少之后,最大计数和比率低于covid-19大流行之前的任何最低比率。
■猩红热发病率的记录,喉咙痛或扁桃体炎,侵袭性A组链球菌感染,和相关的抗生素处方,2022年12月达到顶峰。初级保健数据可以通过与相关处方数据的联系以及对临床和人口统计学亚组的详细分析来补充现有的传染病监测。
UNASSIGNED: To investigate the effect of the covid-19 pandemic on the number of patients with group A streptococcal infections and related antibiotic prescriptions.
UNASSIGNED: Retrospective cohort
study in England using OpenSAFELY-TPP.
UNASSIGNED: Primary care practices in England that used TPP SystmOne software, 1 January 2018 to 31 March 2023, with the approval of NHS England.
UNASSIGNED: Patients registered at a TPP practice at the start of each month of the
study period. Patients with missing data for sex or age were excluded, resulting in a population of 23 816 470 in January 2018, increasing to 25 541 940 by March 2023.
UNASSIGNED: Monthly counts and crude rates of patients with group A streptococcal infections (sore throat or tonsillitis, scarlet fever, and invasive group A streptococcal infections), and recommended firstline, alternative, and reserved antibiotic prescriptions linked with a group A streptococcal infection before (pre-April 2020), during, and after (post-April 2021) covid-19 restrictions. Maximum and minimum count and rate for each infectious season (time from September to August), as well as the rate ratio of the 2022-23 season compared with the last comparably high season (2017-18).
UNASSIGNED: The number of patients with group A streptococcal infections, and antibiotic prescriptions linked to an indication of group A streptococcal infection, peaked in December 2022, higher than the peak in 2017-18. The rate ratios for monthly sore throat or tonsillitis (possible group A streptococcal throat infection), scarlet fever, and invasive group A streptococcal infection in 2022-23 relative to 2017-18 were 1.39 (95% confidence interval (CI) 1.38 to 1.40), 2.68 (2.59 to 2.77), and 4.37 (2.94 to 6.48), respectively. The rate ratio for prescriptions of first line, alternative, and reserved antibiotics to patients with group A streptococcal infections in 2022-23 relative to 2017-18 were 1.37 (95% CI 1.35 to 1.38), 2.30 (2.26 to 2.34), and 2.42 (2.24 to 2.61), respectively. For individual antibiotic prescriptions in 2022-23, azithromycin showed the greatest relative increase versus 2017-18, with a rate ratio of 7.37 (6.22 to 8.74). This finding followed a marked decrease in the recording of patients with group A streptococcal infections and associated prescriptions during the period of covid-19 restrictions where the maximum count and rates were lower than any minimum rates before the covid-19 pandemic.
UNASSIGNED: Recording of rates of scarlet fever, sore throat or tonsillitis, and invasive group A streptococcal infections, and associated antibiotic prescribing, peaked in December 2022. Primary care data can supplement existing infectious disease surveillance through linkages with relevant prescribing data and detailed analysis of clinical and demographic subgroups.