Risk factors associated with antibiotic prescriptions for cases of enteric pathogens in Canada, 2015–2019

• Published in: Epidemiology and infection Vol. 152; p. e131
• Main Authors: Dougherty, Brendan, Finley, Rita, Dumoulin, Danielle, Weese, J. Scott, Harper, Sherilee, Parmley, E. Jane, Papadopoulos, Andrew
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 23.10.2024
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents - therapeutic use; Antibiotic resistance; Antibiotics; Antimicrobial Stewardship; Bacterial infections; Canada - epidemiology; Child; Child, Preschool; Diarrhea; Diarrhea - drug therapy; Diarrhea - epidemiology; Diarrhea - microbiology; Drug Prescriptions - statistics & numerical data; Drug resistance; Female; Health surveillance; Humans; Hypothesis testing; Illnesses; Infant; Infant, Newborn; International travel; Laboratories; Male; Middle Aged; Original Paper; Pathogens; Population; Public health; Questionnaires; Regression analysis; Regression models; Risk Factors; Surveillance systems; Variables; Young Adult; Canada; antibiotic prescribing practices; antimicrobial stewardship; antibiotic resistance; antibiotics; food-borne infections; surveillance system
• ISSN: 0950-2688; 1469-4409; 1469-4409
• DOI: 10.1017/S0950268824001365

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.