Impact of chronic diseases on the prescription of antibiotics according to clinical guidelines in the community

Between April 2010 and March 2017, children treated for a common infection received an antibiotic recommended in provincial clinical guidelines at least 88% of the time. Children with asthma received matching prescriptions slightly less often (3% less often at most), when compared to children without diabetes, respiratory disease or mental disorder.

Between 2010 and 2017, in adults with a current infection, the choice of antibiotic agreed at least 73% of the time with the guidelines in force, except for pharyngitis where the agreement was lower. Taking the assays into account lowered the proportions of concordance, generally below 50%. Prescriptions agreed between 2.4% and 20.4% less often with clinical guidelines in the presence of diabetes, mental disorders, respiratory or cardiovascular diseases, compared to individuals with none of these chronic diseases.

The frequency of mismatched prescriptions can probably be reduced. Support for clinicians in the prescription of antibiotics in the event of chronic diseases could be useful, but these explain only a small part of the observed discrepancy.

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