973. Geographic Variability of Antibacterials Dispensed within the Province of Alberta, Canada
Session: Poster Abstract Session: Stewardship: Epidemiology of Antibiotic Use
Friday, October 4, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • Dalton. Geographic Variability of Antibacterials Dispensed within the Province of Alberta, Canada.pdf (317.1 kB)
  • Background: Appropriate baseline quantification of antibacterial (AB) use is essential to antimicrobial stewardship (AS). As a result, we aimed to quantify and analyze trends in AB use Alberta, Canada (population: ~4 million). Health care is administered through 5 zones in Alberta; Calgary and Edmonton zones are urban cities with populations > 1 million residents, and South, Central and North zones are regions of small urban centres and rural areas.

    Methods: We used data from the IMS Brogan Xponent® database to estimate the use of systemic AB for 8 quarters (Jul 2010 - Jun 2012). The population of each zone was obtained from the Alberta Health Care Insurance Plan (AHCIP) for each year. Estimation of end of quarter population was calculated based on a linear population change model anchored to AHCIP data. Number of prescriptions per 1000 inhabitant-days (PrID) and defined daily doses per 1000 inhabitant-days (DID) were calculated for the zones, stratified by ages 0-17 (pediatrics), 18-64 (adults) and ≥65 years (seniors).  Statistical comparisons of DID and PrID were conducted using tests for person-time data. Non statistical comparisons to published Canadian, American and European rates of antimicrobial use were conducted for perspective.

    Results: The average DID/PrID rates for all zones and ages were 19.1/1.56 (range: 16.0/1.37 [Q2 2012] to 22.7/1.85  [Q1 2011]). Penicillins were the most frequently used class, representing 36% of DID.  Seniors had the highest prescription and DDD consumption, 2.2 PrID and 23.7 DID, respectively, followed by pediatrics (1.57/22.8) and adults (1.54/18.4). All inter-zone comparisons were statistically significant and lowest to highest zones were; North, Calgary, Central, South and Edmonton by DID. Alberta PrID rates were less than the 2010 US national rate of 2.28 PrID, but more than the Canadian national average from 2011 of 17.6 DID. Alberta 2010-2012 compares similarly to the median nation (Iceland, 16th of 33) in terms of DID based on 2009 values in a survey conducted in European countries.

    Conclusion: Benchmarking AB consumption is useful for indentifying targets for AS initiatives. We found that seniors had the highest prescription and DDD consumption, and there were clear differences in AB use between health zones. These data will lay the foundation for future targeted initiatives.

    Bruce Dalton, PharmD1, Deana Sabuda, BSP1, Lauren Bresee, BScPharm, ACPR, MSc, PhD1, Oscar E. Larios, MD2, Bayan Missaghi, MD3,4, Lawrence Svenson4,5,6, Kimberley Simmonds, MSc5,7 and John Conly, MD8,9, (1)Pharmacy, Alberta Health Services, Calgary Zone, Calgary, AB, Canada, (2)Division of Infectious Diseases, University of Calgary, Calgary, AB, Canada, (3)Alberta Health Services, Calgary Zone, Calgary, AB, Canada, (4)University of Calgary, Calgary, AB, Canada, (5)Alberta Health, Edmonton, AB, Canada, (6)School of Public Health, University of Alberta, Edmonton, AB, Canada, (7)Community Health Sciences, University of Calgary, Calgary, AB, Canada, (8)Alberta Health Services, Calgary and Area, Calgary, AB, Canada, (9)Medicine and Microbiology, Immunology & Infectious Diseases, University of Calgary, Calgary, AB, Canada

    Disclosures:

    B. Dalton, None

    D. Sabuda, None

    L. Bresee, None

    O. E. Larios, None

    B. Missaghi, None

    L. Svenson, None

    K. Simmonds, None

    J. Conly, None

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.