ArticleCMAJ open
Regional variability in outpatient antibiotic use in Ontario, Canada: a retrospective cross-sectional study.
Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Appropriateness and determinants of outpatient antibiotic use among migrants in British Columbia, Canada: a population-based study.JAC-antimicrobial resistance · 2026Article
- National retrospective study of regional prescriber-specific variation in community antibiotic prescribing Canada, 2019-2023.BMJ public health · 2026Article
- Universal Pharmacare and Contraceptive Dispensations Among Youth.JAMA pediatrics · 2025Article
- Association between a publicly funded universal drug program and antipsychotic and antidepressant medication dispensing to children.BMC pediatrics · 2025Article
- Prevalence and correlates of oral antibiotic use in Canada.Canada communicable disease report = Releve des maladies transmissibles au Canada · 2024Article
- Physician antimicrobial prescribing and patient outcomes on general medical wards: a multicentre retrospective cohort study.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2023Article
- A Time Series Analysis Evaluating Antibiotic Prescription Rates in Long-Term Care during the COVID-19 Pandemic in Alberta and Ontario, Canada.Antibiotics (Basel, Switzerland) · 2022Article
- The impact of COVID-19 on community antibiotic use in Canada: an ecological study.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2022Article
- The Impact of COVID-19 on Outpatient Antibiotic Prescriptions in Ontario, Canada; An Interrupted Time Series Analysis.Open forum infectious diseases · 2021Article
- Defining appropriate antibiotic prescribing in primary care: A modified Delphi panel approach.Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada · 2020Article
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- Antibiotic susceptibility of urine culture specimens in Ontario: a population-based cohort study.CMAJ openArticle
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Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRegional variability in antibiotic use is associated with both antibiotic overuse and antimicrobial resistance. Our objectives were to benchmark outpatient antibiotic use and to evaluate geographic variability among health regions in the province of Ontario, Canada.
methodsThis was a cross-sectional study of antibiotics dispensed from outpatient retail pharmacies in Ontario between March 2016 and February 2017. We analyzed variability in the number of antibiotic prescriptions dispensed per 1000 population among Ontario's 14 health regions with crude and adjusted Poisson regression models. Adjusted models controlled for rurality, 4 physician characteristics and 6 population characteristics.
resultsThere were 8 352 578 antibiotics dispensed during the 1-year study period or 621 per 1000 population. The most commonly prescribed antibiotic classes were narrow-spectrum penicillins, macrolides, first-generation cephalosporins and second-generation fluoroquinolones, with adult women receiving the highest rate of prescriptions: 985 antibiotic prescriptions per 1000 population. There was geographic variability in total and class-specific antibiotic use. In the health region with the highest use 778 antibiotics were dispensed per 1000 population whereas in the health region with the lowest use 534 antibiotics were dispensed per 1000 population. The adjusted marginal standardized antibiotic prescription rates for the health regions with the highest and lowest use were 787 (95% confidence interval [CI] 658-934) and 546 (95% CI 494-606) antibiotic prescriptions per 1000 population, respectively.
interpretationWe described baseline antibiotic usage in Ontario over a 12-month period, noting variability among some health regions. Our findings highlight the need for interventions to optimize antibiotic use and slow the emergence of antimicrobial resistance.
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