ArticleCMAJ open
Assessing the appropriateness of community-based antibiotic prescribing in Alberta, Canada, 2017-2020, using ICD-9-CM codes: a 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. An erratum has been issued. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 11 citations in OpenAlex.
- A population-based study of community antibiotic prescribing patterns in Alberta from 2010 to 2017: Implications for antibiotic stewardship.Canadian journal of public health = Revue canadienne de sante publique · 2026Article
- Appropriateness and determinants of outpatient antibiotic use among migrants in British Columbia, Canada: a population-based study.JAC-antimicrobial resistance · 2026Article
- Antimicrobial resistance and physician prescribing of antibiotics in Alberta: a qualitative exploration.BMC health services research · 2026Article
- Reducing the environmental impact of medications and improving patient outcomes using the ECO-Rx framework.Canadian family physician Medecin de famille canadien · 2026Review
- Association of patient, physician and visit characteristics with inappropriate antibiotic prescribing in Japanese primary care: a cross-sectional study.BMJ public health · 2025Article
- Use of ICD-9-CM coding for identifying antibiotic prescriptions during hospitalization: a Delphi consensus model.Infection prevention in practice · 2024Article
- Prevalence and correlates of oral antibiotic use in Canada.Canada communicable disease report = Releve des maladies transmissibles au Canada · 2024Article
- The good, the bad, and the ugly of metals as antimicrobials.Biometals : an international journal on the role of metal ions in biology, biochemistry, and medicine · 2024Review
- Article
Corrections and comments
- Erratum issued
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAntimicrobial resistance is a rising threat to human health, and, with up to 90% of antibiotics prescribed in the community, it is critical to examine Canadian antibiotic stewardship practices in outpatient settings. We carried out a large-scale analysis of appropriateness in community-based prescribing of antibiotics to adults in Alberta, reporting on 3 years of data from physicians practising in the province.
methodsThe study cohort was composed of all adult (age 18-65 yr) Alberta residents who filled at least 1 antibiotic prescription written by a community-based physician between Apr. 1, 2017, and Mar. 6, 2020. We linked diagnosis codes from the clinical modification of the
resultsWe identified 3 114 400 antibiotic prescriptions dispensed to 1 351 193 adult patients by 5577 physicians. Of these prescriptions, 253 038 (8.1%) were "always appropriate," 1 168 131 (37.5%) were "potentially appropriate," 1 219 709 (39.2%) were "never appropriate," and 473 522 (15.2%) were not associated with an ICD-9-CM billing code. Among all dispensed antibiotic prescriptions, amoxicillin, azithromycin and clarithromycin were the most commonly prescribed drugs labelled "never appropriate."
interpretationWe found that nearly 40% of prescriptions dispensed to 1.35 million adult patients in Alberta's community-based settings over a 35-month period were inappropriate. This finding suggests that additional policies and programs to improve stewardship among physicians prescribing antibiotics for adult outpatients in Alberta may be warranted.
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