Identifying prescribers of antibiotics in a primary care spinal cord injury cohort

Arrani Senthinathan; Melanie Penner; Karen Tu; Andrew M Morris; B Catharine Craven; Susan B Jaglal

doi:10.1038/s41394-024-00615-8

Identifying prescribers of antibiotics in a primary care spinal cord injury cohort

Spinal Cord Ser Cases. 2024 Feb 1;10(1):3. doi: 10.1038/s41394-024-00615-8.

Authors

Arrani Senthinathan^{1

2}, Melanie Penner^{3

4}, Karen Tu^{5

6

7}, Andrew M Morris^{8

9}, B Catharine Craven^{10

11

12

13}, Susan B Jaglal^{10

11

14

15}

Affiliations

¹ Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada. arani.senthinathan@utoronto.ca.
² KITE (Knowledge Innovation Talent Everywhere), Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada. arani.senthinathan@utoronto.ca.
³ Bloorview Research Institute/Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.
⁴ Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
⁵ Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.
⁶ North York General Hospital, Toronto, ON, Canada.
⁷ Toronto Western Family Health Team, University Health Network, Toronto, ON, Canada.
⁸ Antimicrobial Stewardship Program, University Health Network, Toronto, ON, Canada.
⁹ Department of Medicine, Division of Infectious Diseases, Sinai Health, University Health Network, and University of Toronto, Toronto, ON, Canada.
¹⁰ Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada.
¹¹ KITE (Knowledge Innovation Talent Everywhere), Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada.
¹² Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
¹³ Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada.
¹⁴ Rehabilitation Science Institute and Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
¹⁵ ICES, Toronto, ON, Canada.

PMID: 38302448
PMCID: PMC10834400 (available on 2025-02-01)
DOI: 10.1038/s41394-024-00615-8

Abstract

Study design: A retrospective cross-sectional study.

Objective: To identify who prescribes outpatient antibiotics among a primary care spinal cord injury (SCI) cohort.

Setting: ICES databases in Ontario, Canada.

Methods: A cohort of individuals with SCI were retrospectively identified using a tested-algorithm and chart reviews in a primary care electronic medical records database. The cohort was linked to a drug dispensing database to obtain outpatient antibiotic prescribing information, and prescriber details were obtained from a physician database.

Results: Final cohort included three hundred and twenty individuals with SCI. The average annual number of antibiotic courses dispensed for the SCI cohort was 2.0 ± 6.2. For dispensed antibiotics, 58.9% were prescribed by rostered-primary care practice physicians, compared to 17.9% by emergency and non-rostered primary care physicians, 17.4% by specialists and 6.1% by non-physician prescribers. Those who lived in urban areas and rural areas, compared to those who lived in suburban areas, were more likely to receive antibiotics from emergency and non-rostered primary care physicians than from rostered-primary care practice physicians.

Conclusion: Although individuals with SCI received outpatient antibiotic prescriptions from multiple sources, physicians from an individual's rostered-primary care practice were the main antibiotic prescribers. As such, interventions to optimize antibiotics use in the SCI population should target the primary care practice.

MeSH terms

Anti-Bacterial Agents* / therapeutic use
Cross-Sectional Studies
Drug Prescriptions
Humans
Practice Patterns, Physicians'
Primary Health Care
Retrospective Studies
Spinal Cord Injuries* / drug therapy
Spinal Cord Injuries* / epidemiology

Substances

Anti-Bacterial Agents