Antibiotics in inflammatory arthritis and background population one year before and after diagnosis: a nationwide drug utilization study

Author:

Kragsnaes Maja S12ORCID,Risbo Nickolaj3,Pedersen Jens Kristian12ORCID,Obel Niels4,Finckh Axel5,Pedersen Alma B36,Ellingsen Torkell12ORCID

Affiliation:

1. Department of Rheumatology, Odense University Hospital , Odense, Denmark

2. Department of Clinical Research, University of Southern Denmark , Odense, Denmark

3. Department of Clinical Epidemiology, Aarhus University Hospital , Aarhus, Denmark

4. Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet , Copenhagen, Denmark

5. Division of Rheumatology, Department of Internal Medicine and Department of Medicine, Faculty of Medicine, Geneva University Hospitals , Geneva, Switzerland

6. Department of Clinical Medicine, Aarhus University , Aarhus, Denmark

Abstract

Abstract Objectives To describe antibiotic use in patients with inflammatory arthritis (IA) and in the background population (BP) within one year before and after IA diagnosis. Methods Using data from Danish nationwide registries, we identified all adults with a first-time diagnosis of RA, PsA, or AS/spondyloarthritis (AS/SpA) from 2010 through 2018. For each IA patient, we randomly sampled 10 persons from the BP, matched on sex and birthdate. We calculated the prevalence (n [%]) of any antibiotic dispensing and the total antibiotic dispensing in the year before and after diagnosis. Results We identified 28 504 new-onset IA patients (RA, n = 16 130; PsA, n = 5988; AS/SpA, n = 6386) and 285 040 BP individuals. Within one year before diagnosis, the total amount of dispensed antibiotics was higher in both RA, PsA and As/SpA compared with the BP (prevalence rate ratios [PRR], 1.48 [1.46; 1.51]; 1.67 [1.62; 1.72]; 1.52 [1.47; 1.56], respectively). The amount increased with 22% in IA patients three months before diagnosis compared with the preceding three-month period.  Although the prevalence of any antibiotic dispensing in IA patients decreased in the year following the diagnosis (IA; 40.6%), the total one-year antibiotic dispensing remained constant in RA (PRR 0.99 [0.97; 1.01]), decreased in PsA (0.91 [0.87; 0.94]) and increased in AS/SpA (1.08 [1.04; 1.12]) patients after diagnosis compared with before. Conclusion Antibiotics are more frequently dispensed to individuals developing IA compared with the BP. Antibiotic utilization patterns change after IA diagnosis with marked differences among IA subgroups.

Funder

Novo Nordisk Foundation

Publisher

Oxford University Press (OUP)

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