title: Rates of Community-based Antibiotic Prescriptions and Hospital-treated Infections in Individuals With and Without Type 2 Diabetes: A Danish Nationwide Cohort Study, 2004-2012.
abstract: The excess risk of antibiotic use and hospital-treated infections in patients with type 2 diabetes (T2D) compared with general population is poorly understood.
  
  
  
  In a nationwide cohort of patients with incident T2D (n = 155 158) and an age-, gender-, and residence-matched comparison cohort (n = 774 017), we used Cox regression to compute rates and confounder-adjusted rate ratios (aRRs) of community-based antibiotic prescription redemption and hospital-treated infections during 2004-2012.
  
  
  
  The rates of community-based antibiotic prescriptions in the T2D and comparison cohorts were 364 vs 275 per 1000 person-years after a median follow-up of 1.1 years (aRR = 1.24; 95% confidence interval [CI], 1.23 to 1.25). The corresponding rates for hospital-treated infection were 58 vs 39 per 1000 person-years after a median follow-up of 2.8 years (aRR = 1.49; 95% CI, 1.47 to 1.52). The aRRs were increased particularly for urinary tract infections (UTIs, 1.41; 95% CI, 1.35 to 1.45), skin infections (1.50; 95% CI, 1.45 to 1.55), septicemia (1.60; 95% CI, 1.53 to 1.67), and tuberculosis (1.61; 95% CI, 1.25 to 2.06) and of community-based antibiotics prescribed for UTIs (1.31; 95% CI, 1.29 to 1.33), Staphylococcus aureus infections (1.32; 95% CI, 1.30 to 1.34), and mycobacterial infections (1.69; 95% CI, 1.36 to 2.09). The 1-year aRR declined from 1.89 (95% CI, 1.75 to 2.04) in 2004 to 1.59 (95% CI, 1.45 to 1.74) in 2011 for hospital-treated infection (trend P = .007) and from 1.31 (95% CI, 1.27 to 1.36) in 2004 to 1.26 (95% CI, 1.22 to 1.30) in 2011 for community-based antibiotic prescriptions (trend P = .006).
  
  
  
  Patients with T2D have rates of community-based antibiotic prescriptions and hospital-treated infections that are higher than for the general population.
authors.affiliation: Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital.
authors.forename: Anil
authors.initials: A
authors.lastname: Mor
authors.affiliation: Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital.
authors.forename: Klara
authors.initials: K
authors.lastname: Berencsi
authors.affiliation: Department of Endocrinology, Danish Centre for Strategic Research in Type 2 Diabetes, Diabetes Research Centre, Odense University Hospital.
authors.forename: Jens S
authors.initials: JS
authors.lastname: Nielsen
authors.affiliation: Center for Diabetes Research, Gentofte University Hospital, Copenhagen Institute for Biomedicine, Aarhus University.
authors.forename: Jørgen
authors.initials: J
authors.lastname: Rungby
authors.affiliation: Department of Endocrinology, Danish Centre for Strategic Research in Type 2 Diabetes, Diabetes Research Centre, Odense University Hospital.
authors.forename: Søren
authors.initials: S
authors.lastname: Friborg
authors.affiliation: Department of Endocrinology, Danish Centre for Strategic Research in Type 2 Diabetes, Diabetes Research Centre, Odense University Hospital.
authors.forename: Ivan
authors.initials: I
authors.lastname: Brandslund
authors.affiliation: Department of Internal Medicine and Endocrinology, Institute of Clinical Medicine, Aarhus University Hospital.
authors.forename: Jens S
authors.initials: JS
authors.lastname: Christiansen
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism, Rigshospitalet, and Copenhagen University, Denmark.
authors.forename: Allan
authors.initials: A
authors.lastname: Vaag
authors.affiliation: Department of Endocrinology, Danish Centre for Strategic Research in Type 2 Diabetes, Diabetes Research Centre, Odense University Hospital.
authors.forename: Henning
authors.initials: H
authors.lastname: Beck-Nielsen
authors.affiliation: Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital.
authors.forename: Henrik T
authors.initials: HT
authors.lastname: Sørensen
authors.affiliation: Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital.
authors.forename: Reimar W
authors.initials: RW
authors.lastname: Thomsen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology*; D003718:Denmark / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055656:Prescriptions / Q000706:statistics & numerical data*; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology*; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000453:epidemiology*
chemical_list: D000900:Anti-Bacterial Agents
keywords: antibiotics; epidemiology; infections; time trends; type 2 diabetes mellitus