Outpatient Antibiotic Prescription

Overview

Journal Dtsch Arztebl Int

Specialties General Medicine
Public Health

Date 2016 Jul 15

PMID 27412990

Citations 20

Authors

Jorg Batzing-Feigenbaum

Maike Schulz

Mandy Schulz

Ramona Hering

Winfried V Kern

Affiliations

Soon will be listed here.

Abstract

Background: In view of the rise in antibiotic resistance and Clostridium difficile superinfection, close monitoring of antibiotic prescribing practices is essential so that targeted quality assurance measures can be taken.

Methods: We analyzed nationwide data from multiple statutory health insurance carriers on prescriptions of systemic antibiotics in the years 2008-2014, with special attention to cephalosporins and fluoroqinolones. Prescribing rates were characterized in terms of defined daily doses (DDD) per 1000 statutory insurees per year and were analyzed separately for each age group and each federal state in Germany. Trends were analyzed with joinpoint regression.

Results: Antibiotic prescribing rates for persons aged 15 to 69 increased slightly overall during the period of observation. On the other hand, there was a significant decline in antibiotic prescribing rates for persons under age 15 in all of the German states, with a mean annual decrease of 6.8%. There was also a slight decline in antibiotic prescribing rates for persons aged 70 and above, mainly accounted for by fluoroquinolones. Cephalosporin prescribing rates rose significantly in all states, by an overall average of 7.6% per annum. Cephalo - sporin prescribing rates rose significantly in all age groups except persons under age 15, for whom there was a decline that did not reach statistical significance.

Conclusion: This study revealed an overall decline in outpatient antibiotic prescriptions for persons under age 15 as well as other major changes in prescribing practices for the types of antibiotics studied. The observed marked rise in cephalosporin prescribing rates in all German states demands special attention because of the associated danger of increased antibiotic resistance and C. difficile superinfection. Oral cephalosporins are not recommended as drugs of first choice in current guidelines.

Citing Articles

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Costs are a major driver of antibacterial drug prescriptions in Germany: market analysis from 1985 to 2022.

Bindel L, Seifert R Naunyn Schmiedebergs Arch Pharmacol. 2024; 397(11):8785-8801.

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Patterns and trends of antibacterial treatment in patients with urinary tract infections, 2015-2019: an analysis of health insurance data.

Schmiemann G, Hoffmann F, Hamprecht A, Jobski K BMC Prim Care. 2022; 23(1):204.

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Choucair J, Haddad E, Saliba G, Chehata N, Makhoul J J Infect Prev. 2021; 22(6):289-292.

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Antibiotic prescribing for acute, non-complicated infections in primary care in Germany: baseline assessment in the cluster randomized trial ARena.

Poss-Doering R, Kronsteiner D, Kamradt M, Andres E, Kaufmann-Kolle P, Wensing M BMC Infect Dis. 2021; 21(1):877.

PMID: 34445964 PMC: 8394572. DOI: 10.1186/s12879-021-06571-0.

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