Sandra de Bie1, Florentia Kaguelidou, Katia M C Verhamme, Maria De Ridder, Gino Picelli, Sabine M J M Straus, Carlo Giaquinto, Bruno H Stricker, Julia Bielicki, Mike Sharland, Miriam C J M Sturkenboom. 1. From the *Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands; †Department of Pediatric Pharmacology and Pharmacogenetics, Hôpital Robert Debré, APHP; Univ Paris 7-Diderot, Sorbonne Paris Cité, EA08; INSERM CIC1426, Paris, France; ‡International Pharmaco-epidemiology and Pharmaco-economics Research Center, Desio, Italy; §Medicines Evaluations Board, Utrecht, The Netherlands; ¶Società Italiana di Medicina Generale, Florence, Italy; ‖Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands; and **Paediatric Infectious Diseases Research Group, St George's University London, London, United Kingdom.
Abstract
BACKGROUND: To describe patterns of antibiotic outpatient use in 3 European countries, including 2 new pediatric-specific quality indicators (QIs). METHODS: A cohort study was conducted, 2001-2010, using electronic primary care records of 2,196,312 children up to 14 (Pedianet, Italy) or 18 years (The Health Improvement Network, United Kingdom; Integrated Primary Care Information database, The Netherlands) contributing 12,079,620 person-years. Prevalence rates of antibiotic prescribing per year were calculated and antibiotics accounting (drug utilization) for 90% of all antibiotic prescriptions were identified (drug utilization 90% method). The ratio between users of broad to narrow-spectrum penicillins, cephalosporins and macrolides (B/N ratio) and 2 pediatric-specific QIs: the proportion of amoxicillin users (amoxicillin index) and the ratio between users of amoxicillin to broad-spectrum penicillins, cephalosporins and macrolides (A/B ratio) were determined. RESULTS: The overall annual prevalence of antibiotic prescriptions was 18.0% in the Netherlands, 36.2% in the United Kingdom and 52.0% in Italy. Use was maximal in the first years of life. The number of antibiotics accounting for the drug utilization 90% was comparable. The B/N ratio varied widely from 0.3 to 74.7. The amoxicillin index was highest in the Netherlands and the United Kingdom (50-60%), lowest in Italy (30%) and worsened over time in the United Kingdom and Italy. The A/B ratio in 2010 was 0.3 in Italy, 1.7 in the Netherlands and 5.4 in the United Kingdom. CONCLUSIONS: The patterns of antibiotic prescribing varied highly with age and country. The pediatric-specific QIs combined with the total prevalence rate of use provide a clear picture of the trends of community childhood antibiotic prescribing, allowing monitoring of the impact of policy interventions.
BACKGROUND: To describe patterns of antibiotic outpatient use in 3 European countries, including 2 new pediatric-specific quality indicators (QIs). METHODS: A cohort study was conducted, 2001-2010, using electronic primary care records of 2,196,312 children up to 14 (Pedianet, Italy) or 18 years (The Health Improvement Network, United Kingdom; Integrated Primary Care Information database, The Netherlands) contributing 12,079,620 person-years. Prevalence rates of antibiotic prescribing per year were calculated and antibiotics accounting (drug utilization) for 90% of all antibiotic prescriptions were identified (drug utilization 90% method). The ratio between users of broad to narrow-spectrum penicillins, cephalosporins and macrolides (B/N ratio) and 2 pediatric-specific QIs: the proportion of amoxicillin users (amoxicillin index) and the ratio between users of amoxicillin to broad-spectrum penicillins, cephalosporins and macrolides (A/B ratio) were determined. RESULTS: The overall annual prevalence of antibiotic prescriptions was 18.0% in the Netherlands, 36.2% in the United Kingdom and 52.0% in Italy. Use was maximal in the first years of life. The number of antibiotics accounting for the drug utilization 90% was comparable. The B/N ratio varied widely from 0.3 to 74.7. The amoxicillin index was highest in the Netherlands and the United Kingdom (50-60%), lowest in Italy (30%) and worsened over time in the United Kingdom and Italy. The A/B ratio in 2010 was 0.3 in Italy, 1.7 in the Netherlands and 5.4 in the United Kingdom. CONCLUSIONS: The patterns of antibiotic prescribing varied highly with age and country. The pediatric-specific QIs combined with the total prevalence rate of use provide a clear picture of the trends of community childhood antibiotic prescribing, allowing monitoring of the impact of policy interventions.
Authors: Marieke B Lemiengre; Jan Y Verbakel; Roos Colman; Tine De Burghgraeve; Frank Buntinx; Bert Aertgeerts; Frans De Baets; An De Sutter Journal: Br J Gen Pract Date: 2018-02-12 Impact factor: 5.386
Authors: Pasquale Di Pietro; Ornella Della Casa Alberighi; Michela Silvestri; Maria Angela Tosca; Anna Ruocco; Giorgio Conforti; Giovanni A Rossi; Elio Castagnola; Maria Caterina Merlano; Simona Zappettini; Salvatore Renna Journal: Ital J Pediatr Date: 2017-12-22 Impact factor: 2.638
Authors: Esmé J Baan; Hettie M Janssens; Tine Kerckaert; Patrick J E Bindels; Johan C de Jongste; Miriam C J M Sturkenboom; Katia M C Verhamme Journal: BMJ Open Date: 2018-11-28 Impact factor: 2.692
Authors: Grace Li; Charlotte Jackson; Julia Bielicki; Sally Ellis; Yingfen Hsia; Mike Sharland Journal: Bull World Health Organ Date: 2020-05-08 Impact factor: 9.408