Mari Blandhol1, Thekla Tysland1, Hege Salvesen Blix2, Sigurd Høye3. 1. a Faculty of Medicine , University of Oslo , Oslo , Norway. 2. b Norwegian Institute of Public Health , Nydalen , Oslo , Norway. 3. c Department of General Practice, Antibiotic Centre for Primary Care , Institute of Health and Society, University of Oslo , Blindern , Oslo , Norway.
Abstract
OBJECTIVES: To compare antibiotic treatment failure evaluated as switch from one type of antibiotics to another in ambulatory care. METHODS: Data on all dispensed doxycycline, amoxicillin, phenoxymethylpenicillin and macrolides in Norway June 2013 - May 2015, was retrieved from the Norwegian Prescription Database. We computed switch rates for the selected antibiotics on day 1-28 after initial dispensing, and the corresponding odds-ratios, adjusted for patients´ age and gender, and prescribers´ specialty. RESULTS: Of 1.860.036 dispensed antibiotics, 103.076 (5.5%) were switched within 28 days. Within 10 days after the index date, the switch rate was highest for phenoxymethylpenicillin (4.1%), followed by amoxicillin (2.5%), macrolides and doxycycline (2.2%). CONCLUSIONS: The switch rate after initial dispensing of phenoxymethylpenicillin is higher than that of more broad-spectrum antibiotics. However, it is still low, supporting the recommendation of phenoxymethylpenicillin as first line treatment when an antibiotic is indicated for a respiratory tract infection in primary care.
OBJECTIVES: To compare antibiotic treatment failure evaluated as switch from one type of antibiotics to another in ambulatory care. METHODS: Data on all dispensed doxycycline, amoxicillin, phenoxymethylpenicillin and macrolides in Norway June 2013 - May 2015, was retrieved from the Norwegian Prescription Database. We computed switch rates for the selected antibiotics on day 1-28 after initial dispensing, and the corresponding odds-ratios, adjusted for patients´ age and gender, and prescribers´ specialty. RESULTS: Of 1.860.036 dispensed antibiotics, 103.076 (5.5%) were switched within 28 days. Within 10 days after the index date, the switch rate was highest for phenoxymethylpenicillin (4.1%), followed by amoxicillin (2.5%), macrolides and doxycycline (2.2%). CONCLUSIONS: The switch rate after initial dispensing of phenoxymethylpenicillin is higher than that of more broad-spectrum antibiotics. However, it is still low, supporting the recommendation of phenoxymethylpenicillin as first line treatment when an antibiotic is indicated for a respiratory tract infection in primary care.