Variability in outpatient antimicrobial consumption in Israel

Area of Science:

• Public Health
• Epidemiology
• Pharmacology

Background:

• Antibiotic consumption significantly impacts microbial resistance patterns.
• Nationwide data on outpatient antibiotic use in Israel were previously limited.
• Understanding regional variations in antibiotic prescribing is crucial for public health initiatives.

Purpose of the Study:

• To analyze antibiotic utilization trends in Israel's outpatient settings.
• To identify factors influencing antibiotic consumption patterns.
• To provide data for optimizing antibiotic stewardship programs.

Main Methods:

• Calculated defined daily doses per 1,000 inhabitants per day (DID) for antibiotic use from 2003-2005.
• Utilized prescription data from "Clalit Health Services," covering 55% of Israel's population.
• Analyzed trends in antibiotic use across age groups, antibiotic classes, and geographic districts, including multivariate analysis.

Main Results:

• A significant decrease in overall antibiotic use (1.8-8.2%) was observed across districts between 2003 and 2005.
• Children (<=18 years) accounted for over half of all antibiotic prescriptions.
• Higher diabetes mellitus prevalence was the sole significant variable associated with increased antibiotic use; significant regional variations in consumption were noted.

Conclusions:

• Outpatient antibiotic use declined in Israel between 2003 and 2005.
• Children exhibited the highest antibiotic consumption rates.
• Geographic disparities in antibiotic use were substantial, with physician preferences, local practices, and patient expectations likely driving these differences.