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Updated: May 14, 2026
11:17
Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
Indicators show differences in antibiotic use between general practitioners and paediatricians.
C Pulcini1, C Lions, B Ventelou
1Service d'Infectiologie, CHU de Nice, Nice, France. pulcini.c@chu-nice.fr
Summary
General practitioners (GPs) prescribe 54% more antibiotics than paediatricians. Paediatricians favor co-amoxiclav and cephalosporins, while GPs prescribe more macrolides, revealing distinct outpatient antibiotic use patterns.
Area of Science:
- Pharmacology
- Public Health
- Epidemiology
Background:
- Outpatient antibiotic use varies significantly across different physician specialties.
- Understanding these variations is crucial for optimizing antimicrobial stewardship and combating resistance.
- Existing indicators from the European Surveillance of Antimicrobial Consumption (ESAC) project needed adaptation for individual physician-level analysis in a pediatric context.
Purpose of the Study:
- To adapt ESAC drug-specific indicators for individual physician-level analysis in pediatric care.
- To compare antibiotic prescription patterns between general practitioners (GPs) and paediatricians.
- To identify differences in antibiotic prescribing behaviors and drug choices.
Main Methods:
- Retrospective cross-sectional study analyzing 2009 antibiotic prescriptions for children under 16 in South-Eastern France.
- Utilized the National Health Insurance (NHI) outpatient reimbursement database.
- Employed a generalized linear model, adjusted for physician and patient characteristics, to compare prescribing indicators.
Main Results:
- Included 4,921 GPs and 301 paediatricians.
- Penicillins were the most prescribed class (47% GPs, 45% paediatricians).
- GPs issued 54% more antibiotic prescriptions than paediatricians.
- Paediatricians showed higher use of co-amoxiclav (18% vs. 12%) and cephalosporins (39% vs. 33%), while GPs prescribed more macrolides (14% vs. 9%).
- Significant seasonal variation observed, with ~70% more prescriptions in winter vs. summer quarters.
- Calculated 13 indicators revealed wide variations in antibiotic prescribing among and between GPs and paediatricians.
Conclusions:
- A set of 13 drug-specific indicators can effectively describe outpatient antibiotic use at the physician level using reimbursement data.
- Significant differences exist in antibiotic prescribing profiles between GPs and paediatricians in the pediatric context.
- These findings highlight the need for tailored antimicrobial stewardship interventions for different physician groups.
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