Antibiotic prescription preferences in paediatric outpatient setting in Estonia and Sweden

Area of Science:

• Pharmacology
• Public Health
• Pediatrics

Background:

• Antibiotic resistance is a growing global concern, necessitating careful monitoring of antibiotic use, especially in vulnerable populations like children.
• Sweden and Estonia represent countries with low overall antibiotic consumption and antibacterial resistance levels, making them suitable for comparative studies.

Purpose of the Study:

• To compare paediatric outpatient antibiotic utilization between Sweden and Estonia.
• To assess adherence to Estonian treatment guidelines for paediatric antibiotic prescriptions.

Main Methods:

• A descriptive drug utilization study was conducted using data from the Swedish Prescribed Drug Register and the Estonian Health Insurance Fund database for 2007.
• Prescriptions for systemic antibiotics in children under 18 years were analyzed.

Main Results:

• Total paediatric antibiotic use was 616/1000 in Estonia versus 353/1000 in Sweden.
• The 2-6 year age group showed the largest disparity: 1184 prescriptions/1000 in Estonia vs. 528/1000 in Sweden.
• Estonia predominantly prescribed extended-spectrum amoxicillin and clarithromycin, while Sweden favored narrow-spectrum phenoxymethylpenicillin and erythromycin. For acute bronchitis, 17 antibiotics were used in Estonia despite guidelines recommending against their use.

Conclusions:

• Higher rates of antibiotic use, particularly extended-spectrum agents, in Estonian children compared to Swedish children underscore the need for targeted interventions.
• Promoting appropriate antibiotic prescribing in paediatric care is crucial, even in countries with generally low antibiotic consumption.