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Published on: August 30, 2018
Antibiotic prescribing and expenditures in outpatient paediatrics in Greece, 2010-13
Georgia Kourlaba1, Eleni Kourkouni2, Nikos Spyridis3
1The Stavros Niarchos Foundation - Collaborative Center for Clinical Epidemiology and Outcomes Research (CLEO), University of Athens School of Medicine, Athens, Greece kurlaba@gmail.com.
Insights
Over 7 million antibiotics were prescribed to children in Greece, with most being broad-spectrum for respiratory infections. This highlights a need for antimicrobial stewardship programs in pediatric outpatient care.
Area of Science:
- Pediatric Infectious Diseases
- Public Health
- Pharmacoeconomics
Background:
- Antibiotic prescribing patterns in pediatric outpatient settings are not well-characterized nationally.
- Understanding antibiotic use and costs is crucial for developing effective antimicrobial stewardship.
Purpose of the Study:
- To analyze antibiotic prescribing trends in Greek outpatient pediatrics.
- To determine the economic impact of antibiotic prescriptions in this population.
Main Methods:
- Utilized IMS Health Xponent database for prescriptions in patients aged ≤19 years (July 2010-June 2013).
- Calculated prescribing rates using prescription numbers and census data.
- Assessed total expenditures for prescribed antibiotics.
Main Results:
- Over 7 million antibiotics were prescribed, with an annual rate of 1100/1000 persons.
- Acute respiratory tract infections (ARTIs) were the primary indication (80%), particularly acute otitis media and tonsillitis.
- Broad-spectrum antibiotics constituted 90.4% of prescriptions, with expenditures reaching ~€50 million.
Conclusions:
- Broad-spectrum antibiotic use is prevalent in Greek pediatric outpatient care.
- Findings identify key areas for antimicrobial stewardship interventions targeting specific conditions and practices.
Objectives:
The objectives of this study were to provide a nationally representative analysis of antibiotic prescribing in outpatient paediatrics and to assess overall and class-specific antibiotic costs in Greece.
Methods:
Data on antibiotic prescriptions for patients aged ≤19 years old between July 2010 and June 2013 in Greece were extracted from the IMS Health Xponent database. Antibiotics were grouped into narrow- and broad-spectrum agents. The number of prescribed antibiotics and census denominators were used to calculate prescribing rates. The total costs associated with prescribed antibiotics were calculated.
Results:
More than 7 million antibiotics were prescribed during the study period, with an annual rate of 1100 antibiotics/1000 persons. Prescribing rates were higher among children aged <10 years old. Acute respiratory tract infections (ARTIs) accounted for 80% of prescribed antibiotics, with acute otitis media (22.3%), acute tonsillitis (19.5%) and acute bronchitis/bronchiolitis (13.9%) being the most common clinical diagnoses. Cephalosporins (32.9%), penicillins (32.3%) and macrolides (32.1%) were the most commonly prescribed antibiotic classes. The majority (90.4%) of antibiotics were broad spectrum. Antibiotic expenditures totalled ∼€50 million.
Conclusions:
Broad-spectrum antibiotic prescribing is common in outpatient paediatric patients. These data provide important targets to inform the development of an outpatient antimicrobial stewardship programme targeting specific practices, providers and conditions.
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