The Decline in Outpatient Antibiotic Use.

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Health Services Research

Background:

• National antibiotic resistance strategies in Germany focus on monitoring outpatient prescribing.
• Statutory health-insurance providers nationwide are included in monitoring efforts.
• Data collection aims to inform targeted quality-assurance measures for antibiotic use.

Purpose of the Study:

• To analyze trends in outpatient systemic antibiotic prescription rates across Germany.
• To assess changes in antibiotic prescribing from 2010 to 2018.
• To identify variations in prescribing rates by age group and region.

Main Methods:

• Prescription data from statutory health-insurance carriers in Germany were analyzed.
• Data encompassed age groups 0-14, 15-64, and ≥ 65 years.
• The primary outcome was the annual prescription rate per 1000 insurees.

Main Results:

• A 21% overall decline in antibiotic prescriptions was observed between 2010 and 2018.
• The most significant reduction (41%) occurred in children and adolescents (0-14 years).
• Regional variations persisted, with rates differing by a factor of 1.8 in 2018.

Conclusions:

• Nationwide decline suggests effectiveness of initiatives promoting appropriate antibiotic use.
• Marked reduction in pediatric prescribing indicates a shift in practice.
• Regional disparities highlight the need for tailored programs to promote rational antibiotic use.