Related Experiment Video
Updated: Oct 25, 2025
Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
Encouraging rational antibiotic prescribing behaviour in primary care - prescribing practice among children aged 0-4
Maria Run Gunnlaugsdottir1, Kristjan Linnet2, Jon Steinar Jonsson2,3
1Faculty of Pharmaceutical Sciences, University of Iceland, Reykjavík, Iceland.
Insights
Antibiotic prescriptions for young children decreased by 9% after implementing new guidelines. The study observed a shift in antibiotic choices, aligning with quality improvement goals in Iceland.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Antibiotic prescribing rates in Iceland are notably high compared to other Nordic countries.
- A significant portion of antibiotic prescriptions may be inappropriate for common childhood infections.
- Quality improvement projects are essential for optimizing antibiotic use in primary healthcare.
Purpose of the Study:
- To evaluate the impact of a quality improvement project on antibiotic prescribing patterns in children aged 0-4 years.
- To assess changes in the total number and type of antibiotic prescriptions before and after intervention.
- To align antibiotic prescribing with national guidelines for prudent use in primary care.
Main Methods:
- An observational, descriptive, retrospective quantitative study was conducted.
- Data were collected from primary healthcare centers in the capital region of Iceland (2016-2018).
- Prescriptions for 6,420 children aged 0-4 years were analyzed, excluding out-of-hours prescriptions.
Main Results:
- A 9% reduction in total antibiotic prescriptions was observed between 2017-2018.
- Amoxicillin prescriptions increased by 51.3%, while co-amoxiclav and macrolide use decreased significantly (52.3% and 40.7%, respectively).
- Prescriptions were most common for otitis media, pneumonia, and skin infections.
Conclusions:
- The quality improvement project successfully reduced overall antibiotic prescribing in young children.
- A significant shift in the antibiotic profile towards recommended agents was achieved.
- The findings support the effectiveness of guideline implementation and feedback in promoting judicious antibiotic use.
Objective:
To study antibiotic prescriptions among 0- to 4-year-old children before and after implementing a quality project on prudent prescribing of antibiotics in primary healthcare in the capital region of Iceland.
Design:
An observational, descriptive, retrospective study using quantitative methodology.
Setting:
Primary healthcare in the Reykjavik area with a total population of approximately 220,000.
Subjects:
A total of 6420 children 0-4 years of age presenting at the primary healthcare centres in the metropolitan area over three years from 2016 to 2018.
Main Outcome Measures:
Reduction of antibiotic prescriptions and change in antibiotic profile. Data on antibiotic prescriptions for children 0-4 years of age was obtained from the medical records. Out-of-hours prescriptions were not included in the database.
Results:
The number of prescriptions during the study period ranged from 263.6 to 289.6 prescriptions/1000 inhabitants/year. A reduction of 9% in the total number of prescriptions between 2017-2018 was observed. More than half of all prescriptions were for otitis media, followed by pneumonia and skin infections. Amoxicillin accounted for over half of all prescriptions, increasing between 2016 and 2018 by 51.3%. During this period, the prescribing of co-amoxiclav and macrolides decreased by 52.3% and 40.7%, respectively. These changes were significant in all cases, p < 0.0001.
Conclusion:
The results show an overall decrease in antibiotic prescribing concurrent with a change in the choice of antibiotics prescribed and in line with the recommendations presented in the prescribing guidelines implemented by the Primary Healthcare of the Capital Area, and consistent with the project's goals.Key pointsA substantial proportion of antibiotic prescribing can be considered inappropriate and the antibiotic prescription rate is highest in Iceland of the Nordic countries.After implementing guidance on the treatment of common infections together with feedback on antibiotic prescribing, a decrease in the total number of prescriptions accompanied by a shift in the antibiotic profile was observed.
More Related Videos
08:33Quantitative Polymerase Chain Reaction-based Analyses of Murine Intestinal Microbiota After Oral Antibiotic Treatment
Published on: November 17, 2018
09:17A Robust Pneumonia Model in Immunocompetent Rodents to Evaluate Antibacterial Efficacy against S. pneumoniae, H. influenzae, K. pneumoniae, P. aeruginosa or A. baumannii
Published on: January 2, 2017
Related Concept Videos
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
01:29Drug Dosing: Infants and Children
01:17Pharmacokinetics in Pediatric Patients: Drug Distribution
00:57Antibiotic Selection
01:24Pharmacokinetics in Pediatric Patients: Drug Metabolism