Discrepancy between antibiotic pack sizes and guideline recommendations: a real-world analysis based on claims data

Area of Science:

• Pharmaceutical Sciences
• Infectious Diseases
• Public Health

Background:

• Antibiotic pack sizes often do not align with clinical guidelines.
• This mismatch can lead to leftover medication, promoting self-medication and waste.
• Such practices contribute to the development of antibiotic resistance.

Purpose of the Study:

• To evaluate the extent of non-conformity between prescribed antibiotic pack sizes and guideline recommendations.
• To quantify the potential for inappropriate antibiotic packaging in Switzerland.

Main Methods:

• Retrospective observational study using Swiss health insurance claims data from 2022.
• Analysis of prescriptions for eleven antibiotic substances across five common indications.
• Extrapolation of data to the entire Swiss adult outpatient population.

Main Results:

• Over 947,000 prescriptions were analyzed.
• In 10 of 23 substance/indication combinations, no prescribed pack sizes matched guideline recommendations.
• 31.6% of prescriptions were potentially non-conform, with an estimated 2.7 million tablets overprescribed.

Conclusions:

• Significant discrepancies exist between prescribed antibiotic pack sizes and guideline recommendations.
• Inadequately pre-packaged antibiotics contribute to resistance and waste.
• Implementing alternatives, such as exact pill dispensing, is crucial for antibiotic stewardship.