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Antibiotic Utilization Among People With Multiple Sclerosis in the Netherlands, 2018-2020

Melissa W Y Leung1, Marloes T Bazelier1, Bernard M J Uitdehaag2

  • 1Division of Pharmacoepidemiology and Clinical Pharmacology, Department of Pharmaceutical Sciences, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands.

Pharmacoepidemiology and Drug Safety
|December 11, 2024
PubMed
Abstract

Insights

Antibiotic use is significantly higher in people with multiple sclerosis (pwMS) compared to the general population, indicating a greater infection burden in this group. This study details antibiotic consumption patterns in pwMS in the Netherlands.

Area of Science:

  • Pharmacology and Pharmacoepidemiology
  • Neurology and Infectious Diseases

Background:

  • Multiple sclerosis (MS) is a chronic neurological condition that may increase susceptibility to infections.
  • Understanding antibiotic usage patterns in people with multiple sclerosis (pwMS) is crucial for managing their health and preventing antimicrobial resistance.

Purpose of the Study:

  • To quantify and describe the intensity and patterns of antibiotic drug use among pwMS in the Netherlands.
  • To compare antibiotic consumption in pwMS with the general outpatient population.

Main Methods:

  • Utilized ambulatory hospital records and outpatient pharmacy dispensing data from the PHARMO Database Network (2018-2020).
  • Calculated antibiotic intensity using defined daily doses (DDD)/1000 patient-days (PD).
  • Analyzed dispensing patterns, including prolongations and switches, stratified by demographics, polypharmacy, disease-modifying treatments, and COVID-19 lockdown periods.

Main Results:

  • 1960 (37.8%) of 5179 pwMS received at least one antibiotic prescription.
  • Antibiotic use in pwMS was 18.8 DDD/1000 PD, substantially higher than the general population (7.77-8.90 DDD/1000 PD).
  • Higher antibiotic use was observed in women, older individuals, and those with polypharmacy; use decreased during lockdown. Nitrofurantoin was the most frequent antibiotic.

Conclusions:

  • Antibiotic consumption intensity is considerably higher among pwMS than the general population.
  • This elevated use highlights the significant burden of infections experienced by pwMS.
  • Findings underscore the need for targeted strategies to optimize antibiotic use in this vulnerable population.
Keywords:
Netherlandsantibioticsdrug utilization studyinfectionsmultiple sclerosisnitrofurantoinurinary tract infection

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