Magnitude of antibiotic use

Area of Science:

• Pharmacology
• Infectious Diseases
• Public Health

Background:

• Antibiotic prescribing patterns are crucial for understanding drug resistance and treatment efficacy.
• Historical data provides insights into shifts in therapeutic choices and their underlying reasons.

Purpose of the Study:

• To analyze trends in antibiotic prescribing from 1965 to 1977.
• To identify factors influencing the selection of specific antibiotic classes.

Main Methods:

• Review of dispensed prescription data from IMS America's National Prescription Audit.
• Analysis of antibiotic certification records from the Food and Drug Administration (FDA).

Main Results:

• Prescription data indicated increasing use of erythromycins, penicillins, and cephalosporins until 1973, followed by a plateau.
• Tetracycline use declined after 1973, possibly due to concerns about dental staining.
• Sulfonamide use steadily declined since 1965, likely due to safety considerations.
• Clindamycin use rose until 1975 but decreased following recognition of its association with severe colitis.
• Injectable cephalosporins and gentamicin showed a steady increase in administration volume through 1977.

Conclusions:

• Physician judgment of antibiotic safety significantly influenced prescribing trends.
• Emerging safety concerns, such as dental staining and colitis, impacted the use of specific antibiotics.
• Injectable antibiotics, including cephalosporins and gentamicin, demonstrated continued growth in usage.