Antibiotic Prescribing in Ambulatory Pediatrics in Greece, 2010-2013

G. Kourlaba, N. Spyridis, J. Kopsidas, A. Lourida, K. Mougkou, S. Manta-Maroudi, T. Zaoutis
32nd Annual Meeting of the European Society for Paediatric Infectious Diseases (ESPID 2014)
|Dublin, Ireland, May 6-10, 2014

INTRODUCTION: Antibiotics are commonly prescribed for children with conditions for which they provide no benefit. Up to 50% of prescriptions are unnecessary or inappropriate.

OBJECTIVES: Our objective was to provide a nationally representative analysis of antibiotic prescribing in ambulatory care pediatric patients.

METHODS: Data on antibiotic prescriptions for patients < 19 years old between July 2010 and June 2013 in Greece were extracted from the IMS Health Xponent database, which represents a 100% projection of prescribing activity in the community based on representative sample. Data collected included physicians’ and patients’ demographics, physicians’ specialty, medications prescribed and diagnoses. Antibiotics were grouped into narrow-spectrum antibiotics (penicillin, amoxicillin, 1st generation cephalosporins, tetracyclines, and sulfonamides) and broad spectrum (all other antibiotics). The number of prescriptions and census denominators were used to calculate prescribing rates.

RESULTS: 7 million prescriptions were dispensed; annual rate of 1,100 prescriptions per 1000 persons (95% CI: 1099 – 1101). Prescribing rates were higher among in children < 10 years old (1,633 prescriptions/1000 persons). Acute respiratory infections (ARIs) accounted for 80% of prescriptions. 25% were for ARIs which antibiotics are not clearly indicated. Cephalosporins (32.9%), penicillins (32.3%) and macrolides (32.1%) were the most commonly prescribed antibiotic classes. Clarithromycin (25%), amoxicillin/clavulanic acid (22.6%) and cefprozil (18.4%) were the most frequently prescribed agents. The majority (88%) of antibiotics were broad-spectrum.

CONCLUSION: Broad-spectrum antibiotic prescribing is common in outpatient pediatric patients and frequently inappropriate. The overuse of broad-spectrum antibiotics imposes high cost and leads to increased antimicrobial resistance.