Time Trends and Factors Associated with Antibiotic Prescribing in Swiss Primary Care (2008 to 2020)

Martínez-González, Nahara Anani; Gangi, Stefania Di; Pichierri, Giuseppe; Neuner-Jehle, Stefan; Senn, Oliver; Plate, Andreas

doi:10.3390/antibiotics9110837

Cited by 24 publications

(15 citation statements)

References 42 publications

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“…According to the abovementioned WHO report, the median proportion of Watch group antibiotics was 29% (IQR: 25–36%), with values ranging from less than 20% in the Nordic countries (Denmark, Finland, Iceland, Norway and Sweden) to 52% in Georgia [ 13 ]. Similar to the results of our study, the share of Watch category antibiotics prescribed in Swiss primary care was 42% in the 2008–2020 period [ 22 ]. Community-level consumption of Watch category antibiotics was around 40% in Vietnam in the 2017–2018 period, and the supply from private pharmacies, non-prescription antibiotic sale and the use in children were identified as factors associated with a higher likelihood of Watch-group antibiotic use [ 23 ].…”

Section: Discussionsupporting

confidence: 88%

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Increase and Change in the Pattern of Antibiotic Use in Serbia (2010–2019)

et al. 2021

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The aim of this study was to determine and describe trends in antibiotics utilization in Serbia over a ten-year period. Data were retrieved from publicly available annual reports (2010–2019). The results were expressed as Defined Daily Dose (DDD) per 1000 inhabitants per day (DID). All calculations were performed using the DDD values for the 2020 Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) version for each year of the study, to account for the DDD changes during the study period. Antibiotics were classified using the WHO Access, Watch, Reserve (AWaRe) classification. Total utilization of antibacterials for systemic use increased from 17.25 DID in 2010 to 28.65 DID in 2019. A statistically significant increasing trend in the use of the Watch category antibiotics was observed. A tendency towards use of broad-spectrum antibiotics, apparent by a statistically significant increase in the rate of utilization of broad-spectrum macrolides, quinolones and third-generation cephalosporins vs. narrow-spectrum ones, as well as a significant increasing trend in the use of quinolones was identified. Total antibiotic utilization was found to be well above the European average. Several specific problem areas were identified, which requires further efforts to improve antibiotic prescribing. The present study provides the information needed to facilitate antibiotic stewardship in Serbia further and proposes specific interventions to optimize antibiotic use in Serbia.

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Section: Discussionsupporting

confidence: 88%

“…On the contrary, in Swiss primary care, fluoroquinolones and macrolides/lincosamides prescriptions significantly declined by 53% and 51% between 2008 and 2020. However, this decline might have been at the expense of increased and potentially inappropriate use of broad-spectrum penicillins [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Increase and Change in the Pattern of Antibiotic Use in Serbia (2010–2019)

et al. 2021

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“…Based on the WHO AWaRe classification, the prescribed antibiotics in the study mostly belonged to the "Access" list and more than 80% of these are from Penicillin group and cephalosporin first generation (Martínez-González, Di Gangi, & Pichierri, 2020)which provide the best therapeutic value, while minimizing the resistance potential (Hsia et al, 2019). The WHO AWaRe classification (Access, Watch and Reserve) is intended to be used as an interactive tool for better support antibiotic monitoring and optimal use nevertheless reducing antimicrobial resistance (Hsia et al, 2019).…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

Antibiotic Prescribing Pattern in Primary Care Practice in Federal Territory Kuala Lumpur and Putrajaya, Malaysia

Lim

Wong²,

Thian³

et al. 2021

IJALSR

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Introduction: The emerging of antibiotic resistance has become a challenge to global health and there is a strong association between antibiotic consumption and incidence of resistance. One of the tools to monitor and identify antibiotic prescribing pattern is Point Prevalence Survey (PPS). Objectives: To determine the pattern of antibiotic prescribing in Primary Health Clinics (PHC) in Federal Territory Kuala Lumpur and Putrajaya (FTKLP). Methods: A cross-sectional study was conducted at 17 PHCs in FTKLP using universal sampling. Data from prescriptions received were recorded in PPS-PC data collection form. The compliance of the antibiotics prescribed were determined via cross-referencing with the Malaysian National Antibiotic Guideline (NAG) 2014 and/or Clinical Pathway for Antimicrobial Stewardship Program in PHCs (CP) 2019. Results: A total of 338 prescriptions with antibiotics were received and the prescribing rate of antibiotics at the PHCs in FTKLP 2019 was 5.94%.Only 128 (37.9%) prescriptions with antibiotics prescribed were compliant with either the NAG or the CP while 33 (9.8%) prescriptions were found non-compliant with either guideline. Compliance of the remaining 177 prescriptions could not be determined due to non-specific diagnoses. The most commonly prescribed drug class was penicillin (n=198, 58.4%), followed by cephalosporins (n=80, 23.6%) and macrolides (n=41, 12%). Conclusion: This PPS study showed a low compliance of antibiotic prescribing to guidelines compared to recent studies and indicate the need for further action to be taken in order to improve antimicrobial prescribing in PHCs. KEYWORDS: Point prevalence survey, antibiotic, primary care

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“…Evidence exists that there is a gradual decline in overall antibiotics use, particularly from 'Watch' category, and increase in the prescription and consumption of 'Access' antibiotics over many years because of continuous surveillance and implementation of National Action Plan. 42,43 Thus, regional and national guidelines can use this AWaRe classification in antibiotic surveillance framework as part of their WHO National Action Plan. Over and above, it is the highest priority national goal for preserving critical antibiotics by increasing use of 'Access' antibiotics and reducing higher risk of AMR by limiting use of 'Watch' and 'Reserve' antibiotics at the same time.…”

Section: P-55mentioning

confidence: 99%

Antibiotic Prescribing Practice in Chronic Kidney Disease Patients in a Tertiary Care Teaching Hospital: Analysis Based on 2019 WHO AWaRe Classification

Juveriya¹,

Mounika²,

Venkataramana³

et al. 2021

Int J Life Sci Pharm Res

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Chronic kidney disease (CKD) patients are prone to infections and inevitably require antibiotics. Antimicrobial resistance (AMR) is a global threat to humans. Indeed, the most important cause for spread of AMR is irrational use of antibiotics. Therefore, the present study evaluates prescribing practice of antibiotics in CKD patients. A cross-sectional study was carried out in 382 CKD in-patients prescribed with antibiotics. The data were analysed using the WHO prescribing indicators and the WHO Access, Watch, and Reserve (AWaRe) classification. The average number of drugs prescribed per encounter was 3.1. Antibiotics prescribed by generic name and prescribed from the Essential Medicines List were 52.9% and 47.1%, respectively. % Encounters with antibiotics and parenteral antibiotics were 59.2% and 77.4%, respectively. Third generation cephalosporins (76.9%), particularly cefoperazone (40%) and ceftriaxone (21.2%), were the most commonly prescribed antibiotics. A total of 19 specific antibiotics (Access 5, Watch 13, Reserve 1, and Not Recommended 0) were prescribed. According to WHO AWaRe classification, 10.6%, 89%, and 0.4% of antibiotics prescribed were from the ‘Access’, ‘Watch’, ‘Reserve’ categories, respectively. ‘Watch’ category antibiotics, particularly cephalosporins (98%), were prescribed in high rate. The most commonly prescribed ‘Access’ and ‘Watch’ category antibiotics were amikacin (37%) and cefoperazone (44.9%), respectively. Amoxicillin index was 1.6 and ‘Access-to-Watch’ index was 0.1, which were below the priority values. Prescription pattern of antibiotics observed in this study was not fully met the WHO recommendations. Additionally, ‘Watch’ category antibiotics, particularly cephalosporins, were prescribed frequently. Changes in prescription pattern and monitoring of antibiotic use are essential to preserve effectiveness and promote rational use of antibiotics, and to overcome AMR.

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Time Trends and Factors Associated with Antibiotic Prescribing in Swiss Primary Care (2008 to 2020)

Cited by 24 publications

References 42 publications

Increase and Change in the Pattern of Antibiotic Use in Serbia (2010–2019)

Increase and Change in the Pattern of Antibiotic Use in Serbia (2010–2019)

Antibiotic Prescribing Pattern in Primary Care Practice in Federal Territory Kuala Lumpur and Putrajaya, Malaysia

Antibiotic Prescribing Practice in Chronic Kidney Disease Patients in a Tertiary Care Teaching Hospital: Analysis Based on 2019 WHO AWaRe Classification

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