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. 2022 Jan 31;11(2):189.
doi: 10.3390/antibiotics11020189.

Prescribing Patterns and Variations of Antibiotic Use for Children in Ambulatory Care: A Nationwide Study

Githa Fungie Galistiani  1   2 , Ria Benkő  1   3   4 , Balázs Babarczy  5 , Renáta Papp  6   7 , Ágnes Hajdu  5 , Éva Henrietta Szabó  8 , Réka Viola  1   3   9 , Erika Papfalvi  10 , Ádám Visnyovszki  10 , Mária Matuz  1   3
Affiliations

Prescribing Patterns and Variations of Antibiotic Use for Children in Ambulatory Care: A Nationwide Study

Githa Fungie Galistiani et al. Antibiotics (Basel). .

Abstract

The aim of this study was to analyse characteristics of paediatric antibiotic use in ambulatory care in Hungary. Data on antibiotics for systemic use dispensed to children (0-19 years) were retrieved from the National Health Insurance Fund. Prescribers were categorised by age and specialty. Antibiotic use was expressed as the number of prescriptions/100 children/year or month. For quality assessment, the broad per narrow (B/N) ratio was calculated as defined by the European Surveillance of Antimicrobial Consumption (ESAC) network. Paediatric antibiotic exposure was 108.28 antibiotic prescriptions/100 children/year and was the highest in the age group 0-4 years. Sex differences had heterogenous patterns across age groups. The majority of prescriptions were issued by primary care paediatricians (PCP). The use of broad-spectrum agents dominated, co-amoxiclav alone being responsible for almost one-third of paediatric antibiotic use. Elderly physicians tended to prescribe less broad-spectrum agents. Seasonal variation was found to be substantial: antibiotic prescribing peaked in January with 16.6 prescriptions/100 children/month, while it was the lowest in July with 4 prescriptions/100 children/month. Regional variation was prominent with an increasing west to east gradient (max: 175.6, min: 63.8 prescriptions/100 children/year). The identified characteristics of paediatric antibiotic use suggest that prescribing practice should be improved.

Keywords: antibiotic exposure; antibiotic stewardship; drug utilisation study; number of prescriptions; outpatient use; physician specialty; prescription rate; public health; regional variation; seasonality.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Use of antibiotics of broad-/narrow-spectrum categories defined by ESAC [15] according to different prescribers’ groups and children’s age groups in ambulatory care in Hungary, 2017. Broad-spectrum antibiotics: broad-spectrum penicillins, cephalosporins and macrolides (J01(CR+DC+DD+[F-FA01])). Narrow-spectrum antibiotics: narrow-spectrum penicillins, cephalosporins and macrolides (J01(CE+DB+FA01)). Unclassified antibiotics: all other antibiotics.
Figure 2
Figure 2
(a) Regional differences in paediatric antibiotic use (expressed as the number of prescriptions/100 children/year) in Hungary, 2017; Diamond symbol (♦) for the lowest prescribing rate, triangle symbol (▲) for the highest prescribing rate. (b) Regional differences of paediatric antibiotic use (expressed as the proportion of narrow-spectrum penicillins, cephalosporins and macrolides relative to all antibiotics) in Hungary, 2017; Diamond symbol (♦) for the lowest percentage, triangle symbol (▲) for the highest percentage.
Figure 3
Figure 3
Seasonality of antibiotic use in children by age groups (expressed as the number of prescriptions/100 children/month) in Hungary, 2017.
See this image and copyright information in PMC

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