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. 2022 Nov 17:13:1042418.
doi: 10.3389/fphar.2022.1042418. eCollection 2022.

Antibiotic use in elderly patients in ambulatory care: A comparison between Hungary and Sweden

Ikhwan Yuda Kusuma  1   2 , Maria Matuz  1   3 , Réka Bordás  1 , Maria Juhasz Haverinen  4 , Muh Akbar Bahar  1   5 , Edit Hajdu  6 , Ádám Visnyovszki  6 , Roxána Ruzsa  1 , Péter Doró  1 , Zsófi Engi  1 , Dezső Csupor  1   7 , Ria Benko  1   3   8
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Antibiotic use in elderly patients in ambulatory care: A comparison between Hungary and Sweden

Ikhwan Yuda Kusuma et al. Front Pharmacol. .

Abstract

Background: The elderly use antibiotics frequently due to their increasing infection susceptibility. Given the high and increasing proportion of elderly in the population, their antibiotic use is substantial. Objective: This study aimed to compare antibiotic use in the elderly in the ambulatory care sector between Hungary and Sweden. Methods: This retrospective, descriptive, cross-national, comparative study included antibacterial use data from the Hungarian National Health Insurance Fund and the Swedish eHealth Agency. Antibiotic use (anatomical therapeutical chemical: J01) was expressed as the number of prescriptions/1000 inhabitants/year or month and was further stratified by age and sex. Results: Antibiotic exposure was higher in the Hungarian elderly population (649.8 prescriptions/1000 inhabitants/year) compared to its Swedish counterparts (545.0 prescriptions/1000 inhabitants/year). Hungary had a similar scale of antibacterial exposure across all elderly age subgroups, with different trends in males and females, while Sweden had a stepwise increase in antibiotic exposure by age in both sexes. The seasonal fluctuation was high in Hungary and reached a peak of 80.7 prescriptions/1000 inhabitants/month in January 2017, while even antibiotic use was detected throughout the year in Sweden. The pattern of antibiotic use in the elderly considerably differed between the two countries. Penicillin and beta-lactamase combinations, such as co-amoxiclav, were more frequently used in Hungary than in Sweden (19.08% vs 1.83% of corresponding total ambulatory antibiotic use). Likewise, quinolones were more commonly used in Hungary than in Sweden (34.53% vs. 9.98). The elderly in Sweden were mostly prescribed narrow spectra penicillins (26.71% vs. 0.29% in Hungary). Conclusion: This cross-national comparison revealed important differences in all aspects of antibiotic use in the elderly between the two countries. The identical scale and pattern of antibiotic use cannot be anticipated due to the poorer health status of the Hungarian elderly population. However, the substantial differences indicate some room for improvement in the antibiotic prescription for the Hungarian elderly.

Keywords: ambulatory care; antibacterials; antibiotic stewardship; cross national comparison; drug utilization study; elderly; prescrptions/1000 inhabitants/year; public health.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Antibacterial use in different elderly age subgroups in Hungary and Sweden (2017).
FIGURE 2
FIGURE 2
Sex-specific use of antibiotics in ambulatory care presented by age subgroups in the elderly population in Hungary and Sweden (2017).
FIGURE 3
FIGURE 3
Seasonal variation of antibiotic use among the elderly population in Hungary and Sweden in 2017.
See this image and copyright information in PMC

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