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. 2024 Mar 21;11(4):ofae172.
doi: 10.1093/ofid/ofae172. eCollection 2024 Apr.

Identifying General Practitioners' Antibiotic Prescribing Profiles Based on National Health Reimbursement Data

Pauline Arias  1   2 , Matta Matta  1 , Alessio Strazzulla  1 , Christine Le Mener  3 , Sébastien Gallien  4   5 , Sylvain Diamantis  1   5
Affiliations

Identifying General Practitioners' Antibiotic Prescribing Profiles Based on National Health Reimbursement Data

Pauline Arias et al. Open Forum Infect Dis. .

Abstract

Background: Antibiotic selection pressure in human medicine is a significant driver of antibiotic resistance in humans. The primary aspect of antibiotic consumption is associated with general practitioner (GP) prescriptions. We aimed to identify prescriber profiles for targeted antimicrobial stewardship programs using novel indicators.

Methods: A cross-sectional study was conducted in 2018 investigating GPs' antibiotic prescriptions in a French department, utilizing the reimbursement database of the national health service. Three antibiotic prescribing indicators were used. Specific targets were established for each indicator to identify the antibiotic prescribers most likely contributing to the emergence of resistance.

Results: Over 2018, we had 2,908,977 visits to 784 GPs, leading to 431,549 antibiotic prescriptions. Variations between GPs were shown by the 3 indicators. The median antibiotic prescription rate per visit was 13.6% (interquartile range [IQR], 9.8%-17.7%). Median ratios of the prescriptions of low-impact antibiotics to the prescriptions of high-impact antibiotics and of amoxicillin prescriptions to amoxicillin-clavulanic acid prescriptions were 2.5 (IQR, 1.7-3.7) and 2.94 (IQR, 1.7-5), respectively. We found 163 (21%) high prescribers of antibiotics with 3 distinct patterns: The first group overuses broad-spectrum antibiotics but without an overprescription rate per visit, the second group displays an overprescription rate but no excessive use of broad-spectrum antibiotics, and the third group shows both an overprescription rate and excessive use of broad-spectrum antibiotics.

Conclusions: Prescription-based indicators enable the identification of distinct profiles of antibiotic prescribers. This identification may allow for targeted implementation of stewardship programs focused on the specific prescribing patterns of each profile.

Keywords: antibiotic consumption; antibiotic stewardship; general practitioners; primary healthcare; quality indicators.

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Conflict of interest statement

Potential conflicts of interest. All authors: No reported conflicts of interest.

Figures

Figure 1.
Figure 1.
General practitioners above the threshold for each set of indicators and their repartition by type of profile. Abbreviations: AMR, antimicrobial resistance; GP, general practitioner.
See this image and copyright information in PMC

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References

    1. Antimicrobial Resistance Collaborators . Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet 2022; 399:629–55. Erratum: Lancet 2022; 400:1102. - PMC - PubMed
    1. Cassini A, Högberg LD, Plachouras D, et al. . Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis. Lancet Infect Dis 2019; 19:56–66. - PMC - PubMed
    1. de Kraker ME, Stewardson AJ, Harbarth S. Will 10 million people die a year due to antimicrobial resistance by 2050? PLoS Med 2016; 13:e1002184. - PMC - PubMed
    1. Andremont A, Brun-Buisson C, Struelens M. Evaluating and predicting the ecologic impact of antibiotics. Clin Microbiol Infect 2001; 7(Suppl 5):1–6. - PubMed
    1. Sharland M, Pulcini C, Harbarth S, et al. . Classifying antibiotics in the WHO essential medicines list for optimal use—be AWaRe. Lancet Infect Dis 2018; 18:18–20. - PubMed