Antibiotic prescribing in Danish general practice 2004-13

Rune Aabenhus, Volkert Siersma, Malene Plejdrup Hansen, Lars Bjerrum

Research output: Contribution to journalArticleResearchpeer-review

16 Citations (Scopus)

Abstract

Objectives: Antibiotic consumption in the primary care sector is often perceived as synonymous with consumption in general practice despite the fact that few countries stratify the primary care sector by providers' medical specialty. We aimed to characterize and quantify antibiotic use in Danish general practice relative to the entire primary care sector. 

Methods: This was a registry-based study including all patients who redeemed an antibiotic prescription between July 2004 and June 2013 at a Danish community pharmacy. Antibiotic use was expressed as DDDs and treatments/1000 inhabitants/day (DIDs and TIDs, respectively) and assessed according to antibiotic spectrum (narrow versus broad) and their anatomical therapeutic classification codes in total as well as in six age groups. 

Results: The contribution of general practice to the entire antibiotic use in the primary care sector declined during the study period (TIDs, 79%-75%; DIDs, 77%-73%). Antibiotic use in general practice increased 8% when expressed as DIDs, while a 9% decrease was observed when expressed as TIDs. The use of broad-spectrum agents increased while narrow-spectrum agents decreased. The decline in antibiotic use was most prominent in children aged <5 years, while elderly patients were increasingly prescribed antibiotics. 

Conclusions: Using the entire primary care sector as a proxy for general practice prescribing is imprecise. Antibiotic use in general practice is at a stable high level, but DID and TID analyses show different trends and both should be applied when detailing changes in antibiotic consumption. While children are prescribed fewer narrow-spectrum agents, the observed increase in the use of broad-spectrum agents is worrisome and should be addressed in future interventions.

Original languageEnglish
Pages (from-to)2286-2294
Number of pages9
JournalJournal of Antimicrobial Chemotherapy
Volume71
Issue number8
DOIs
Publication statusPublished - 1 Aug 2016

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General Practice
Anti-Bacterial Agents
Primary Health Care
Dichlorodiphenyldichloroethane
Pharmacies
Proxy
Prescriptions
Registries
Age Groups
Medicine
Therapeutics

Cite this

Aabenhus, R., Siersma, V., Hansen, M. P., & Bjerrum, L. (2016). Antibiotic prescribing in Danish general practice 2004-13. Journal of Antimicrobial Chemotherapy, 71(8), 2286-2294. https://doi.org/10.1093/jac/dkw117
Aabenhus, Rune ; Siersma, Volkert ; Hansen, Malene Plejdrup ; Bjerrum, Lars. / Antibiotic prescribing in Danish general practice 2004-13. In: Journal of Antimicrobial Chemotherapy. 2016 ; Vol. 71, No. 8. pp. 2286-2294.
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abstract = "Objectives: Antibiotic consumption in the primary care sector is often perceived as synonymous with consumption in general practice despite the fact that few countries stratify the primary care sector by providers' medical specialty. We aimed to characterize and quantify antibiotic use in Danish general practice relative to the entire primary care sector. Methods: This was a registry-based study including all patients who redeemed an antibiotic prescription between July 2004 and June 2013 at a Danish community pharmacy. Antibiotic use was expressed as DDDs and treatments/1000 inhabitants/day (DIDs and TIDs, respectively) and assessed according to antibiotic spectrum (narrow versus broad) and their anatomical therapeutic classification codes in total as well as in six age groups. Results: The contribution of general practice to the entire antibiotic use in the primary care sector declined during the study period (TIDs, 79{\%}-75{\%}; DIDs, 77{\%}-73{\%}). Antibiotic use in general practice increased 8{\%} when expressed as DIDs, while a 9{\%} decrease was observed when expressed as TIDs. The use of broad-spectrum agents increased while narrow-spectrum agents decreased. The decline in antibiotic use was most prominent in children aged <5 years, while elderly patients were increasingly prescribed antibiotics. Conclusions: Using the entire primary care sector as a proxy for general practice prescribing is imprecise. Antibiotic use in general practice is at a stable high level, but DID and TID analyses show different trends and both should be applied when detailing changes in antibiotic consumption. While children are prescribed fewer narrow-spectrum agents, the observed increase in the use of broad-spectrum agents is worrisome and should be addressed in future interventions.",
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Aabenhus, R, Siersma, V, Hansen, MP & Bjerrum, L 2016, 'Antibiotic prescribing in Danish general practice 2004-13' Journal of Antimicrobial Chemotherapy, vol. 71, no. 8, pp. 2286-2294. https://doi.org/10.1093/jac/dkw117

Antibiotic prescribing in Danish general practice 2004-13. / Aabenhus, Rune; Siersma, Volkert; Hansen, Malene Plejdrup; Bjerrum, Lars.

In: Journal of Antimicrobial Chemotherapy, Vol. 71, No. 8, 01.08.2016, p. 2286-2294.

Research output: Contribution to journalArticleResearchpeer-review

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