Objective
This study aimed to describe prescription of antibiotics to the elderly population in general practice in Denmark from 2010–2017.
Design
This is a national register-based observational study.
Setting
General practice, Denmark
Main outcome measure
The main outcome measure was prescriptions/1,000 inhabitants/day (PrID) in relation to year, age and sex, indication, and antibiotic agent.
Subjects
In this study, we included inhabitants of Denmark, ≥65 years of age between 01st July 2010–30th June 2017.
Results
A total of 5,168,878 prescriptions were included in the study. Antibiotic prescriptions decreased from 2.2 PrID to 1.7 (-26.9%, CI95% [-31.1;-22.4]) PrID during the study. The decrease in PrID was most noticeable among 65–74-year-olds (-25%). The ≥85-year-olds were exposed to twice as many PrID than the 65–74-year-olds, but only accounted for 20% of the total use. Urinary tract infection (UTI) was the most common indication for antibiotic prescription and increased with advancing age. The most commonly prescribed antibiotics were pivmecillinam and phenoxymethylpenicillin. Prescribing with no informative indication was present in one third of all cases.
Conclusion
The prescription of antibiotics in the elderly population in general practice decreased from 2010 to 2017. The oldest age group was exposed twice as frequently to antibiotic prescriptions as the 65–74-year-olds. The smallest reduction was observed for the ≥85-year-olds, suggesting targeting interventions at this group.
Key Points
High antibiotic use among elderly is well known and studies indicate mis- and overuse within this population. Our study shows.
The prescription rate is decreasing within all age groups of the elderly population.
The ≥85-year-olds receive twice as many prescriptions/1000/day as the 65–74-years-olds.
Background
To curb future antibiotic resistance it is important to monitor and investigate current prescription patterns of antibiotics.
Objectives
To examine trends in antibiotic prescription to children aged 0–6 years old and the association with socioeconomic status of municipalities in the Capital region of Denmark between 2009 and 2018.
Methods
This is a register-based study combining data on antibiotic treatments from 2009 to 2018, inhabitant-data and socioeconomic municipality scores. Subjects were children aged 0–6 years, residing in the Capital Region of Denmark. The study quantifies the use of antibiotics as number of antibiotic treatments/1000 inhabitants/year (TIY), inhabitants defined as children aged 0–6. Socioeconomic status of the municipalities is evaluated by a score from 3 to 12.
Results
The average TIY of the municipalities decreased from 741.2 [95%CI 689.3–793.2] in 2009 to 348.9 [329.4–368.4] in 2018. The difference between the highest and lowest prescribing municipalities was reduced from 648.3 TIY in 2009–212.5 TIY in 2018. The average increase in TIY per unit increase in socioeconomic municipality score changed from 20.05 [7.69–31.06] in 2009 to −4.58 [-16.02–5.60] in 2018, representing a decreasing association between socioeconomic municipality score and use of antibiotic in the respective municipalities.
Conclusion
The trend in antibiotic prescription to children aged 0–6 years old decreased substantially in all the investigated municipalities in the 10-year study period. Local differences in prescription rates declined towards a more uniform prescription pattern across municipalities and association with socioeconomic status of the municipalities was reduced.
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