Correlation of Recommendations of Treatment Guidelines and Frequently Prescribed Antibiotics: Evaluation of Their Pharmaceutical Pack Size

Abstract

There are various factors that contribute to development of antimicrobial resistance. Overuse, inappropriate prescribing and extensive agricultural use of antibiotics are some of the factors which have been identified. Antibiotics are almost always universally packaged by manufacturers in packs that are heavily driven by cost of economies and convenience rather than by any scientific basis or duration of therapy. So, in this study, the correlation of the treatment guidelines with the choice of antibiotics and whether packing size contributes to leftover dosing units when used according to guideline recommendations were assessed.

Evaluation of accordance of antibiotics package size with recommended treatment duration of guidelines for sore throat and urinary tract infections

“…The results of this study are consistent with findings of previous studies on this topic [10, 11]. Out of 32 most common antibiotic-prescribing scenarios in Australia, there were only 4 in which the drug package size aligned with duration recommended by The Australian (electronic) Therapeutic Guidelines.…”

“…Mukherjee et al . found comparable results in India and proposed revision of antibiotic package sizes by specialists, industry and health policy makers to devise steps for reducing leftover antibiotics [10].…”

“…An outpatient antimicrobial stewardship intervention, consisting of clinician education may significantly reduce off-guideline antibiotic use [9]. However, previous studies have raised concerns that antibiotics prepacked by the manufacturer may limit prescribers ability to follow antibiotic prescribing guidelines [10, 11]. Improper duration of treatment with antibiotics and leftover excess units of antibiotics may contribute to antibiotic resistance and may increase antibiotic consumption [12].…”

Correlation of registered drug packs with Maastricht V/Florence Consensus Report and national treatment guidelines for management of Helicobacter pylori infection

“…Poor correlation of the size of drug packs has been previously discussed, for most frequent indications in primary care or antimicrobials that are greatly consumed. [2][3][4] These considerations should further be expanded to indications with great prevalence that are expected to have rising incidence or require combination antibiotic treatments.…”

“…Antibiotic resistance has been emerging worldwide . Patient behaviour, treatment adherence, leftover antibiotics and drug waste should be identified as potential targets for restraining antibiotic resistance, and these may be of greatest interest in primary care, outpatient setting or for infections with great prevalence . Considering the latter, it is estimated that 50% of the world's population will be infected with Helicobacter pylori .…”