Outpatient Antibiotic Prescriptions in France: Patients and Providers Characteristics and Impact of the COVID-19 Pandemic
In France, despite several successive plans to control antimicrobial resistance, antibiotic use remains high in the outpatient setting. This study aims to better understand outpatient antibiotic use and prescription in order to identify tailored targets for future public health actions. Using data f...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-05-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/11/5/643 |
| _version_ | 1797502087106396160 |
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| author | Wilfried BARA Christian Brun-Buisson Bruno Coignard Laurence Watier |
| author_facet | Wilfried BARA Christian Brun-Buisson Bruno Coignard Laurence Watier |
| author_sort | Wilfried BARA |
| collection | DOAJ |
| description | In France, despite several successive plans to control antimicrobial resistance, antibiotic use remains high in the outpatient setting. This study aims to better understand outpatient antibiotic use and prescription in order to identify tailored targets for future public health actions. Using data from the French National Health Data System, we described and compared the individual characteristics of patients with and without an antibiotic prescription. The prescribed antibiotics (ATC-J01) were detailed and compared between 2019 and 2020. Antibiotic prescribing indicators that take prescriber activity into account were estimated and compared. Patients who were female, advanced age, and the presence of comorbidities were associated with antibiotic prescriptions. The overall prescription rate was estimated at 134 per 1000 consultations and 326 per 1000 patients seen in 2019. General practitioners (GPs), dentists and paediatricians were associated with 78.0%, 12.2% and 2.2% of antibiotic prescriptions, respectively, with high prescription rates (391, 447, and 313 p. 1000 patients seen, respectively). In comparison with 2019, this rate decreased in 2020 for paediatricians (−30.4%) and GPs (−17.9%) whereas it increased among dentists (+17.9%). The reduction was twice as high among the male prescribers than among their female counterparts (−26.6 and −12.0, respectively). The reduction in prescriptions observed in 2020 (−18.2%) was more marked in children (−35.8%) but less so among individuals ≥65 years (−13.1%) and those with comorbidities (−12.5%). The decrease in penicillin prescriptions represents 67.3% of the overall reduction observed in 2020. The heterogeneous decrease in prescriptions by age and antibiotic class could be explained by the impact of COVID-19 control measures on the spread of respiratory viruses; thus, a substantial proportion of the prescriptions avoided in 2020 is likely inappropriate, particularly among children. In order to keep the rate of prescriptions comparable to that observed in 2020, male prescribers, paediatricians and GPs should be encouraged to maintain that level, while a campaign to raise awareness of the appropriate use of antibiotics should be aimed at dentists in particular. |
| first_indexed | 2024-03-10T03:27:52Z |
| format | Article |
| id | doaj.art-f39a3750951c4d2dacf488c3cfdcda45 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-10T03:27:52Z |
| publishDate | 2022-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-f39a3750951c4d2dacf488c3cfdcda452023-11-23T09:49:02ZengMDPI AGAntibiotics2079-63822022-05-0111564310.3390/antibiotics11050643Outpatient Antibiotic Prescriptions in France: Patients and Providers Characteristics and Impact of the COVID-19 PandemicWilfried BARA0Christian Brun-Buisson1Bruno Coignard2Laurence Watier3Center for Research in Epidemiology and Population Health (CESP), INSERM U1018, Université Paris-Saclay, UVSQ, 78180 Montigny-Le-Bretonneux, FranceCenter for Research in Epidemiology and Population Health (CESP), INSERM U1018, Université Paris-Saclay, UVSQ, 78180 Montigny-Le-Bretonneux, FranceSanté publique France, the French National Public Health Agency, 94415 Saint-Maurice, FranceCenter for Research in Epidemiology and Population Health (CESP), INSERM U1018, Université Paris-Saclay, UVSQ, 78180 Montigny-Le-Bretonneux, FranceIn France, despite several successive plans to control antimicrobial resistance, antibiotic use remains high in the outpatient setting. This study aims to better understand outpatient antibiotic use and prescription in order to identify tailored targets for future public health actions. Using data from the French National Health Data System, we described and compared the individual characteristics of patients with and without an antibiotic prescription. The prescribed antibiotics (ATC-J01) were detailed and compared between 2019 and 2020. Antibiotic prescribing indicators that take prescriber activity into account were estimated and compared. Patients who were female, advanced age, and the presence of comorbidities were associated with antibiotic prescriptions. The overall prescription rate was estimated at 134 per 1000 consultations and 326 per 1000 patients seen in 2019. General practitioners (GPs), dentists and paediatricians were associated with 78.0%, 12.2% and 2.2% of antibiotic prescriptions, respectively, with high prescription rates (391, 447, and 313 p. 1000 patients seen, respectively). In comparison with 2019, this rate decreased in 2020 for paediatricians (−30.4%) and GPs (−17.9%) whereas it increased among dentists (+17.9%). The reduction was twice as high among the male prescribers than among their female counterparts (−26.6 and −12.0, respectively). The reduction in prescriptions observed in 2020 (−18.2%) was more marked in children (−35.8%) but less so among individuals ≥65 years (−13.1%) and those with comorbidities (−12.5%). The decrease in penicillin prescriptions represents 67.3% of the overall reduction observed in 2020. The heterogeneous decrease in prescriptions by age and antibiotic class could be explained by the impact of COVID-19 control measures on the spread of respiratory viruses; thus, a substantial proportion of the prescriptions avoided in 2020 is likely inappropriate, particularly among children. In order to keep the rate of prescriptions comparable to that observed in 2020, male prescribers, paediatricians and GPs should be encouraged to maintain that level, while a campaign to raise awareness of the appropriate use of antibiotics should be aimed at dentists in particular.https://www.mdpi.com/2079-6382/11/5/643antibioticsoutpatient prescriptionprimary care physiciansCOVID-19ambulatory careFrench National Health Insurance Databases (SNDS) |
| spellingShingle | Wilfried BARA Christian Brun-Buisson Bruno Coignard Laurence Watier Outpatient Antibiotic Prescriptions in France: Patients and Providers Characteristics and Impact of the COVID-19 Pandemic Antibiotics antibiotics outpatient prescription primary care physicians COVID-19 ambulatory care French National Health Insurance Databases (SNDS) |
| title | Outpatient Antibiotic Prescriptions in France: Patients and Providers Characteristics and Impact of the COVID-19 Pandemic |
| title_full | Outpatient Antibiotic Prescriptions in France: Patients and Providers Characteristics and Impact of the COVID-19 Pandemic |
| title_fullStr | Outpatient Antibiotic Prescriptions in France: Patients and Providers Characteristics and Impact of the COVID-19 Pandemic |
| title_full_unstemmed | Outpatient Antibiotic Prescriptions in France: Patients and Providers Characteristics and Impact of the COVID-19 Pandemic |
| title_short | Outpatient Antibiotic Prescriptions in France: Patients and Providers Characteristics and Impact of the COVID-19 Pandemic |
| title_sort | outpatient antibiotic prescriptions in france patients and providers characteristics and impact of the covid 19 pandemic |
| topic | antibiotics outpatient prescription primary care physicians COVID-19 ambulatory care French National Health Insurance Databases (SNDS) |
| url | https://www.mdpi.com/2079-6382/11/5/643 |
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