JAC Advance Access published online on September 1, 2003
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkg412
© 2003 by The British Society for Antimicrobial Chemotherapy
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Brief report
1 Julius Center for Health Sciences and Primary Care, University Medical Center (UMC) Utrecht, PO Box 85060, 3508 AB Utrecht, The Netherlands
* Corresponding author. E-mail: m.m.kuyvenhoven{at}med.uu.nl.
Received 17 March 2003
; revised 27 June 2003
; accepted 12 July 2003
Objectives: Although Dutch outpatient
antibiotic prescription rates are low compared with other European countries,
continuing to scrutinize trends in outpatient antibiotic use is
important in order to identify possible increases in antibiotic
use or inappropriate increases in the use of particular classes
of antibiotics. Methods: We assessed the volume of Dutch outpatient
antibiotic prescriptions from 1992 to 2001 by calculating the mean
number of outpatient antibiotic prescriptions (indicating the number
of times physicians decide to prescribe an antibiotic agent) per
1000 patients insured by the Dutch Sickness Fund per year, according
to subgroups (narrow-spectrum penicillins, broad-spectrum penicillins,
tetracyclines, macrolides, sulphonamides and trimethoprim, and quinolones).
Data were obtained from the Dutch Drug Information Project/Health
Care Insurance Board. Results: The total volume of outpatient antibiotic
prescriptions in 2001 was 394 prescriptions per 1000 patients insured
by the Dutch Sickness Fund. Overall, the rates were stable between
1992 and 2001, with small variations across years, but with marked
differences in volumes within antibiotic groups across these years:
a decrease in prescribing of narrow-spectrum penicillins (-29%),
amoxicillin (-23%), tetracycline (-24%),
doxycycline (-19%) and trimethoprim and derivatives
(-45%) was accompanied by an increase in prescribing
of co-amoxiclav (+85%), macrolides (+110%)
and quinolones (+86%). Conclusions: The international trend of a decline
in the use of narrow-spectrum and older penicillins and prescribing
more broad-spectrum and new chemotherapeutics was shown to exist
in a low prescribing country, The Netherlands. Therefore, inappropriate
antibiotic prescribing should remain prominent on the research agenda
in intervention studies in order to improve the appropriate selection
of antibiotic class and to reduce the prescription of antibiotics.
Keywords: antibiotic prescription, broader-spectrum antibiotics,
newer antibiotics, general practice, The Netherlands
Outpatient antibiotic prescriptions from 1992 to
2001 in
The Netherlands
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