Evolution of antibiotic prescription in Primary Health Care according to the indicators of the Spanish Action Plan on Antibiotic Resistance (PRAN)

Abstract

Introduction

Spain is the fourth European country with the highest antibiotic consumption at the community level, being children aged 0-4 years one of the age groups with the highest amount of consumption. The aim of this study was to analyze the evolution of antibiotic prescription of the pediatric population in a Primary Health Care area according to the indicators of the Spanish Action Plan on Antibiotic Resistance (PRAN) in a period of ten years (2014-2023), as well as to evaluate the impact of the COVID-19 pandemic by the comparison between 2020-2021 years and a previous (2014-2019) and a later periods of time (2022-2023).

Material and methods

Retrospective observational study of the prescription of antibiotics for systemic use (J01 group of the Anatomical Therapeutic Chemical Classification) in pediatric patients (0-14 years) belonging to the Primary Health Care area of the Gerencia de Atención Integrada (GAI) de Albacete between 2014 and 2023.

Results

Mean antibiotic prescription was 16.90 defined daily doses per 1000 inhabitants per day (DID) and 12.10 DOT (days of therapy). Pre-pandemic data (2014-2019) was 19.32 DID and 13.92 DOT, being reduced during the two years of the pandemic (2020-2021) to 8.30 DID and 6.05 DOT and subsequently increased to 18.05 DID and 12.40 DOT in post-pandemic years (2022-2023). An improvement in the adequacy of antibiotic prescription was observed after the COVID-19 pandemic, with a reduction of the consumption of amoxicillin-clavulanate and a greater consumption of penicillin and amoxicillin during pre-pandemic and pandemic years (p < 0.05).

Conclusions

Thoughout the period of years analysed, an improvement in the consumption indicators proposed by the PRAN, with a higher use of beta-lactamase sensitive penicillins and amoxicillin and a reduced consumption of amoxicillin-clavulanate.