Study: Certain Antibiotics Often Overprescribed, Despite Guidelines

Researchers in Denmark believe that second-line antibiotics are overprescribed and that general practice guidelines for responsible prescribing have not been followed.

Rune Aabenhus, PhD, and colleagues from the University of Copenhagen evaluated data from electronic prescriptions from Danish general medical practice. The prescriptions were labeled with clinical indications, and the study focused on prescriptions for acute respiratory tract infections.

They found that there were 456,532 antibiotic prescriptions for acute respiratory tract infections given between July 2012 and June 2013. Of those prescriptions, 178,354 (39%) were issued for pneumonia, which was the most common indication. There were also prescriptions issued for acute tonsillitis (21%) and acute otitis media (19%).

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The researchers assessed the types of antibiotics prescribed and found that 58% of prescriptions were for penicillin V, while 18% were for macrolides and 15% were for amoxicillin.

Patients aged greater than 75 years accounted for more than 40% of the prescriptions, the researchers noted. For all indications, there were increased numbers of prescriptions as patients’ age increased. In addition, women were more likely to receive an antibiotic prescription for any clinical indication.

“Strategies to improve the quality of antibiotic prescribing especially for pneumonia, acute otitis media and acute rhinosinusitis are warranted,” the study’s authors stated.

They added, “The overuse of antibiotics, particularly so-called 'second-line' agents such as amoxicillin, increases resistance and may lead to a potentially catastrophic scenario where antibiotics are no longer effective.”

The researchers said that the percent of prescriptions for penicillin V (58%) should be improved, too. They also recommended further analyzing prescribing habits of out-of-hours clinics. 

—Lauren LeBano

Reference

Aabenhus R, Hansen MP, Saust LT, Bjerrum L. Characterisation of antibiotic prescriptions for acute respiratory tract infections in Danish general practice: a retrospective registry based cohort study. NPJ Prim Care Respir Med. 2017;27(1):37. doi: 10.1038/s41533-017-0037-7.