Patterns of Antibiotic Prescription in Colombia: Are There Differences between Capital Cities and Municipalities?

Jorge Enrique Machado-Alba,Luis Fernando Valladales-Restrepo,Manuel Enrique Machado-Duque,Andrés Gaviria-Mendoza,Albert Figueras

doi:10.3390/antibiotics9070389

Abstract

The use of antibiotics is the most important modifiable risk factor for the development of microorganism resistance. A cross-sectional study of outpatients receiving antibiotic prescriptions registered in a population database in Colombia was conducted. The characteristics of the consumption in capital cities and small municipalities was studied and the AWaRe classification was used. AWaRe classifies antibiotics into three stewardship groups: Access, Watch and Reserve, to emphasize the importance of their optimal use and potential harms of antimicrobial resistance. A total of 182,397 patients were prescribed an antibiotic; the most common were penicillins (38.6%), cephalosporins (30.2%) and fluoroquinolones (10.9%). ‘Access’ antibiotics (86.4%) were the most frequently prescribed, followed by ‘Watch’ antibiotics (17.0%). Being 18 or older, being male, living in a municipality, having one or more comorbidities and urinary, respiratory or gastrointestinal disorders increased the probability of receiving ‘Watch’ or ‘Reserve’ antibiotics. Penicillin and urinary antiseptic prescriptions predominated in cities, while cephalosporin and fluoroquinolone prescriptions predominated in municipalities. This analysis showed that the goal set by the WHO Access of mainly using Access antibiotics is being met, although the high use of Watch antibiotics in municipalities should be carefully studied to determine if it is necessary to design specific campaigns to improve antibiotics use.

Highlights

The discovery of antibiotics remains one of the most important recent scientific advances in human health as it has increased the life expectancy of the population
In the United States, approximately 2 million people contract antibiotic-resistant bacterial infections each year, and 23,000 of them die as a result of these infections [9]
In the United States and in European countries, 67.9% of the total disability-adjusted life year (DALY) per 100,000 were due to infections caused by four antibiotic-resistant bacteria: E. coli resistant to third-generation cephalosporins, Methicillin-resistant S. aureus, carbapenem-resistant P. aeruginosa, and third-generation cephalosporin-resistant K. pneumoniae [10]

Summary

Introduction

The discovery of antibiotics remains one of the most important recent scientific advances in human health as it has increased the life expectancy of the population. Infections caused by resistant microorganisms are associated with an increased risk of morbidity, complications, mortality, health services use, and increased costs [3,7,8]. It is estimated that worldwide, 17 million people die each year from bacterial infections [9]. In the United States, approximately 2 million people contract antibiotic-resistant bacterial infections each year, and 23,000 of them die as a result of these infections [9]. In the United States and in European countries, 67.9% of the total disability-adjusted life year (DALY) per 100,000 were due to infections caused by four antibiotic-resistant bacteria: E. coli resistant to third-generation cephalosporins, Methicillin-resistant S. aureus, carbapenem-resistant P. aeruginosa, and third-generation cephalosporin-resistant K. pneumoniae [10]

Methods

Results

Discussion

Conclusion