Differences in outpatient antibiotic use between a Spanish region and a Nordic country.

INTRODUCTION: Antibiotic use and misuse are linked to pathogen resistance and, as such, both constitute a public health issue with local, national, and global dimensions. Early studies have shown striking variations in the use of these drugs between Nordic and Mediterranean countries. The aim of the present study was to describe and compare antibiotic prescribing in Primary Care in Denmark and Aragón (a North-eastern Spanish region). METHODS: Outpatient antibiotic prescription data (2010) were obtained from the National Institute for Health Data and Disease Control (Denmark), and the Information System on Medication Consumption in Aragón. The consumption of antibiotics (ATC J01) was analyzed from the prescription rates and the number of defined daily dose (DDD) per 1000 inhabitants/day (DID). RESULTS: The rate of antibiotic prescription in 2010 in Aragón was greater than in Denmark (407 compared to 315 exposed individuals/1000 inhabitants). There were significant differences as regards overall consumption of antibiotics (23.2 DID in Aragón and 17.0 DID in Denmark), as well as the therapeutic group selection. There was an elevated use of broad spectrum penicillins, quinolones and cephalosporins in the Spanish region while, in Denmark, the most-consumed antibiotic was narrow spectrum penicillin. CONCLUSION: The use of antibiotics in the Spanish region is very high, and there are marked differences in the choice of drug between this region and Denmark. Interventions are needed that promote the rational use of these drugs to reduce potential bacterial resistance, and to avoid unnecessary risks to patients.

[Outpatient antibiotic prescription in Aragón and the differences by gender and age]. / Prescripción extrahospitalaria de antibióticos en Aragón y sus diferencias por género y edad.

BACKGROUND: The objective of the study is to describe the use of antibiotics among outpatients, the pattern of sub-group prescribing, as well as to analyse age- and gender-specific patterns of use, and to identify high users. METHODS: A retrospective, observational study was designed, in which the rate of patients treated with antibiotics in Aragon (Spain) in 2008 was calculated. Data were extracted from the Aragon Pharmaceutical Consumption Database, a complete register of all dispensed prescriptions in Aragon in 2008. Defined Daily Dose (DDD) per 1000 inhabitants per day (DID) was calculated, and the number of patients who had received an antibacterial drug was analysed. RESULTS: The antibiotic prescription rate in 2008 in Aragón was 339.81 per 1000 inhabitants (303.54 and 375.34 per 1000 for men and women, respectively). The DID was 23.72. Population prevalence of antimicrobial use changed markedly between different age groups and between genders. Children (0-4 years) had the highest rate. Females, in general, used antibiotics more than males. Penicillins was the most used antibacterial group in all age groups, except for people of advanced age (>80 years), where quinolones were the most frequently used. Most of the individuals defined as high users (using more than 60 DDDs/year) were in the 60-80 years age group. CONCLUSION: We observed a high antibiotic prescription rate in Aragon, particularly in children. There are differences between men and women in the use of antibiotics.

Comparative study of paediatric prescription drug utilization between the Spanish and immigrant population.

BACKGROUND: The immigrant population has increased greatly in Spain in recent years to the point where immigrants made up 12% of the infant population in 2008. There is little information available on the profile of this group with regard to prescription drug utilization in universal public health care systems such as that operating in Spain. This work studies the overall and specific differences in prescription drug utilization between the immigrant and Spanish population. METHODS: Use was made of the Aragonese Health Service databases for 2006. The studied population comprises 159,908 children aged 0-14 years, 13.6% of whom are foreign nationals. Different utilization variables were calculated for each group. Prescription-drug consumption is measured in Defined Daily Doses (DDD) and DDD/1000 persons/day/(DID). RESULTS: A total of 833,223 prescriptions were studied. Utilization is lower for immigrant children than in Spanish children for both DID (66.27 v. 113.67) and average annual expense (euro21.55 v. euro41.14). Immigrant children consume fewer prescription drugs than Spanish children in all of the therapy groups, with the most prescribed (in DID) being: respiratory system, anti-infectives for systemic use, nervous system, sensory organs. Significant differences were observed in relation to the type of drugs and the geographical background of immigrants. CONCLUSION: Prescription drug utilization is much greater in Spanish children than in immigrant children, particularly with reference to bronchodilators (montelukast and terbutaline) and attention-disorder hyperactivity drugs such as methylphenidate. There are important differences regarding drug type and depending on immigrants' geographical backgrounds that suggest there are social, cultural and access factors underlying these disparities.

Differences in methylphenidate use between immigrants and spaniards in the child population of aragon, Spain: a retrospective study.

The aim of this research is to study the differences in methylphenidate use in children from different ethnic groups in the region of Aragon, Spain. Differences in the use of methylphenidate between both groups of children, immigrants and Spanish nationals, were assessed based on the total number of methylphenidate prescriptions made out for all children in Aragon in 2008 (N = 98 837). We have used defined daily doses and the defined daily doses per 1000 inhabitants per day. Defined daily doses per 1000 inhabitants per day of methylphenidate use was 18.49 in Spanish boys compared with 2.70 in immigrant boys, and 5.48 in Spanish girls versus 0.83 in immigrant girls. All differences between groups were statistically significant (P < .001). This study confirms that methylphenidate use is higher in a local population than in an immigrant population. Western European and North American children show the highest use, followed by Latin Americans and Eastern Europeans.

Differences in outpatient antibiotic use between a Spanish region and a Nordic country

INTRODUCTION: Antibiotic use and misuse are linked to pathogen resistance and, as such, both constitute a public health issue with local, national, and global dimensions. Early studies have shown striking variations in the use of these drugs between Nordic and Mediterranean countries. The aim of the present study was to describe and compare antibiotic prescribing in Primary Care in Denmark and Aragón (a North-eastern Spanish region). METHODS: Outpatient antibiotic prescription data (2010) were obtained from the National Institute for Health Data and Disease Control (Denmark), and the Information System on Medication Consumption in Aragón. The consumption of antibiotics (ATC J01) was analyzed from the prescription rates and the number of defined daily dose (DDD) per 1000 inhabitants/day (DID). RESULTS: The rate of antibiotic prescription in 2010 in Aragón was greater than in Denmark (407 compared to 315 exposed individuals/1000 inhabitants). There were significant differences as regards overall consumption of antibiotics (23.2 DID in Aragón and 17.0 DID in Denmark), as well as the therapeutic group selection. There was an elevated use of broad spectrum penicillins, quinolones and cephalosporins in the Spanish region while, in Denmark, the most-consumed antibiotic was narrow spectrum penicillin. CONCLUSIÓN: The use of antibiotics in the Spanish region is very high, and there are marked differences in the choice of drug between this region and Denmark. Interventions are needed that promote the rational use of these drugs to reduce potential bacterial resistance, and to avoid unnecessary risks to patients

INTRODUCCIÓN: El uso inadecuado de antibióticos se ha relacionado con la aparición de resistencias microbianas, constituyendo así un problema de salud pública de dimensiones locales, nacionales y globales. Estudios previos han mostrado importantes diferencias en el uso de estos fármacos entre los países nórdicos y los mediterráneos. El objetivo de este estudio fue describir y comparar la prescripción antibiótica en atención primaria en Dinamarca y Aragón. MÉTODOS: Los datos de utilización extrahospitalaria de antibióticos (2010) se obtuvieron del National Institute for Health Data and Disease Control (Dinamarca) y del Sistema de Información de Consumo Farmacéutico de Aragón. El consumo de antibióticos (ATC J01) se analizó mediante las tasas de prescripción y el número de dosis diaria definida por 1.000 habitantes/día (DHD). RESULTADOS: La tasa de prescripción antibiótica en 2010 en Aragón fue superior a la de Dinamarca (407 frente a 315 expuestos/1.000 habitantes). Se observaron diferencias significativas en cuanto al consumo total de antibióticos (23,2 DHD en Aragón y 17 DHD en Dinamarca), así como en la elección del grupo terapéutico. La utilización de penicilinas de amplio espectro, quinolonas y cefalosporinas en la región española fue elevada, mientras que en Dinamarca el antibiótico más consumido fue una penicilina de espectro reducido. CONCLUSIÓN: El uso de antibióticos en Aragón es elevado, y existen importantes diferencias en la elección del tipo de fármaco entre esta región y Dinamarca. Sería conveniente desarrollar intervenciones que promuevan el uso racional de estos fármacos, para reducir las resistencias bacterianas y evitar riesgos innecesarios a los pacientes

Prescripción extrahospitalaria de antibióticos en Aragón y sus diferencias por género y edad / Outpatient antibiotic prescription in Aragón and the differences by gender and age

Introducción: El objetivo de este estudio es describir la prescripción de antibióticos en atención extrahospitalaria y su patrón de consumo por subgrupos, analizar los patrones de utilización por edad y sexo e identificar pacientes hiperconsumidores. Métodos Estudio observacional retrospectivo en el que se estimó la proporción de habitantes de Aragón que habían sido tratados con antibióticos en 2008. Los datos se obtuvieron del Sistema de Información de Consumo Farmacéutico de Aragón, que recoge las recetas dispensadas en oficinas de farmacia. Se calcularon la tasa de habitantes expuestos a tratamiento antibiótico y la dosis diaria definida (DDD) por mil habitantes/día (DHD).Resultados La tasa de prescripción de antibióticos en 2008 en Aragón fue de 339,81 por 1.000 habitantes (303,54 por 1.000 en hombres y 375,34 por 1.000 en mujeres). La prescripción extrahospitalaria de antibióticos en Aragón fue de 23,72 DHD. La frecuencia de consumo presenta diferencias importantes en función de la edad y el sexo. En los niños de 0 a 4 años se observa la mayor tasa de utilización de antibióticos, y las mujeres, en general, presentan una mayor frecuencia de consumo que los hombres. Las penicilinas son el subgrupo de antibióticos más utilizado en todos los grupos de edad, excepto en los mayores de 80 años, en quienes son desplazadas por las quinolonas. El mayor porcentaje de pacientes considerados hiperconsumidores en adultos (más de 60 DDD de antibióticos al año) tuvo lugar en el grupo entre 60 y 80 años. Conclusión Se observó una elevada prescripción de antibióticos en Aragón, siendo llamativo el elevado consumo en los niños más pequeños, y las diferencias entre mujeres y hombres (AU)

Background: The objective of the study is to describe the use of antibiotics among outpatients, the pattern of sub-group prescribing, as well as to analyse age- and gender-specific patterns of use, and to identify high users. Methods: A retrospective, observational study was designed, in which the rate of patients treated with antibiotics in Aragon (Spain) in 2008 was calculated. Data were extracted from the Aragon Pharmaceutical Consumption Database, a complete register of all dispensed prescriptions in Aragon in 2008. Defined Daily Dose (DDD) per 1000 inhabitants per day (DID) was calculated, and the number of patients who had received an antibacterial drug was analysed. Results: The antibiotic prescription rate in 2008 in Aragón was 339.81 per 1000 inhabitants (303.54and 375.34 per 1000 for men and women, respectively). The DID was 23.72. Population prevalence of antimicrobial use changed markedly between different age groups and between genders. Children (0-4 years) had the highest rate. Females, in general, used antibiotics more than males. Penicillins was the most used antibacterial group in all age groups, except for people of advanced age (>80 years), where quinolones were the most frequently used. Most of the individuals defined as high users (using more than60 DDDs/year) were in the 60-80 years age group. Conclusion: We observed a high antibiotic prescription rate in Aragon, particularly in children. There are differences between men and women in the use of antibiotics (AU)