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Cross-border comparison of antibiotic prescriptions among children and adolescents between the north of the Netherlands and the north-west of Germany.

Dik JW, Sinha B, Friedrich AW, Lo-Ten-Foe JR, Hendrix R, Köck R, Bijker B, Postma MJ, Freitag MH, Glaeske G, Hoffmann F - Antimicrob Resist Infect Control (2016)

Bottom Line: The proportion of primary care patients receiving at least one antibiotic was lower in northern Netherlands (29.8 %; 95 % confidence interval [95 % CI]: 29.3-30.3), compared to north-west Germany (38.9 %; 95 % CI: 38.2-39.6).Most profound was the difference in second-generation cephalosporins: for German children 25 % of the total prescriptions, while for Dutch children it was less than 0.1 %.Considering increasing cross-border healthcare, these comparisons are highly valuable and help act upon antibiotic resistance in the first line of care in an international approach.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.

ABSTRACT

Background: Antibiotic resistance is a worldwide problem and inappropriate prescriptions are a cause. Especially among children, prescriptions tend to be high. It is unclear how they differ in bordering regions. This study therefore examined the antibiotic prescription prevalence among children in primary care between northern Netherlands and north-west of Germany.

Methods: Two datasets were used: The Dutch (IADB) comprises representative data of pharmacists in North Netherland and the German (BARMER GEK) includes nationwide health insurance data. Both were filtered using postal codes to define two comparable bordering regions with patients under 18 years for 2010.

Results: The proportion of primary care patients receiving at least one antibiotic was lower in northern Netherlands (29.8 %; 95 % confidence interval [95 % CI]: 29.3-30.3), compared to north-west Germany (38.9 %; 95 % CI: 38.2-39.6). Within the respective countries, there were variations ranging from 27.0 to 44.1 % between different areas. Most profound was the difference in second-generation cephalosporins: for German children 25 % of the total prescriptions, while for Dutch children it was less than 0.1 %.

Conclusions: This study is the first to compare outpatient antibiotic prescriptions among children in primary care practices in bordering regions of two countries. Large differences were seen within and between the countries, with overall higher prescription prevalence in Germany. Considering increasing cross-border healthcare, these comparisons are highly valuable and help act upon antibiotic resistance in the first line of care in an international approach.

No MeSH data available.


Small area variations (by postal codes) in the proportion of children and adolescents with prescriptions of antibiotics in the northern Netherlands and north-west Germany
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Fig2: Small area variations (by postal codes) in the proportion of children and adolescents with prescriptions of antibiotics in the northern Netherlands and north-west Germany

Mentions: Overall, the proportion of children and adolescents receiving at least one antibiotic course in 2010 was lower in the northern Netherlands (29.8 %; 95 % CI: 29.3–30.3) compared to north-west Germany (38.9 %; 95 % CI: 38.2–39.6). There were small area variations ranging from 27.0 to 36.4 % in the northern Netherlands and from 35.1 to 44.1 % in north-west Germany (Fig. 2). Prevalence stratified by region, sex and age groups is shown in Tables 1 and 2. The age groups with the highest proportion of prescriptions were children between 0–2 years (northern Netherlands vs. north-west Germany: 43.1 % vs. 49.9 %) and those between 3–6 years (37.4 % vs. 54.8 %). The proportion was considerably higher in Germany than in the Netherlands in all age groups, for males and for females. Males had a lower prevalence of antibiotic prescriptions than females for both Netherlands and Germany in all age groups, except for children aged 0–2 years old (Table 2).Fig. 2


Cross-border comparison of antibiotic prescriptions among children and adolescents between the north of the Netherlands and the north-west of Germany.

Dik JW, Sinha B, Friedrich AW, Lo-Ten-Foe JR, Hendrix R, Köck R, Bijker B, Postma MJ, Freitag MH, Glaeske G, Hoffmann F - Antimicrob Resist Infect Control (2016)

Small area variations (by postal codes) in the proportion of children and adolescents with prescriptions of antibiotics in the northern Netherlands and north-west Germany
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4836103&req=5

Fig2: Small area variations (by postal codes) in the proportion of children and adolescents with prescriptions of antibiotics in the northern Netherlands and north-west Germany
Mentions: Overall, the proportion of children and adolescents receiving at least one antibiotic course in 2010 was lower in the northern Netherlands (29.8 %; 95 % CI: 29.3–30.3) compared to north-west Germany (38.9 %; 95 % CI: 38.2–39.6). There were small area variations ranging from 27.0 to 36.4 % in the northern Netherlands and from 35.1 to 44.1 % in north-west Germany (Fig. 2). Prevalence stratified by region, sex and age groups is shown in Tables 1 and 2. The age groups with the highest proportion of prescriptions were children between 0–2 years (northern Netherlands vs. north-west Germany: 43.1 % vs. 49.9 %) and those between 3–6 years (37.4 % vs. 54.8 %). The proportion was considerably higher in Germany than in the Netherlands in all age groups, for males and for females. Males had a lower prevalence of antibiotic prescriptions than females for both Netherlands and Germany in all age groups, except for children aged 0–2 years old (Table 2).Fig. 2

Bottom Line: The proportion of primary care patients receiving at least one antibiotic was lower in northern Netherlands (29.8 %; 95 % confidence interval [95 % CI]: 29.3-30.3), compared to north-west Germany (38.9 %; 95 % CI: 38.2-39.6).Most profound was the difference in second-generation cephalosporins: for German children 25 % of the total prescriptions, while for Dutch children it was less than 0.1 %.Considering increasing cross-border healthcare, these comparisons are highly valuable and help act upon antibiotic resistance in the first line of care in an international approach.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.

ABSTRACT

Background: Antibiotic resistance is a worldwide problem and inappropriate prescriptions are a cause. Especially among children, prescriptions tend to be high. It is unclear how they differ in bordering regions. This study therefore examined the antibiotic prescription prevalence among children in primary care between northern Netherlands and north-west of Germany.

Methods: Two datasets were used: The Dutch (IADB) comprises representative data of pharmacists in North Netherland and the German (BARMER GEK) includes nationwide health insurance data. Both were filtered using postal codes to define two comparable bordering regions with patients under 18 years for 2010.

Results: The proportion of primary care patients receiving at least one antibiotic was lower in northern Netherlands (29.8 %; 95 % confidence interval [95 % CI]: 29.3-30.3), compared to north-west Germany (38.9 %; 95 % CI: 38.2-39.6). Within the respective countries, there were variations ranging from 27.0 to 44.1 % between different areas. Most profound was the difference in second-generation cephalosporins: for German children 25 % of the total prescriptions, while for Dutch children it was less than 0.1 %.

Conclusions: This study is the first to compare outpatient antibiotic prescriptions among children in primary care practices in bordering regions of two countries. Large differences were seen within and between the countries, with overall higher prescription prevalence in Germany. Considering increasing cross-border healthcare, these comparisons are highly valuable and help act upon antibiotic resistance in the first line of care in an international approach.

No MeSH data available.