Study of prescription-indication of tetracyclines in a population in Colombia

Fundam Clin Pharmacol. 2022 Apr;36(2):390-396. doi: 10.1111/fcp.12724. Epub 2021 Sep 13.

Abstract

The inappropriate use of antibiotics is associated with increased antimicrobial resistance, adverse reactions, medical care costs, and worse clinical outcomes. The objective of this study is to determine the prescription patterns and approved and unapproved indications for tetracyclines in a group of patients in Colombia. This was a cross-sectional study, based on a database of medication dispensing of approximately 8.5 million people affiliated with the Colombian Health System, of the indications for the use of tetracyclines in outpatients. Sociodemographic, pharmacological, and comorbidity variables were considered. A total of 20 699 patients with a prescription of tetracyclines were identified, with a median age of 26.1 years; 65.0% were women. The most prescribed tetracycline was doxycycline (95.1%), especially for the treatment of acne (55.3%). A total of 23.5% of the prescriptions was used for unapproved indications, for example, vaginitis-vulvitis-vulvovaginitis (8.1%). Increasing age, prescriptions of doxycycline made by general physician, and woman attended by general physician were associated with a greater probability that a tetracycline was used for unapproved indications. Residing in Bogota-Cundinamarca Region and woman that residing in Bogota-Cundinamarca reduced this risk. A high proportion of patients received tetracyclines for dermatological conditions, with a lower proportion of use for gynecological and respiratory infections. For approximately one quarter of the cases, tetracyclines were prescribed for indications not approved by regulatory agencies, especially in those over 18 years and when the prescriptions of doxycycline was made by a general practitioners.

Keywords: acne vulgaris; doxycycline; inappropriate prescribing; pharmacoepidemiology; vaginitis.

MeSH terms

  • Adult
  • Anti-Bacterial Agents* / adverse effects
  • Colombia
  • Cross-Sectional Studies
  • Female
  • Humans
  • Practice Patterns, Physicians'
  • Prescriptions
  • Tetracyclines* / adverse effects

Substances

  • Anti-Bacterial Agents
  • Tetracyclines