Antibiotic prescription in ambulatory care for COVID-19 patients: a cohort analysis in four European countries

Eur J Clin Microbiol Infect Dis. 2024 Jan;43(1):115-119. doi: 10.1007/s10096-023-04716-4. Epub 2023 Nov 18.

Abstract

Objective: To analyse antibiotic prescription rates in ambulatory care for COVID-19 patients by general practitioners (GPs) in four European countries.

Methods: A total of 4,513,955 anonymised electronic prescribing records of 3656 GPs in four European countries were analysed. Diagnosis and prescriptions were retrieved. Antibiotic prescription rates during COVID-19 consultations were analysed and compared between France, the UK, Belgium and Romania.

Results: Overall prescription rate was in France and Belgium (6.66 and 7.46%). However, analysing median GP prescribing rates, we found that 33.9% of the GPs in Belgium prescribed antibiotics with a median of 16 prescriptions per 100 COVID-19 consultations, while 55.21% of the GPs in France prescribed a median of 8 antibiotic prescriptions per 100 COVID-19 consultations. Overall antibiotic prescription rates were less in Romania than in the UK (22% vs 32%); however, 73% of the Romanian GPs vs 57% of the British GPs prescribed antibiotics. Depending on the country, the proportion of each type of antibiotic was statistically different, with the proportion of azithromycin being more than 50% of all antibiotics in each country except for the UK where it was less than 1%.

Conclusion: Both individual GPs prescribing patterns in addition to overall consumption patterns should be analysed in order to implement a tailored antimicrobial stewardship programme. Furthermore, antibiotic prescribing rates in COVID-19 are lower than other respiratory tract infections.

Keywords: Antibiotic consumption; COVID-19; Europe; General practitioners; Outpatient care.

MeSH terms

  • Ambulatory Care
  • Anti-Bacterial Agents / therapeutic use
  • COVID-19*
  • Cohort Studies
  • Drug Prescriptions
  • Humans
  • Practice Patterns, Physicians'
  • Respiratory Tract Infections* / diagnosis

Substances

  • Anti-Bacterial Agents