THE IMPACT OF A NATIONAL ELECTRONIC PRESCRIBING SYSTEM ON ANTIBIOTIC PRESCRIBING IN PEDIATRIC OUTPATIENTS IN GREECE.

Molocha N.M., Kourlaba G., Kourkouni E., Kopsidas I., Zaoutis T.  

37th Annual Meeting of the European Society for Paediatric Infectious Diseases (ESPID 2019)
Ljubljana, Slovenia, 6-11 May, 2019

RESEARCH QUESTION: Antibiotic resistance is a major problem for public health, which has accelerated by the overuse of antibiotics worldwide. A national electronic prescribing system(NEPS) was implemented in 2012 as a tool to control excessive antibiotic prescriptions in Greece. The objective of this study was to determine whether the NEPS has led to a reduction in antibiotic prescriptions.

METHODS:  Data on antibiotic prescriptions for patients aged ≤19 years old in Greece were extracted from the Intercontinental Marketing Services Health Xponent database for the periods 2010-2013 and 2015-2018. Antibiotics were grouped into narrow- and broad-spectrum agents. Narrow-spectrum antibiotics included amoxicillin and penicillin. The number of prescribed antibiotics and census denominators were used to calculate prescribing rates for each period separately. As inappropriate prescribing was defined the prescriptions for diagnoses in which antibiotics are not indicated.

RESULTS:  7.005 and 6.323 million antibiotics were prescribed for the periods 2010-2013 and 2015-2018, respectively. This resulted in annual prescribing rates of 1100 antibiotics per 1000 persons and 993 antibiotics per 1000 persons, respectively. In 2010-2013, acute respiratory tract infections accounted for 76.1% of prescribed antibiotics, while in 2015-2018 this percentage was reduced to 72.5%. Inappropriate prescribing accounted for 25.5% of all prescriptions in 2010-2013, while only 21.2% in 2015-2018. In 2010-2013, the vast majority of all prescribed antibiotics were broad-spectrum (90.4%). A similar percentage (89.9%) was observed from 2015-2018.

CONCLUSIONS: Antibiotic prescribing decreased slightly after the implementation of the NEPS. This study demonstrates the need to strengthen the NEPS with recommendations, reminders and guidelines to promote judicious prescription of antibiotics.