Evolution of antibiotic prescription in Primary Health Care according to the indicators of the Spanish Action Plan on Antibiotic Resistance (PRAN)

Introduction: Spain is the fourth European country with the highest antibiotic consumption at the community level, being children aged 0-4 years one of the age groups with the highest amount of consumption. The aim of this study was to analyze the evolution of antibiotic prescription of the pediatri...

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Main Authors: Carlos Marcilla Vázquez, Juan Ríos Laorden, Ángeles Lloret Callejo, Francisco Tejada Cifuentes, María José Tirado Peláez, Ignacio Párraga-Martínez
Format: Article
Language:Spanish
Published: Elsevier 2025-05-01
Series:Anales de Pediatría (English Edition)
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Online Access:http://www.sciencedirect.com/science/article/pii/S2341287925001279
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author Carlos Marcilla Vázquez
Juan Ríos Laorden
Ángeles Lloret Callejo
Francisco Tejada Cifuentes
María José Tirado Peláez
Ignacio Párraga-Martínez
author_facet Carlos Marcilla Vázquez
Juan Ríos Laorden
Ángeles Lloret Callejo
Francisco Tejada Cifuentes
María José Tirado Peláez
Ignacio Párraga-Martínez
author_sort Carlos Marcilla Vázquez
collection DOAJ
description Introduction: Spain is the fourth European country with the highest antibiotic consumption at the community level, being children aged 0-4 years one of the age groups with the highest amount of consumption. The aim of this study was to analyze the evolution of antibiotic prescription of the pediatric population in a Primary Health Care area according to the indicators of the Spanish Action Plan on Antibiotic Resistance (PRAN) in a period of ten years (2014-2023), as well as to evaluate the impact of the COVID-19 pandemic by the comparison between 2020-2021 years and a previous (2014-2019) and a later periods of time (2022-2023). Material and methods: Retrospective observational study of the prescription of antibiotics for systemic use (J01 group of the Anatomical Therapeutic Chemical Classification) in pediatric patients (0-14 years) belonging to the Primary Health Care area of the Gerencia de Atención Integrada (GAI) de Albacete between 2014 and 2023. Results: Mean antibiotic prescription was 16.90 defined daily doses per 1000 inhabitants per day (DID) and 12.10 DOT (days of therapy). Pre-pandemic data (2014-2019) was 19.32 DID and 13.92 DOT, being reduced during the two years of the pandemic (2020-2021) to 8.30 DID and 6.05 DOT and subsequently increased to 18.05 DID and 12.40 DOT in post-pandemic years (2022-2023). An improvement in the adequacy of antibiotic prescription was observed after the COVID-19 pandemic, with a reduction of the consumption of amoxicillin-clavulanate and a greater consumption of penicillin and amoxicillin during pre-pandemic and pandemic years (p < 0.05). Conclusions: Thoughout the period of years analysed, an improvement in the consumption indicators proposed by the PRAN, with a higher use of beta-lactamase sensitive penicillins and amoxicillin and a reduced consumption of amoxicillin-clavulanate. Resumen: Introducción: España es el cuarto país europeo con mayor consumo de antibióticos a nivel comunitario, siendo los niños de 0-4 años uno de los rangos de edad de mayor consumo. El objetivo de este estudio fue analizar la evolución de la prescripción de antibióticos en la población pediátrica de Atención Primaria de un área Sanitaria en función de los indicadores del PRAN durante diez años (2014-2023), así como, evaluar el impacto de la pandemia de COVID-19 comparando el periodo 2020-2021 respecto al previo (2014-2019) y posterior (2022-2023). Material y métodos: Estudio observacional retrospectivo de prescripción de antibióticos sistémicos (grupo J01, clasificación Anatomical Therapeutic Chemical Classification) en población pediátrica (0-14 años) en el ámbito de Atención Primaria de la Gerencia de Atención Integrada (GAI) de Albacete entre 2014 y 2023. Resultados: La prescripción media de antibacterianos fue de 16,90 dosis diaria definida por 1000 habitantes/día (DHD) y 12,10 DOT (days of therapy). Los datos prepandemia (2014-2019) fueron de 19,32 DHD y 13,92 DOT, reduciéndose durante la pandemia (2020-2021) hasta 8,30 DHD y 6,05 DOT y aumentando, posteriormente (2022-2023), hasta 18,05 DHD y 12,40 DOT. Se observó una mejora en la adecuación de la prescripción tras la pandemia, con menor utilización de amoxicilina/clavulánico y mayor de penicilina y amoxicilina que antes y durante pandemia (p < 0,05). Conclusiones: A lo largo del periodo estudiado se observó una mejoría de los indicadores de consumo propuestos por el PRAN, mostrando mayor uso de penicilinas sensibles a betalactamasas y de amoxicilina, y menor consumo de amoxicilina/clavulánico.
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spelling doaj-art-88ff27c34d544ea186e28346ec4e06fd2025-08-20T03:47:34ZspaElsevierAnales de Pediatría (English Edition)2341-28792025-05-01102550384010.1016/j.anpede.2025.503840Evolution of antibiotic prescription in Primary Health Care according to the indicators of the Spanish Action Plan on Antibiotic Resistance (PRAN)Carlos Marcilla Vázquez0Juan Ríos Laorden1Ángeles Lloret Callejo2Francisco Tejada Cifuentes3María José Tirado Peláez4Ignacio Párraga-Martínez5Servicio de Pediatría, Complejo Hospitalario Universitario de Albacete, Gerencia de Atención Integrada de Albacete, Albacete, Spain; Corresponding author.Pediatría de Atención Primaria, Centro de Salud Zona VI de Albacete, Gerencia de Atención Integrada de Albacete, Albacete, SpainServicio de Farmacia, Centro de Salud Zona I de Albacete, Gerencia de Atención Integrada de Albacete, Albacete, SpainServicio de Farmacia, Centro de Salud Zona I de Albacete, Gerencia de Atención Integrada de Albacete, Albacete, SpainServicio de Farmacia, Centro de Salud Zona I de Albacete, Gerencia de Atención Integrada de Albacete, Albacete, SpainCentro de Salud Zona VIII de Albacete, Gerencia de Atención Integrada de Albacete, Spain; Facultad de Medicina de Albacete, Universidad de Castilla-La Mancha, Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Albacete, Spain; Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Instituto de Salud Carlos III, Madrid, SpainIntroduction: Spain is the fourth European country with the highest antibiotic consumption at the community level, being children aged 0-4 years one of the age groups with the highest amount of consumption. The aim of this study was to analyze the evolution of antibiotic prescription of the pediatric population in a Primary Health Care area according to the indicators of the Spanish Action Plan on Antibiotic Resistance (PRAN) in a period of ten years (2014-2023), as well as to evaluate the impact of the COVID-19 pandemic by the comparison between 2020-2021 years and a previous (2014-2019) and a later periods of time (2022-2023). Material and methods: Retrospective observational study of the prescription of antibiotics for systemic use (J01 group of the Anatomical Therapeutic Chemical Classification) in pediatric patients (0-14 years) belonging to the Primary Health Care area of the Gerencia de Atención Integrada (GAI) de Albacete between 2014 and 2023. Results: Mean antibiotic prescription was 16.90 defined daily doses per 1000 inhabitants per day (DID) and 12.10 DOT (days of therapy). Pre-pandemic data (2014-2019) was 19.32 DID and 13.92 DOT, being reduced during the two years of the pandemic (2020-2021) to 8.30 DID and 6.05 DOT and subsequently increased to 18.05 DID and 12.40 DOT in post-pandemic years (2022-2023). An improvement in the adequacy of antibiotic prescription was observed after the COVID-19 pandemic, with a reduction of the consumption of amoxicillin-clavulanate and a greater consumption of penicillin and amoxicillin during pre-pandemic and pandemic years (p < 0.05). Conclusions: Thoughout the period of years analysed, an improvement in the consumption indicators proposed by the PRAN, with a higher use of beta-lactamase sensitive penicillins and amoxicillin and a reduced consumption of amoxicillin-clavulanate. Resumen: Introducción: España es el cuarto país europeo con mayor consumo de antibióticos a nivel comunitario, siendo los niños de 0-4 años uno de los rangos de edad de mayor consumo. El objetivo de este estudio fue analizar la evolución de la prescripción de antibióticos en la población pediátrica de Atención Primaria de un área Sanitaria en función de los indicadores del PRAN durante diez años (2014-2023), así como, evaluar el impacto de la pandemia de COVID-19 comparando el periodo 2020-2021 respecto al previo (2014-2019) y posterior (2022-2023). Material y métodos: Estudio observacional retrospectivo de prescripción de antibióticos sistémicos (grupo J01, clasificación Anatomical Therapeutic Chemical Classification) en población pediátrica (0-14 años) en el ámbito de Atención Primaria de la Gerencia de Atención Integrada (GAI) de Albacete entre 2014 y 2023. Resultados: La prescripción media de antibacterianos fue de 16,90 dosis diaria definida por 1000 habitantes/día (DHD) y 12,10 DOT (days of therapy). Los datos prepandemia (2014-2019) fueron de 19,32 DHD y 13,92 DOT, reduciéndose durante la pandemia (2020-2021) hasta 8,30 DHD y 6,05 DOT y aumentando, posteriormente (2022-2023), hasta 18,05 DHD y 12,40 DOT. Se observó una mejora en la adecuación de la prescripción tras la pandemia, con menor utilización de amoxicilina/clavulánico y mayor de penicilina y amoxicilina que antes y durante pandemia (p < 0,05). Conclusiones: A lo largo del periodo estudiado se observó una mejoría de los indicadores de consumo propuestos por el PRAN, mostrando mayor uso de penicilinas sensibles a betalactamasas y de amoxicilina, y menor consumo de amoxicilina/clavulánico.http://www.sciencedirect.com/science/article/pii/S2341287925001279PediatríaAntibióticosAtención PrimariaProgramas de optimización de uso de antibióticos (PROA)COVID-19
spellingShingle Carlos Marcilla Vázquez
Juan Ríos Laorden
Ángeles Lloret Callejo
Francisco Tejada Cifuentes
María José Tirado Peláez
Ignacio Párraga-Martínez
Evolution of antibiotic prescription in Primary Health Care according to the indicators of the Spanish Action Plan on Antibiotic Resistance (PRAN)
Anales de Pediatría (English Edition)
Pediatría
Antibióticos
Atención Primaria
Programas de optimización de uso de antibióticos (PROA)
COVID-19
title Evolution of antibiotic prescription in Primary Health Care according to the indicators of the Spanish Action Plan on Antibiotic Resistance (PRAN)
title_full Evolution of antibiotic prescription in Primary Health Care according to the indicators of the Spanish Action Plan on Antibiotic Resistance (PRAN)
title_fullStr Evolution of antibiotic prescription in Primary Health Care according to the indicators of the Spanish Action Plan on Antibiotic Resistance (PRAN)
title_full_unstemmed Evolution of antibiotic prescription in Primary Health Care according to the indicators of the Spanish Action Plan on Antibiotic Resistance (PRAN)
title_short Evolution of antibiotic prescription in Primary Health Care according to the indicators of the Spanish Action Plan on Antibiotic Resistance (PRAN)
title_sort evolution of antibiotic prescription in primary health care according to the indicators of the spanish action plan on antibiotic resistance pran
topic Pediatría
Antibióticos
Atención Primaria
Programas de optimización de uso de antibióticos (PROA)
COVID-19
url http://www.sciencedirect.com/science/article/pii/S2341287925001279
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