(Fluoro)quinolone prescriptions for upper respiratory tract infections in the German outpatient sector: a health insurance claims analysis

Background: Acute upper respiratory tract infections (URTIs) are frequent causes of medical treatment by general practitioners (GPs). In general, these are viral and self-limiting illnesses, but antibiotics are prescribed. In Germany, fluoroquinolones are not authorised for the indications pharyngit...

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Main Authors: Arens, Birgit, L’hoest, Helmut, Wolf, Alissa, Hennig, Beata, Marschall, Ursula, Nachtigall, Irit
Format: Article
Language:English
Published: German Medical Science GMS Publishing House 2025-05-01
Series:GMS Infectious Diseases
Online Access:https://journals.publisso.de/de/journals/id/volume13/id000091
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author Arens, Birgit
L’hoest, Helmut
Wolf, Alissa
Hennig, Beata
Marschall, Ursula
Nachtigall, Irit
author_facet Arens, Birgit
L’hoest, Helmut
Wolf, Alissa
Hennig, Beata
Marschall, Ursula
Nachtigall, Irit
author_sort Arens, Birgit
collection DOAJ
description Background: Acute upper respiratory tract infections (URTIs) are frequent causes of medical treatment by general practitioners (GPs). In general, these are viral and self-limiting illnesses, but antibiotics are prescribed. In Germany, fluoroquinolones are not authorised for the indications pharyngitis, laryngitis, tonsillitis and acute bronchitis due to possible serious side effects. This analysis looks at fluoroquinolone prescriptions for URTI by GPs in 2022. Methods: Frequency of fluoroquinolone prescriptions were analysed at case level and regionally using administrative insurance data from the German health insurance company BARMER. We included patients treated in GP practices without relevant concomitant diseases. Results: In 2022, 25% (1,197,568/4,720,786) of insured persons with upper respiratory tract infections (URTI) were prescribed antibiotics. After excluding comorbidities and other risk factors such as previous hospitalisation, the prescription rate for uncomplicated URTIs was calculated to be 6% (80,786/1,365,646). Fluoroquinolones were given in 2.4% of antibiotic prescriptions (1,951/80,786). Nationwide, 3.7% of the GPs prescribed fluoroquinolones, most frequently in the region Brandenburg with 6.6% (74/1,121). Conclusion: This analysis showed that fluoroquinolones are still prescribed for uncomplicated URTI, which must be considered as alarming regarding the nature of the disease and the unfavourable risk-benefit profiles. There were clear regional differences in fluoroquinolone prescribing, indicating potential for improvement in the use of reserve antibiotics for uncomplicated upper respiratory tract infections.
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institution OA Journals
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publishDate 2025-05-01
publisher German Medical Science GMS Publishing House
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spelling doaj-art-ebc9b492563743389a982e99f273b73d2025-08-20T02:34:44ZengGerman Medical Science GMS Publishing HouseGMS Infectious Diseases2195-88312025-05-0113Doc0110.3205/id000091(Fluoro)quinolone prescriptions for upper respiratory tract infections in the German outpatient sector: a health insurance claims analysisArens, Birgit 0L’hoest, Helmut1Wolf, Alissa2Hennig, Beata3Marschall, Ursula4Nachtigall, Irit5Kompetenz-Centrum Qualitätssicherung, Medizinischer Dienst Baden-Württemberg, Lahr, GermanyBarmer Institut für Gesundheitssystemforschung, Medizin und Versorgungsforschung, Berlin, GermanyKompetenz-Centrum Qualitätssicherung, Medizinischer Dienst Baden-Württemberg, Lahr, GermanyBarmer Institut für Gesundheitssystemforschung, Medizin und Versorgungsforschung, Berlin, GermanyBarmer Institut für Gesundheitssystemforschung, Medizin und Versorgungsforschung, Berlin, GermanyVivantes Netzwerk für Gesundheit GmbH, Head of Translationale Forschung, Lehre und Kooperation, Berlin, GermanyBackground: Acute upper respiratory tract infections (URTIs) are frequent causes of medical treatment by general practitioners (GPs). In general, these are viral and self-limiting illnesses, but antibiotics are prescribed. In Germany, fluoroquinolones are not authorised for the indications pharyngitis, laryngitis, tonsillitis and acute bronchitis due to possible serious side effects. This analysis looks at fluoroquinolone prescriptions for URTI by GPs in 2022. Methods: Frequency of fluoroquinolone prescriptions were analysed at case level and regionally using administrative insurance data from the German health insurance company BARMER. We included patients treated in GP practices without relevant concomitant diseases. Results: In 2022, 25% (1,197,568/4,720,786) of insured persons with upper respiratory tract infections (URTI) were prescribed antibiotics. After excluding comorbidities and other risk factors such as previous hospitalisation, the prescription rate for uncomplicated URTIs was calculated to be 6% (80,786/1,365,646). Fluoroquinolones were given in 2.4% of antibiotic prescriptions (1,951/80,786). Nationwide, 3.7% of the GPs prescribed fluoroquinolones, most frequently in the region Brandenburg with 6.6% (74/1,121). Conclusion: This analysis showed that fluoroquinolones are still prescribed for uncomplicated URTI, which must be considered as alarming regarding the nature of the disease and the unfavourable risk-benefit profiles. There were clear regional differences in fluoroquinolone prescribing, indicating potential for improvement in the use of reserve antibiotics for uncomplicated upper respiratory tract infections.https://journals.publisso.de/de/journals/id/volume13/id000091
spellingShingle Arens, Birgit
L’hoest, Helmut
Wolf, Alissa
Hennig, Beata
Marschall, Ursula
Nachtigall, Irit
(Fluoro)quinolone prescriptions for upper respiratory tract infections in the German outpatient sector: a health insurance claims analysis
GMS Infectious Diseases
title (Fluoro)quinolone prescriptions for upper respiratory tract infections in the German outpatient sector: a health insurance claims analysis
title_full (Fluoro)quinolone prescriptions for upper respiratory tract infections in the German outpatient sector: a health insurance claims analysis
title_fullStr (Fluoro)quinolone prescriptions for upper respiratory tract infections in the German outpatient sector: a health insurance claims analysis
title_full_unstemmed (Fluoro)quinolone prescriptions for upper respiratory tract infections in the German outpatient sector: a health insurance claims analysis
title_short (Fluoro)quinolone prescriptions for upper respiratory tract infections in the German outpatient sector: a health insurance claims analysis
title_sort fluoro quinolone prescriptions for upper respiratory tract infections in the german outpatient sector a health insurance claims analysis
url https://journals.publisso.de/de/journals/id/volume13/id000091
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