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Antibiotic use in elderly patients in ambulatory care: A comparison between Hungary and Sweden

Affiliation
Institute of Clinical Pharmacy ,University of Szeged ,Szeged ,Hungary
Kusuma, Ikhwan Yuda;
Affiliation
Institute of Clinical Pharmacy ,University of Szeged ,Szeged ,Hungary
Matuz, Maria;
Affiliation
Institute of Clinical Pharmacy ,University of Szeged ,Szeged ,Hungary
Bordás, Réka;
Affiliation
Public Healthcare Services Committee ,Stockholm ,Sweden
Juhasz Haverinen, Maria;
Affiliation
Institute of Clinical Pharmacy ,University of Szeged ,Szeged ,Hungary
Bahar, Muh. Akbar;
Affiliation
Albert Szent-Györgyi Health Centre ,Department of Internal Medicine Infectiology Unit ,University of Szeged ,Szeged ,Hungary
Hajdu, Edit;
Affiliation
Albert Szent-Györgyi Health Centre ,Department of Internal Medicine Infectiology Unit ,University of Szeged ,Szeged ,Hungary
Visnyovszki, Ádám;
Affiliation
Institute of Clinical Pharmacy ,University of Szeged ,Szeged ,Hungary
Ruzsa, Roxána;
Affiliation
Institute of Clinical Pharmacy ,University of Szeged ,Szeged ,Hungary
Doró, Péter;
Affiliation
Institute of Clinical Pharmacy ,University of Szeged ,Szeged ,Hungary
Engi, Zsófi;
Affiliation
Institute of Clinical Pharmacy ,University of Szeged ,Szeged ,Hungary
Csupor, Dezső;
Affiliation
Institute of Clinical Pharmacy ,University of Szeged ,Szeged ,Hungary
Benko, Ria

Background: The elderly use antibiotics frequently due to their increasing infection susceptibility. Given the high and increasing proportion of elderly in the population, their antibiotic use is substantial. Objective: This study aimed to compare antibiotic use in the elderly in the ambulatory care sector between Hungary and Sweden. Methods: This retrospective, descriptive, cross-national, comparative study included antibacterial use data from the Hungarian National Health Insurance Fund and the Swedish eHealth Agency. Antibiotic use (anatomical therapeutical chemical: J01) was expressed as the number of prescriptions/1000 inhabitants/year or month and was further stratified by age and sex. Results: Antibiotic exposure was higher in the Hungarian elderly population (649.8 prescriptions/1000 inhabitants/year) compared to its Swedish counterparts (545.0 prescriptions/1000 inhabitants/year). Hungary had a similar scale of antibacterial exposure across all elderly age subgroups, with different trends in males and females, while Sweden had a stepwise increase in antibiotic exposure by age in both sexes. The seasonal fluctuation was high in Hungary and reached a peak of 80.7 prescriptions/1000 inhabitants/month in January 2017, while even antibiotic use was detected throughout the year in Sweden. The pattern of antibiotic use in the elderly considerably differed between the two countries. Penicillin and beta-lactamase combinations, such as co-amoxiclav, were more frequently used in Hungary than in Sweden (19.08% vs 1.83% of corresponding total ambulatory antibiotic use). Likewise, quinolones were more commonly used in Hungary than in Sweden (34.53% vs. 9.98). The elderly in Sweden were mostly prescribed narrow spectra penicillins (26.71% vs. 0.29% in Hungary). Conclusion: This cross-national comparison revealed important differences in all aspects of antibiotic use in the elderly between the two countries. The identical scale and pattern of antibiotic use cannot be anticipated due to the poorer health status of the Hungarian elderly population. However, the substantial differences indicate some room for improvement in the antibiotic prescription for the Hungarian elderly.

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License Holder: Copyright © 2022 Kusuma, Matuz, Bordás, Juhasz Haverinen, Bahar, Hajdu, Visnyovszki, Ruzsa, Doró, Engi, Csupor and Benko.

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