Antibiotics | Surging Antibiotic Prescriptions in Children: European Medication Trends Study in the Post-Pandemic Era

This study systematically analyzes antibiotic prescription trends in the post-pandemic era across six European countries using longitudinal prescription databases, revealing a sharp increase in pediatric and adolescent medication use and providing critical public health warnings.

 

Literature Overview
This article titled "Antibiotic Prescription Patterns in the Post-COVID-19 Era in Six European Countries: A Cross-Sectional Study", published in the journal Antibiotics, reviews the evolution of outpatient antibiotic prescription patterns across six European countries from 2021 to 2024, with a focus on medication changes in pediatric and adolescent populations. The study highlights rebound trends in antibiotic use following the pandemic and underscores the necessity for strengthened antimicrobial stewardship.

Background Knowledge
Respiratory infections have shown significant rebound trends post-pandemic, particularly among children and adolescents, linked to immunity gaps and resumption of viral transmission. While antibiotics are critical for treating bacterial infections, they may be misused during viral outbreaks. Studies indicate antibiotic prescriptions declined from 2020 to 2021 but rebounded sharply in 2022 as pandemic restrictions eased, especially in pediatric populations. Although antibiotic stewardship improved during early pandemic phases, the post-pandemic rebound highlights the urgency for optimizing clinical prescribing strategies. Furthermore, variations in prescription patterns (e.g., amoxicillin vs. azithromycin usage) reflect differing national clinical guidelines and prescribing habits. This study provides cross-national data support, emphasizing the critical need for promoting rational antibiotic use in outpatient and primary care settings.

 

 

Research Methods and Experiments
The study employed a cross-sectional design using outpatient prescription databases (LRx) from IQVIA covering Germany, France, Italy, Belgium, the UK, and Poland. The database includes anonymized patient information, prescribed medications, dates, and demographics from 2021 to 2024. Prescription trends were stratified by age groups and gender, with comparative analysis of medication proportions across countries.

Key Conclusions and Perspectives

• In 2022, antibiotic prescriptions rebounded significantly in all countries, with Belgium showing the highest increase (+39.3%) and France the lowest (+12.0%).
• Prescription growth in pediatric and adolescent groups far exceeded other age groups, with prescriptions for UK children under 10 increasing by 75%, indicating major shifts in clinical prescribing practices for this population.
• Growth trends slowed in 2023, though Germany maintained steady increases while Poland showed slight declines, reflecting varying recovery trajectories across countries.
• By 2024, prescriptions stabilized in most countries, but continued growth was observed in adolescent groups in the UK and Germany, while prescriptions for elderly groups declined in France, Italy, and Belgium.
• Amoxicillin remained the most prescribed antibiotic, particularly in France and Belgium where it accounted for over 70% of prescriptions. Azithromycin use also showed increasing trends, raising concerns about potential antibiotic resistance.

Research Significance and Prospects
This study represents the first systematic comparison of antibiotic prescription trends in post-pandemic Europe, emphasizing surging pediatric use and gender disparities. Future research should integrate clinical diagnosis and microbiological data to differentiate bacterial from viral infections and optimize prescribing practices. Additionally, antimicrobial stewardship programs (ASPs) require broader implementation in primary healthcare settings.

 

 

Conclusion
This study reveals significant rebounds in antibiotic prescriptions across European countries following the pandemic, particularly among children and adolescents, with sustained growth observed in some nations through 2024. Variations in prescription patterns reflect differing healthcare systems and clinical practices. The findings call for enhanced strategies promoting rational antibiotic use, especially in outpatient and primary care, to prevent resistance escalation and resource waste. Future research should combine electronic health records with pathogen-specific data for more precise assessment of prescription appropriateness and support updated clinical guidelines.

 

Karel Kostev, Swati Upadhyaya, Oliver Utsch, Marcel Konrad, and Christian Tanislav. Antibiotic Prescription Patterns in the Post-COVID-19 Era in Six European Countries: A Cross-Sectional Study. Antibiotics.