title: Antibiotic prescribing and expenditures in outpatient paediatrics in Greece, 2010-13.
abstract: OBJECTIVE
  The objectives of this study were to provide a nationally representative analysis of antibiotic prescribing in outpatient paediatrics and to assess overall and class-specific antibiotic costs in Greece.
  
  
  METHODS
  Data on antibiotic prescriptions for patients aged ≤19 years old between July 2010 and June 2013 in Greece were extracted from the IMS Health Xponent database. Antibiotics were grouped into narrow- and broad-spectrum agents. The number of prescribed antibiotics and census denominators were used to calculate prescribing rates. The total costs associated with prescribed antibiotics were calculated.
  
  
  RESULTS
  More than 7 million antibiotics were prescribed during the study period, with an annual rate of 1100 antibiotics/1000 persons. Prescribing rates were higher among children aged <10 years old. Acute respiratory tract infections (ARTIs) accounted for 80% of prescribed antibiotics, with acute otitis media (22.3%), acute tonsillitis (19.5%) and acute bronchitis/bronchiolitis (13.9%) being the most common clinical diagnoses. Cephalosporins (32.9%), penicillins (32.3%) and macrolides (32.1%) were the most commonly prescribed antibiotic classes. The majority (90.4%) of antibiotics were broad spectrum. Antibiotic expenditures totalled ∼€50 million.
  
  
  CONCLUSIONS
  Broad-spectrum antibiotic prescribing is common in outpatient paediatric patients. These data provide important targets to inform the development of an outpatient antimicrobial stewardship programme targeting specific practices, providers and conditions.
authors.affiliation: The Stavros Niarchos Foundation - Collaborative Center for Clinical Epidemiology and Outcomes Research (CLEO), University of Athens School of Medicine, Athens, Greece kurlaba@gmail.com.
authors.forename: Georgia
authors.initials: G
authors.lastname: Kourlaba
authors.affiliation: The Stavros Niarchos Foundation - Collaborative Center for Clinical Epidemiology and Outcomes Research (CLEO), University of Athens School of Medicine, Athens, Greece.
authors.forename: Eleni
authors.initials: E
authors.lastname: Kourkouni
authors.affiliation: Aglaia Kyriakou Children's Hospital, Second Department of Pediatrics, University of Athens School of Medicine, Athens, Greece.
authors.forename: Nikos
authors.initials: N
authors.lastname: Spyridis
authors.affiliation: Division of Infectious Diseases, Children's Hospital of Philadelphia, UPENN School of Medicine, Philadelphia, PA, USA.
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Gerber
authors.affiliation: The Stavros Niarchos Foundation - Collaborative Center for Clinical Epidemiology and Outcomes Research (CLEO), University of Athens School of Medicine, Athens, Greece.
authors.forename: John
authors.initials: J
authors.lastname: Kopsidas
authors.affiliation: The Stavros Niarchos Foundation - Collaborative Center for Clinical Epidemiology and Outcomes Research (CLEO), University of Athens School of Medicine, Athens, Greece.
authors.forename: Katerina
authors.initials: K
authors.lastname: Mougkou
authors.affiliation: The Stavros Niarchos Foundation - Collaborative Center for Clinical Epidemiology and Outcomes Research (CLEO), University of Athens School of Medicine, Athens, Greece.
authors.forename: Athanasia
authors.initials: A
authors.lastname: Lourida
authors.affiliation: The Stavros Niarchos Foundation - Collaborative Center for Clinical Epidemiology and Outcomes Research (CLEO), University of Athens School of Medicine, Athens, Greece Division of Infectious Diseases, Children's Hospital of Philadelphia, UPENN School of Medicine, Philadelphia, PA, USA.
authors.forename: Theoklis E
authors.initials: TE
authors.lastname: Zaoutis
mesh_terms: D000293:Adolescent; D000553:Ambulatory Care / Q000379:methods*; D000900:Anti-Bacterial Agents / Q000191:economics* / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D011307:Drug Prescriptions; D004363:Drug Utilization; D005260:Female; D006115:Greece; D005102:Health Expenditures; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: acute respiratory infections; ambulatory paediatric patients; antimicrobial prescription; cost