Differences in antibiotic prescribing quality in Belgian out-of-hours primary care services

ABSTRACT

Objectives

This study aims to compare trends in antibiotic prescribing behaviour for lower urinary tract infections among different out-of-hours primary care services.

Methods

Cross-sectional study using routine prescription data extracted from electronic health records from six out-of-hours services. The study population included 5888 cases diagnosed with an uncomplicated lower urinary tract infection from 2016 to 2020. Prescriptions were assessed based on the national guidelines.

Results

Considering the total study period, an antibiotic was prescribed in 98.9% of cases. Among these cases, 55.0% was prescribed a guideline recommended antibiotic, 21.0% was prescribed fosfomycin, 17.4% was prescribed a quinolone and 1.8% was prescribed more than one antibiotic. Guideline recommended prescribing improved substantially over time. However, there were significant differences among out-of-hours services in terms of proportion over the total study period (between 49.0% and 66.7%) as well as in terms of time-trend pattern.

Conclusion

Substantial differences among out-of-hours services suggest a potential for further improvement in the quality of antibiotic prescribing. Monitoring prescribing behaviour per out-of-hours primary care service can guide focused interventions.

KEYWORDS:

• Urinary tract infection
• antimicrobial therapy
• primary care out-of-hours services
• prescribing behavior
• adherence to guidelines

Author contributions

JDM, RR and HP conceived and designed the study. HP was in charge of data curation.

JDM performed the statistical analysis, interpreted the data and drafted the manuscript. RR and HP critically reviewed the manuscript. All authors read and approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

The data underlying this article will be shared on reasonable request to the corresponding author.

Additional information

Funding

This work was supported by the Faculty of Medicine and Health Sciences of the University of Antwerp [Grant ID 37025]; Universiteit Antwerpen