Stollberg Sabrina M, Graber Sereina M, Kronenberg Andreas, Senn Oliver, Neuner-Jehle Stefan, Pluess-Suard Catherine, Huber Carola A, Plate Andreas
Department of Health Sciences, Helsana Group, Zurich, Switzerland.
Swiss Centre for Antibiotic Resistance (ANRESIS), Institute for Infectious Diseases, University of Bern, Bern, Switzerland.
Infection. 2025 Jun;53(3):1029-1039. doi: 10.1007/s15010-024-02420-9. Epub 2024 Oct 23.
Antibiotics are often only available in predefined pack sizes, which may not align with guideline recommendations. This can result in leftover pills, leading to inappropriate self-medication or waste disposal, which can both foster the development of antibiotic resistance. The magnitude of inappropriate pack sizes is largely unknown. The objective of this study was to evaluate the potential non-conformity of prescribed antibiotic pack sizes.
This retrospective observational study was based on claims data from a large Swiss health insurance company. The study analysed the prescriptions of eleven different antibiotic substances recommended for the five most common indications for antibiotics in Switzerland. All prescriptions for adult outpatients issued by general practitioners in 2022 were included and extrapolated to the entire Swiss population. Potential non-conformity was defined as a mismatch between the total dosage in a pack and the total dosage recommended.
A total of n = 947,439 extrapolated prescriptions were analysed. In 10 of 23 of all analysed substance/indication combinations none of the prescribed packs aligned with the respective guideline recommendation. Considering pack sizes in which the total prescribed dosage of a substance did not correspond to any of the total dosages recommended in at least one of the guidelines, 31.6% of prescriptions were potentially non-conform and an estimated number of 2.7 million tablets were overprescribed.
We found a large discrepancy between prescribed pack sizes and guideline recommendations. Since inadequately prepacked antibiotics may lead to antibiotic resistance and unnecessary waste, efforts are needed to implement alternatives like exact pill dispensing.
抗生素通常只有预定义的包装规格，这可能与指南建议不一致。这可能导致剩余药片，从而导致不适当的自我用药或废物处理，这两者都可能助长抗生素耐药性的发展。不适当包装规格的程度在很大程度上尚不清楚。本研究的目的是评估规定的抗生素包装规格的潜在不符合情况。
这项回顾性观察研究基于一家大型瑞士健康保险公司的理赔数据。该研究分析了针对瑞士五种最常见抗生素适应症推荐的11种不同抗生素物质的处方。纳入了2022年全科医生为成年门诊患者开具的所有处方，并推算至整个瑞士人口。潜在不符合被定义为一包中的总剂量与推荐的总剂量之间的不匹配。
共分析了n = 947439份推算处方。在所有分析的物质/适应症组合中的23种中有10种，所开处方的包装没有一种符合各自的指南建议。考虑到某种物质的总处方剂量与至少一项指南中推荐的任何总剂量都不对应的包装规格，31.6%的处方可能不符合规定，估计有270万片药物被过量开处方。
我们发现所开处方的包装规格与指南建议之间存在很大差异。由于预包装不当的抗生素可能导致抗生素耐药性和不必要的浪费，需要努力实施精确配药等替代方法。
