(69) The Issue of Antibiotic Combinations Prescribing in Outpatients in Syria

Sunday, August 28, 2022

8:00 AM – 1:45 PM CEST

Location: Hall C

Publication Number: 1114

Presenting Author(s)

Ana Tomas, MD, PhD
– Assistant Professor, Faculty or Medicine, University of Novi Sad, University of Novi Sad, Faculty of Medicine, Novi Sad, Vojvodina, Serbia

Co-Author(s)

Saleh Aljadeeah
– Institute of Medical Management and Health Sciences, University of Bayreuth, Germany

Background: Unnecessary use of combination of antibiotics poses a risk to local and global health by promoting antimicrobial resistance while putting patients at an increased risk of side effects. There is limited information on how widespread this practice is in resource limited settings.

Objectives: This study aimed to determine the prevalence and prescribing patterns of combination antibiotic dispensing in outpatients in Syria.

Methods: This retrospective cross-sectional study was based on the outpatient dispensing data for 81,314 beneficiaries with health-insurance from thirteen Syrian governates from June 2018 to May 2019. The ATC/DDD index version 2020 was used for classification, and drugs belonging to the J01 group were included in the analysis. The combination use was defined as dispensing more than one different antibiotic to a single patient during a single dispensing event. Results were reported by the number of patients, the number of prescriptions, and the age and sex-adjusted rates expressed as number of prescriptions per 1000 persons per year.

Results: Out of 59,404 prescriptions for antibiotics, 14.98% contained antibiotic combinations, distributed to 22.49% of the patients. The prevalence of dispensing antibiotic combinations was higher in female patients (23.00%), and the youngest (18–30 years, 26.19%) and oldest age groups (>70 years, 25.19%). The most commonly combined antibiotics were broad spectrum - penicillins, including beta-lactamase inhibitors and third-generation cephalosporins, followed by the combination of third-generation cephalosporins and macrolides, and two different cephalosporins. Over 60% of the combinations contained ceftriaxone alone or in combination with sulbactam. The present study shows an alarmingly widespread prescription of antibiotic combinations, posing a risk to global health by promoting resistance development.

Conclusions: The rate of prescribing combination antibiotics to outpatients in Syria seems excessive. Broad-spectrum antibiotic overprescribing poses a huge threat to global health, but could also result in a tangible health impact for these patients.