• Manon W H Janssen, de BontEefje G P MEGPM0000-0002-2700-4752Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands., HoebeChristian J P ACJPA0000-0003-1815-0974Department of Sexual, Health, Infectious Diseases, and Environmental Health, Public Health Service South Limburg, Heerlen, The Netherlands.Department of Social Medicine, Care and Public Health Research Institute , CalsJochen W LJWL0000-0001-9550-5674Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands., and den HeijerCasper D JCDJ0000-0003-1476-4346Department of Sexual, Health, Infectious Diseases, and Environmental Health, Public Health Service South Limburg, Heerlen, The Netherlands.Department of Social Medicine, Care and Public Health Research Institute (.
• Department of Sexual, Health, Infectious Diseases, and Environmental Health, Public Health Service South Limburg, Heerlen, The Netherlands.
• Fam Pract. 2023 Feb 9; 40 (1): 616761-67.

BackgroundAntibiotic resistance is mainly driven by (incorrect) use of antibiotics. Most antibiotics are prescribed in family medicine. Therefore, regularly monitoring of antibiotic prescriptions and evaluation of their (non-) prudent use in primary care is warranted.ObjectivesThe aim of this study was to determine time trends in antibiotic prescriptions by Dutch family physicians (FPs) and to identify determinants of nonprudent antibiotic prescriptions by Dutch FPs.MethodsRetrospective study among 27 Dutch general practices from the Research Network Family Medicine Maastricht, from 2015 to 2019.ResultsIn total 801,767 patient years were analysed. Antibiotic prescriptions mainly increased in patients aged 65+ while prescriptions mainly decreased in patients below 65 years. Nonprudent antibiotic prescriptions decreased from 2015 to 2019 with the highest percentage of decline found in skin infections (66.9% [2015] to 53.9% [2019]). Overall, higher likelihood of nonprudent antibiotic prescriptions was found among men (odds ratio [OR] 4.11, 95% confidence interval [CI]: 3.91-4.33), patients aged 80+ (OR 1.44, 95% CI: 1.03-2.01; reference category ≤17 years), patients with comedication (OR 1.24, 95% CI: 1.17-1.31), and patients in urban general practices (OR 1.47, 95% CI: 1.38-1.56).ConclusionsAntibiotic prescriptions increased over time in the elderly aged categories. Although an overall decrease in nonprudent antibiotic prescriptions was established from 2015 to 2019, percentages of nonprudent prescriptions remained high for skin infections and respiratory tract infections. Additionally, men, elderly aged patients (80+), patients with comedication and patients in urban general practices were more likely to receive nonprudent antibiotic prescriptions. Our results will help FPs to prioritize optimalization of antibiotic prescriptions in family medicine.© The Author(s) 2022. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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