Indications and prescriptions of penicillins in a population of Colombia: A cross-sectional study v1

Introduction: Inappropriateuse of antibiotics plays a key role in increasing bacterial resistance, whichis a global problem that has increased over time. Objective: Todetermine the prescription patterns and indications for the use of penicillinsin a group of patients from Colombia. Methods: This study was across-sectional study on the use of penicillins in outpatients. Approved andunapproved indications were determined from records of the Food and DrugAdministration (FDA) of the United States and the National Institute of Foodand Drug Surveillance (INVIMA) of Colombia. Descriptive and multivariate analyseswere performed. Results: A total of 137,070patients were identified; the average age was 35.8 ± 23.5 years, and 56.2% werewomen. Amoxicillin (73.4%), dicloxacillin (11.7%) and sultamicillin (6.0%) werethe most commonly prescribed penicillins, mainly for upper respiratory tractinfections (43.0%). In 68.9% of cases, penicillins were used for approvedindications, especially to treat Helicobacterpylori (17.3%). In 31.1% of cases, penicillin prescriptions were used forunapproved indications (e.g., acute rhinopharyngitis [8.1%]). Patients under 18years of age (OR: 1.87; 95% CI: 1.78-1.96), those from municipalities (OR:1.51; 95% CI: 1.44-1.57), those with previous antibiotic use (OR: 2.49; 95% CI:2.26-2.74), those with skin and soft tissue infections (OR: 2.82; 95% CI:2.57-3.09), those with lower respiratory tract infections (OR: 2.02; 95% CI:1.89-2.16), those managed with general medicine (OR: 1.37; 95% CI: 1.25-1.51),and those treated with dicloxacillin (OR: 2, 84; 95% CI: 2.07-3.89) were morelikely to be prescribed penicillins for unapproved indications. Conclusions:Amoxicillin was the most widely used penicillin in outpatients. Penicillinswere frequently used for unapproved indications not recommended by clinicalpractice guidelines.