Variability between health areas in antibiotic consumption among pediatric outpatients of Principado de Asturias, Spain (2005-2018)

Antibiotics in Spain are mainly prescribed in the community sector, remarking a high variability between areas. The aim of this study is to describe the variability between health areas in the antibiotic consumption in the pediatric population of Asturias during 2005-2018 period. Retrospective and comparative study using data about consumption of antibacterial agents for systemic use (J01C group in ATC, Anatomical Therapeutic Chemical, classification) in the pediatric outpatients of the eight health areas of Principado de Asturias between 2005 and 2018, based on defined daily dose (DDD) per 1000 inhabitants and day (DID). Mean antibiotic consumption in pediatric outpatients in Principado de Asturias (2005-2018) was 14 DID (CI95% 13.4 - 14.6). Consumption increased until 2009 (15.2 DID) and decreased from 2015 onwards (11.9 DID in 2018). β-lactam penicillins was the most consumed therapeutic group (10.7 DID). There were statistically significant differences among the areas with the highest and the lowest consumption rates (Avilés, 19 DID; Oviedo, 11.5 DID). A high variability between health areas was observed when analysing data temporally (difference of 11.8 DID in 2011) and therapeutic groups. The consumption of macrolides in Langreo health area and quinolones in Jarrio health area were 2.3 and 4.1 times higher, respectively, comparing to Gijón health area. There is a wide quantitative and qualitative variability of antibiotic consumption in the pediatric outpatients among the different health areas of Asturias.