Strategies for the rational use of antibiotics and analysis of their effects

This study aims to evaluate the strategies and their effects on the rational use of antibiotics in our country based on data related to antibiotic prescriptions in primary care. Strategic plans, developed in our country for rational antibiotic use, were examined. Within this context, data on antibiotic consumption were requested from the TITCK which has a systematic and regular database and data such as the antibiotic prescription rate by family physicians, the antibiotic prescription rate for acute pharyngitis and upper respiratory tract infections, the rate of antibiotic consumption on a box basis, and the percentage of antibiotic costs in the total drug budget were analyzed. The results were compared with similar strategies implemented worldwide, and the necessity of additional measures was discussed. According to the RBS, which recorded a total of 1,168,718,923 prescriptions between 2011 and 2019, the percentage of prescriptions containing at least one antibiotic among all prescriptions by family physicians was 34.9% in 2011 and decreased to 23.9% in 2019. The most prescribed beta-lactam antibiotics and penicillins (J01C) for acute pharyngitis and upper respiratory tract infections, which were 17.3 million boxes in 2011, decreased to 13.6 million boxes in 2019. With the introduction of prescription restrictions for antibiotics and the acceleration of educational activities after 2014, a significant decrease in the use of all antibiotics has been observed in recent years. In 2011, the cost of antibiotics, which constituted 13.1% of all drugs on a box basis, decreased over the years, and in 2019, the box ratio within total drugs decreased to 8.0%, and the cost to 4.7%. The results of our study indicate a significant decrease in the antibiotic prescription rates by family physicians in 2019 compared to 2011, showing that the strategies related to rational antibiotic use in our country have had a positive impact as expected. These studies are successful and meaningful in terms of preventing antimicrobial resistance and can serve as an example for other countries. However, there is a need for integrated, comprehensive strategies, and monitoring systems that can reflect antibiotic prescribing information from all healthcare providers.