An Analysis of Primary Health Care Antibiotic Prescription Rates within Castile and Leon (Spain): 2013 - 2023

Background/Objectives: According to the World Health Organization, bacterial resistance is one of the main threats to public health and could within a short time become the principal cause of death. This study proposes to study antibiotic prescription rates at Basic Health Centres (BHC) within Castile and Leon over the period 2013-2023, and to determine which sociodemographic variables might influence the prescription of antibiotics. Methods: A descriptive, observational, ecological study was conducted on the basis of data provided by Concylia (Pharmaceutical information system-Castile & Leon Health Service). Comparable variables (time of prescription and type of Health Centre) and variables of results (Defined Daily Dose per 1000 health-center card-holders per day and qualitative antibiotic selection variables) were analyzed. Results: During the first years under analysis, prescriptions increased, followed by a reduction at the start of 2015 that continued up until 2021, after which a new increase was recorded and they once again reached values in 2023 that were comparable to those observed in 2019. Throughout all of Castile and Leon, there were more prescriptions within urban areas; but when analyzed by provinces, prescriptions were mainly higher in rural areas within most provinces. The percentage of macrolides was higher in urban areas, whereas the percentage of fluoroquinolones was higher in rural areas. Conclusions: The variation was repeated throughout the period under study in a similar way in all the provinces of Castile and Leon and at a national level. Differences were observed in prescriptions between the provinces of the autonomous region. Higher prescriptions rates were observed in the rural areas of most provinces.