Evidence map›Paper›PMID 39441463›Full record

Observational studyInfection2025

Discrepancy between antibiotic pack sizes and guideline recommendations: a real-world analysis based on claims data.

Sabrina M Stollberg, Sereina M Graber, Andreas Kronenberg, Oliver Senn, Stefan Neuner-Jehle, Catherine Pluess-Suard, Carola A Huber, Andreas Plate

Abstract readObservational Study
In one paragraph

Observational study in Infection, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Sabrina M Stollberg *Department of Health Sciences, Helsana Group, Zurich, Switzerland.
Sereina M Graber *Department of Health Sciences, Helsana Group, Zurich, Switzerland.
Andreas KronenbergSwiss Centre for Antibiotic Resistance (ANRESIS), Institute for Infectious Diseases, University of Bern, Bern, Switzerland.
Oliver SennInstitute of Primary Care, University of Zurich and University Hospital Zurich, Pestalozzistrasse 24, Zurich, 8091, Switzerland.
Stefan Neuner-JehleInstitute of Primary Care, University of Zurich and University Hospital Zurich, Pestalozzistrasse 24, Zurich, 8091, Switzerland.
Catherine Pluess-SuardSwiss Centre for Antibiotic Resistance (ANRESIS), Institute for Infectious Diseases, University of Bern, Bern, Switzerland.
Carola A Huber *Department of Health Sciences, Helsana Group, Zurich, Switzerland.
Andreas Plate *Institute of Primary Care, University of Zurich and University Hospital Zurich, Pestalozzistrasse 24, Zurich, 8091, Switzerland. Andreas.Plate@usz.ch.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeAntibiotics are often only available in predefined pack sizes, which may not align with guideline recommendations. This can result in leftover pills, leading to inappropriate self-medication or waste disposal, which can both foster the development of antibiotic resistance. The magnitude of inappropriate pack sizes is largely unknown. The objective of this study was to evaluate the potential non-conformity of prescribed antibiotic pack sizes.

methodsThis retrospective observational study was based on claims data from a large Swiss health insurance company. The study analysed the prescriptions of eleven different antibiotic substances recommended for the five most common indications for antibiotics in Switzerland. All prescriptions for adult outpatients issued by general practitioners in 2022 were included and extrapolated to the entire Swiss population. Potential non-conformity was defined as a mismatch between the total dosage in a pack and the total dosage recommended.

resultsA total of n = 947,439 extrapolated prescriptions were analysed. In 10 of 23 of all analysed substance/indication combinations none of the prescribed packs aligned with the respective guideline recommendation. Considering pack sizes in which the total prescribed dosage of a substance did not correspond to any of the total dosages recommended in at least one of the guidelines, 31.6% of prescriptions were potentially non-conform and an estimated number of 2.7 million tablets were overprescribed.

conclusionsWe found a large discrepancy between prescribed pack sizes and guideline recommendations. Since inadequately prepacked antibiotics may lead to antibiotic resistance and unnecessary waste, efforts are needed to implement alternatives like exact pill dispensing.

Indexed as

Anti-Bacterial AgentsDrug PackagingDrug PrescriptionsGuideline AdherenceAdultAgedFemaleHumansMaleMiddle AgedPractice Guidelines as TopicRetrospective StudiesSwitzerlandAnti-Bacterial AgentsAntibiotic resistanceAntibioticsHealthcare claims dataNon-conformity with guidelinesPack size

Identifiers

PMID39441463
PMCPMC12137524

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.