{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T15:15:01Z","timestamp":1761491701683,"version":"3.41.2"},"reference-count":41,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,8,2]],"date-time":"2024-08-02T00:00:00Z","timestamp":1722556800000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>In clinical practice, a discrepancy may exist between the prescribed amount of a drug and the commercially available pack sizes in the pharmacy, potentially contributing to drug waste. This study aimed\u2014as an example of this phenomena\u2014to quantify leftover of amoxicillin suspension prescribed to children, due to discrepancies between physician\u2010prescribed and pharmacy\u2010dispensed amounts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective cohort study including amoxicillin suspension dispensations for patients aged 0\u201312\u2009years between 2017 and 2019 utilizing the Dutch PHARMO database. Leftover amount of amoxicillin was estimated by assessing the discrepancy between the prescribed and dispensed amounts. Extrapolated amoxicillin weight and economic spillage estimates for the Netherlands were determined. The impact of two theoretical interventions on leftover amount was assessed: (1) introducing vials with half the volume of the current 100 and 30\u2009mL vials and (2) a combination of the first intervention with a maximum of 10% round\u2010down by the dispensing pharmacy of the prescribed dose.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 79\u2009512 amoxicillin suspension dispensations for 62\u2009252 patients. The mean leftover amount of amoxicillin suspension per dispensing was 27%. The yearly amount of amoxicillin leftover was 49.8\u2009kg in the study cohort, equivalent to yearly 633\u2009kg and \u20ac621\u2009000 when extrapolated to the Netherlands. Employing the first theoretical intervention reduced the mean leftover per dispensing to 20%, reducing the yearly leftover to 31.6\u2009kg amoxicillin in the study cohort, and to 400\u2009kg and \u20ac400\u2009000 extrapolated. The second theoretical intervention further reduced leftover to 17%, reducing the yearly leftover to 24.3\u2009kg amoxicillin in the study cohort, and to 300\u2009kg and \u20ac300\u2009000 extrapolated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Approximately a quarter of amoxicillin suspension remains as leftover per dispensing. Applying different theoretical intervention shows the potential for a significant reduction of amoxicillin leftover.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.5868","type":"journal-article","created":{"date-parts":[[2024,8,2]],"date-time":"2024-08-02T08:32:45Z","timestamp":1722587565000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Leftover of Amoxicillin Suspension After Use by Children in the Netherlands"],"prefix":"10.1002","volume":"33","author":[{"given":"Milad","family":"Sadreghaemy","sequence":"first","affiliation":[{"name":"Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS) Utrecht University  Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magdalena\u00a0A.","family":"Gamba","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS) Utrecht University  Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0014-8625","authenticated-orcid":false,"given":"Lourens\u00a0T.","family":"Bloem","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS) Utrecht University  Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1758-7779","authenticated-orcid":false,"given":"Toine\u00a0C.\u00a0G.","family":"Egberts","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS) Utrecht University  Utrecht The Netherlands"},{"name":"Department of Clinical Pharmacy University Medical Center Utrecht  Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,8,2]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.33549\/physiolres.934609"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2015.00803"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.884482"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11096-009-9340-x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sapharm.2018.03.064"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sapharm.2016.11.003"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11096-014-9981-2"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2023.4865"},{"key":"e_1_2_10_10_1","first-page":"387","volume-title":"StatPearls [Internet]","author":"Akhavan B. 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