{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T10:41:38Z","timestamp":1776163298383,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,12,11]],"date-time":"2024-12-11T00:00:00Z","timestamp":1733875200000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The purpose of this study was to describe the intensity and patterns of antibiotic drug use among people with multiple sclerosis (pwMS) in the Netherlands.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>People with prevalent MS between 1 January 2018 and 31 December 2020 were identified using ambulatory hospital records from the PHARMO Database Network that contains routinely collected healthcare data from the Netherlands. Out\u2010patient pharmacy dispensing data were used to assess type of antibiotic, dosage, and amounts dispensed. Antibiotic intensity in defined daily doses (DDD)\/1000 patient\u2010days (PD) was calculated together with frequency of dispensing of the same (prolongation) or different (switch) antibiotic up to 3\u2009days after the end of the last antibiotic prescription; and stratified by sex, age, polypharmacy (use of &gt;\u20094 out\u2010patient prescription drugs for &gt;\u200929\u2009days), type of disease\u2010modifying treatment, and Sars\u2010CoV\u20102\u2010related lockdown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1960 (37.8%) out of 5179 pwMS were dispensed \u2265\u20091 antibiotic. Of the 8762 dispensing events, 27.6%% were part of a prolongation, and 16.3% of a switch. Overall antibiotic use among pwMS was 18.8 DDD\/1000 PD (95% confidence interval [95% CI]: 18.7\u201319.0) compared to 7.77\u20138.90 DDD\/1000 PD in the general out\u2010patient population, as reported by the Dutch Working Party on Antibiotic Policy. Antibiotic use was higher among women, increased with age, and was higher in people with polypharmacy and lower during lockdown. Nitrofurantoin was the most commonly dispensed antibiotic (41.7%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The intensity of antibiotic use is considerably higher among pwMS than the general population. This reflects the burden of infection in this susceptible population.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.70070","type":"journal-article","created":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T01:36:19Z","timestamp":1733967379000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Antibiotic Utilization Among People With Multiple Sclerosis in the Netherlands, 2018\u20132020"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4710-5841","authenticated-orcid":false,"given":"Melissa W. Y.","family":"Leung","sequence":"first","affiliation":[{"name":"Division of Pharmacoepidemiology and Clinical Pharmacology, Department of Pharmaceutical Sciences, Faculty of Science Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University  Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0795-1381","authenticated-orcid":false,"given":"Marloes T.","family":"Bazelier","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Clinical Pharmacology, Department of Pharmaceutical Sciences, Faculty of Science Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University  Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9226-7364","authenticated-orcid":false,"given":"Bernard M. J.","family":"Uitdehaag","sequence":"additional","affiliation":[{"name":"Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience Amsterdam University Medical Center  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4112-7572","authenticated-orcid":false,"given":"Hilda J. I.","family":"De Jong","sequence":"additional","affiliation":[{"name":"PHARMO Institute  Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olaf H.","family":"Klungel","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Clinical Pharmacology, Department of Pharmaceutical Sciences, Faculty of Science Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University  Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1334-2144","authenticated-orcid":false,"given":"Ewoudt M. 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