{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:23:49Z","timestamp":1787009029685,"version":"build-2736575974"},"reference-count":48,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2021,5,8]],"date-time":"2021-05-08T00:00:00Z","timestamp":1620432000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Italian College of General Practitioners and Primary Care"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,7,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There are few data comparing the relative effectiveness of the individual \u03b2-lactams.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To quantify the reduced effectiveness, defined as switching to a different antibiotic being prescribed for the same indication, among new users of \u03b2-lactam antibiotics in primary care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted using the Health Search Database, an Italian primary care data source. Patients newly prescribed with \u03b2-lactams for a specific indication between 1 January 2013 and 31 December 2017 were identified. A switch to a different antibiotic for the same indication occurring during a 30day follow-up was the study outcome. Cox regression was adopted to assess the risk of switching between the different \u03b2-lactams.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 178\u200a256 patients newly treated with \u03b2-lactam antibiotics, 1172 (0.65%) switched to a different antibiotic. Amoxicillin\/clavulanate (co-amoxiclav: n\u200a=\u200a104\u200a891) and amoxicillin (n\u200a=\u200a21\u200a699) were the most frequently prescribed \u03b2-lactams. The other antibiotics showed significantly higher risk of switching when compared with co-amoxiclav for lower respiratory tract [e.g. ceftriaxone, hazard ratio (HR): 1.6, 95% CI: 1.2\u20132.0], dental [e.g. amoxicillin, HR: 4.2, 95% CI: 2.9\u20135.9], and middle ear infections [e.g. amoxicillin, HR: 1.8, 95% CI: 1.1\u20132.7]. The same results were gathered when parenteral formulations were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The prevalence of reduced effectiveness of newly prescribed \u03b2-lactam antibiotics was lower than 1%. Specifically, the rate of switch to another antibiotic, when it was prescribed to treat low respiratory tract, dental, and middle ear infections, was lower among users of co-amoxiclav than those prescribed with other \u03b2-lactams.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkab128","type":"journal-article","created":{"date-parts":[[2021,3,31]],"date-time":"2021-03-31T15:10:06Z","timestamp":1617203406000},"page":"2186-2194","source":"Crossref","is-referenced-by-count":4,"title":["Reduced effectiveness among \u03b2-lactam antibiotics: a population-based cohort study in primary care in Italy"],"prefix":"10.1093","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4342-9128","authenticated-orcid":false,"given":"Francesco","family":"Lapi","sequence":"first","affiliation":[{"name":"Health Search, Italian College of General Practitioners and Primary Care, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ettore","family":"Marconi","sequence":"additional","affiliation":[{"name":"Health Search, Italian College of General Practitioners and Primary Care, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena","family":"Pecchioli","sequence":"additional","affiliation":[{"name":"Health Search, Italian College of General Practitioners and Primary Care, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Lagolio","sequence":"additional","affiliation":[{"name":"Italian College of General Practitioners and Primary Care, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Rossi","sequence":"additional","affiliation":[{"name":"Italian College of General Practitioners and Primary Care, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ercole","family":"Concia","sequence":"additional","affiliation":[{"name":"Infectious Diseases Section, Diagnostic and Public Health Department, University of Verona, Policlinico \u2018G. 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