{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T02:35:14Z","timestamp":1772850914121,"version":"3.50.1"},"reference-count":36,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2020,7,8]],"date-time":"2020-07-08T00:00:00Z","timestamp":1594166400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>The use of antibiotics is the most important modifiable risk factor for the development of microorganism resistance. A cross-sectional study of outpatients receiving antibiotic prescriptions registered in a population database in Colombia was conducted. The characteristics of the consumption in capital cities and small municipalities was studied and the AWaRe classification was used. AWaRe classifies antibiotics into three stewardship groups: Access, Watch and Reserve, to emphasize the importance of their optimal use and potential harms of antimicrobial resistance. A total of 182,397 patients were prescribed an antibiotic; the most common were penicillins (38.6%), cephalosporins (30.2%) and fluoroquinolones (10.9%). \u2018Access\u2019 antibiotics (86.4%) were the most frequently prescribed, followed by \u2018Watch\u2019 antibiotics (17.0%). Being 18 or older, being male, living in a municipality, having one or more comorbidities and urinary, respiratory or gastrointestinal disorders increased the probability of receiving \u2018Watch\u2019 or \u2018Reserve\u2019 antibiotics. Penicillin and urinary antiseptic prescriptions predominated in cities, while cephalosporin and fluoroquinolone prescriptions predominated in municipalities. This analysis showed that the goal set by the WHO Access of mainly using Access antibiotics is being met, although the high use of Watch antibiotics in municipalities should be carefully studied to determine if it is necessary to design specific campaigns to improve antibiotics use.<\/jats:p>","DOI":"10.3390\/antibiotics9070389","type":"journal-article","created":{"date-parts":[[2020,7,8]],"date-time":"2020-07-08T11:47:46Z","timestamp":1594208866000},"page":"389","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Patterns of Antibiotic Prescription in Colombia: Are There Differences between Capital Cities and Municipalities?"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8455-0936","authenticated-orcid":false,"given":"Jorge Enrique","family":"Machado-Alba","sequence":"first","affiliation":[{"name":"Grupo de Investigaci\u00f3n en Farmacoepidemiolog\u00eda y Farmacovigilancia, Universidad Tecnol\u00f3gica de Pereira-Audifarma S.A, 660003 Pereira, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis Fernando","family":"Valladales-Restrepo","sequence":"additional","affiliation":[{"name":"Grupo de Investigaci\u00f3n en Farmacoepidemiolog\u00eda y Farmacovigilancia, Universidad Tecnol\u00f3gica de Pereira-Audifarma S.A, 660003 Pereira, Colombia"},{"name":"Grupo de Investigaci\u00f3n Biomedicina, Facultad de Medicina, Fundaci\u00f3n Universitaria Aut\u00f3noma de las Am\u00e9ricas, 660003 Pereira, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2500-7658","authenticated-orcid":false,"given":"Andr\u00e9s","family":"Gaviria-Mendoza","sequence":"additional","affiliation":[{"name":"Grupo de Investigaci\u00f3n en Farmacoepidemiolog\u00eda y Farmacovigilancia, Universidad Tecnol\u00f3gica de Pereira-Audifarma S.A, 660003 Pereira, Colombia"},{"name":"Grupo de Investigaci\u00f3n Biomedicina, Facultad de Medicina, Fundaci\u00f3n Universitaria Aut\u00f3noma de las Am\u00e9ricas, 660003 Pereira, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuel Enrique","family":"Machado-Duque","sequence":"additional","affiliation":[{"name":"Grupo de Investigaci\u00f3n en Farmacoepidemiolog\u00eda y Farmacovigilancia, Universidad Tecnol\u00f3gica de Pereira-Audifarma S.A, 660003 Pereira, Colombia"},{"name":"Grupo de Investigaci\u00f3n Biomedicina, Facultad de Medicina, Fundaci\u00f3n Universitaria Aut\u00f3noma de las Am\u00e9ricas, 660003 Pereira, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2740-2013","authenticated-orcid":false,"given":"Albert","family":"Figueras","sequence":"additional","affiliation":[{"name":"Departament de Farmacologia, Terap\u00e8utica i Toxicolog\u00eda, Universitat Aut\u00f2noma de Barcelona, 08193 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,7,8]]},"reference":[{"key":"ref_1","first-page":"1308","article-title":"US outpatient antibiotic prescribing variation according to geography, patient population, and provider specialty in 2011","volume":"60","author":"Hicks","year":"2015","journal-title":"Clin. Infect. Dis."},{"key":"ref_2","first-page":"3","article-title":"Tackling threats and future problems of multidrug-resistant bacteria","volume":"398","author":"Medina","year":"2016","journal-title":"Curr. Top. Microbiol. Immunol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/j.idc.2016.02.001","article-title":"Overview: Global and local impact of antibiotic resistance","volume":"30","author":"Watkins","year":"2016","journal-title":"Infect. Dis. Clin. N. Am."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"30266","DOI":"10.2807\/1560-7917.ES.2016.21.26.30266","article-title":"Antibiotic prescribing and expenditures in outpatient adults in Greece, 2010 to 2013: Evidence from real-world practice","volume":"21","author":"Kourlaba","year":"2016","journal-title":"Eurosurveillance"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1998","DOI":"10.1111\/jgs.15518","article-title":"Outpatient antibiotic prescribing for older adults in the United States: 2011 to 2014","volume":"66","author":"Kabbani","year":"2018","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2278","DOI":"10.1016\/j.xphs.2016.06.002","article-title":"Antibiotic resistance: The need for a global strategy","volume":"105","author":"Elder","year":"2016","journal-title":"J. Pharm. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Bell, B.G., Schellevis, F., Stobberingh, E., Goossens, H., and Pringle, M. (2014). A systematic review and meta-analysis of the effects of antibiotic consumption on antibiotic resistance. BMC Infect. Dis., 14.","DOI":"10.1186\/1471-2334-14-13"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1016\/j.eimc.2014.10.004","article-title":"Antibiotic resistance: A global crisis","volume":"33","author":"Also","year":"2015","journal-title":"Enferm. Infect. Microbiol. Clin."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1038\/ja.2017.30","article-title":"The antibiotic resistance crisis, with a focus on the United States","volume":"70","author":"Martens","year":"2017","journal-title":"J. Antibiot."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/S1473-3099(18)30605-4","article-title":"Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic area in 2015: A population-level modelling analysis","volume":"19","author":"Cassini","year":"2019","journal-title":"Lancet Infect. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1093\/jac\/dkt301","article-title":"Antibiotic prescribing for adults in ambulatory care in the USA, 2007\u20132009","volume":"69","author":"Shapiro","year":"2014","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Ab Rahman, N., Teng, C.L., and Sivasampu, S. (2016). Antibiotic prescribing in public and private practice: A cross-sectional study in primary care clinics in Malaysia. BMC Infect. Dis., 16.","DOI":"10.1186\/s12879-016-1530-2"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/S1473-3099(17)30724-7","article-title":"Classifying antibiotics in the WHO Essential Medicines List for optimal use-be AWaRe","volume":"18","author":"Sharland","year":"2018","journal-title":"Lancet Infect. Dis."},{"key":"ref_14","unstructured":"World Health Organization (2020, April 06). The 2019 WHO AWaRe Classification of Antibiotics for Evaluation and Monitoring of Use. Available online: https:\/\/apps.who.int\/iris\/handle\/10665\/327957."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1016\/S1473-3099(19)30532-8","article-title":"Encouraging AWaRe-ness and discouraging inappropriate antibiotic use-the new 2019 Essential Medicines List becomes a global antibiotic stewardship tool","volume":"19","author":"Sharland","year":"2019","journal-title":"Lancet Infect. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Zhang, X., Cui, Y., Liu, C., Zuo, K., and Tang, Y. (2019). Antibiotic sales in primary care in Hubei Province, China: An analysis of 2012\u20132017 procurement records. Int. J. Environ. Res. Public Health., 16.","DOI":"10.3390\/ijerph16183376"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"vi17","DOI":"10.1093\/jac\/dky115","article-title":"Variation in antibiotic use among and within different settings: A systematic review","volume":"73","author":"Zanichelli","year":"2018","journal-title":"J. Antimicrob Chemother."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1093\/jac\/dkl147","article-title":"Hospital consumption of antibiotics in 15 European countries: Results of the ESAC retrospective data collection (1997\u20132002)","volume":"58","author":"Elseviers","year":"2006","journal-title":"J. Antimicro. Chemother."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"888","DOI":"10.3109\/00365548.2014.954264","article-title":"Antibiotic consumption in relation to socio-demographic factors, co-morbidity, and accessibility of primary health care","volume":"46","author":"Ternhag","year":"2014","journal-title":"Scand. J. Infect. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"De Jong, J., Bos, J.H., de Vries, T.W., and de Jong-van den Berg, L.T. (2014). Use of antibiotics in rural and urban regions in The Netherlands: An observational drug utilization study. BMC Pub Health, 14.","DOI":"10.1186\/1471-2458-14-677"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"251","DOI":"10.2147\/CEOR.S161299","article-title":"Prevalence of antibiotic prescription in southern Italian outpatients: Real-world data analysis of socioeconomic and sociodemographic variables at a municipality level","volume":"10","author":"Russo","year":"2018","journal-title":"ClinicoEcon. Outcomes Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1111\/j.1469-0691.2010.03348.x","article-title":"Antibiotic use in adult outpatients in Switzerland in relation to regions, seasonality and point of care tests","volume":"17","author":"Achermann","year":"2011","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Haeseker, M.B., Dukers-Muijrers, N.H., Hoebe, C.J., Bruggeman, C.A., Cals, J.W., and Verbon, A. (2012). Trends in antibiotic prescribing in adults in Dutch general practice. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0051860"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"214","DOI":"10.11604\/pamj.2017.28.214.13940","article-title":"Antibiotic prescription pattern in a Ghanaian primary health care facility","volume":"28","author":"Prah","year":"2017","journal-title":"Pan Afr. Med. J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/s13293-018-0187-5","article-title":"Sexual dimorphism in bacterial infections","volume":"9","year":"2018","journal-title":"Biol. Sex Differ."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.1086\/512810","article-title":"Comparison of outpatient systemic antibacterial use in 2004 in the United States and 27 European countries","volume":"44","author":"Goossens","year":"2007","journal-title":"Clin. Infect. Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1002\/pds.1244","article-title":"Antibiotic use in ambulatory care in Europe (ESAC data 1997\u20132002): Trends, regional differences and seasonal fluctuations","volume":"16","author":"Elseviers","year":"2007","journal-title":"Pharmacoepidemiol. Drug Saf."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1590\/S0124-00642009000500006","article-title":"Dispensaci\u00f3n de antibi\u00f3ticos de uso ambulatorio en una poblaci\u00f3n colombiana","volume":"11","year":"2009","journal-title":"Rev. Salud. Pub."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"5092","DOI":"10.1136\/bmj.k5092","article-title":"Appropriateness of outpatient antibiotic prescribing among privately insured US patients: ICD-10-CM based cross sectional study","volume":"364","author":"Chua","year":"2019","journal-title":"BMJ"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1007\/s15010-006-6618-y","article-title":"Regional variation in outpatient antibiotic prescribing in Germany","volume":"34","author":"Kern","year":"2006","journal-title":"Infection"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Nga do, T.T., Chuc, N.T., Hoa, N.P., Hoa, N.Q., Nguyen, N.T., Loan, H.T., and Wertheim, H.F. (2014). Antibiotic sales in rural and urban pharmacies in northern Vietnam: An observational study. BMC Pharmacol. Toxicol., 15.","DOI":"10.1186\/2050-6511-15-6"},{"key":"ref_32","first-page":"135","article-title":"Analysis of a high-prescribing state\u2019s 2016 outpatient antibiotic prescriptions: Implications for outpatient antimicrobial stewardship interventions","volume":"41","author":"Staub","year":"2020","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"3384","DOI":"10.1093\/jac\/dkz321","article-title":"Adaptation of the WHO Essential Medicines List for national antibiotic stewardship policy in England: Being AWaRe","volume":"74","author":"Budd","year":"2019","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/S1473-3099(18)30547-4","article-title":"Consumption of oral antibiotic formulations for young children according to the WHO Access, Watch, Reserve (AWaRe) antibiotic groups: An analysis of sales data from 70 middle-income and high-income countries","volume":"19","author":"Hsia","year":"2019","journal-title":"Lancet Infect. Dis."},{"key":"ref_35","unstructured":"World Health Organization (2020, April 21). WHO Releases the 2019 AWaRe Classification Antibiotics. Available online: https:\/\/www.who.int\/medicines\/news\/2019\/WHO_releases2019AWaRe_classification_antibiotics\/en."},{"key":"ref_36","unstructured":"National Institute for Health an Care Excellence (2020, April 21). Antimicrobial Prescribing Guidelines. Available online: https:\/\/www.nice.org.uk\/about\/what-we-do\/our-programmes\/nice-guidance\/antimicrobial-prescribing-guidelines."}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/9\/7\/389\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:48:56Z","timestamp":1760176136000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/9\/7\/389"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,8]]},"references-count":36,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2020,7]]}},"alternative-id":["antibiotics9070389"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics9070389","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,8]]}}}