Seasonal Variation in an Outpatient Antibiotic Prescription Rates in Alkharj

Main Article Content

Nehad J. Ahmed


Aim: The aim of this study was to describe the seasonal variations in dispensing antibiotic prescriptions in the outpatient setting of a public hospital in Alkharj.

Methodology: A retrospective cross-sectional study was conducted. The outpatient prescriptions in 2017 and 2018 were collected from medical records in a public hospital in Alkharj.

The data include the number of prescribed antibiotics in general, the number of prescribed antibiotics in different months and seasons in the outpatient setting.

Results: In the outpatient setting in 2017 and 2018, antibiotics were prescribed excessively in most of the months. About 27.84 %of the prescriptions in 2017 were in spring season and about 26.64% of the prescriptions in 2018 were in autumn. Total number of antibiotics prescriptions in 2017 and 2018 were 5348 in spring followed by 5097 in autumn.

Conclusion: The results of the present study showed the widespread use of antibiotics by practitioners that was associated with season of prescribing. In general, there are excess use of antibiotics in all months. It is important to understand how the prescribing of antibiotic varies throughout the year to design an appropriate intervention to decrease incorrect antibiotic use.

Seasonal variation, outpatient, out-patients, antibiotics antibacterial agents.

Article Details

How to Cite
Ahmed, N. J. (2020). Seasonal Variation in an Outpatient Antibiotic Prescription Rates in Alkharj. Journal of Pharmaceutical Research International, 32(9), 1-7.
Original Research Article


World Health Organization. Fact sheet–antibiotic resistance–media center. World Health Organization (WHO); 2016.
Accessed October, 10, 2019)‏

Spellberg B, Guidos R, Gilbert D, Bradley J, Boucher HW, Scheld WM, Bartlett JG, Edward J, Jr, Infectious Diseases Society of America. The epidemic of antibiotic-resistant infections: A call to action for the medical community from the Infectious Diseases Society of America. Clin. Infect. Dis. 2008;46:155–164.

Boucher HW, Talbot GH, Benjamin DK, Bradley J, Guidos RJ, Jones RN, Murray BE, Bonomo RA, Gilbert D, Infectious Diseases Society of America. 10 x ’20 progress — development of new drugs active against gram-negative bacilli: An update from the Infectious Diseases Society of America. Clin. Infect. Dis. 2013; 56:1685–1694.

Seppälä H, Klaukka T, Vuopio-Varkila J, Muotiala A, Helenius H, Lager K, et al. The effect of changes in the consumption of macrolide antibiotics on erythromycin resistance in group: A streptococci in Finland. New Engl J Med. 1997;337:441– 446.

Hay AD, Thomas M, Montgomery A, Wetherell M, Lovering A, McNulty Cet al. The relationship between primary care antibiotic prescribing and bacterial resistance in adults in the community: a controlled observational study using individual patient data. J Antimicrob Chemother. 2005;56:146–153.

Austin DJ, Kristinsson KG, Anderson RM. The relationship between the volume of antimicrobial consumption in human communities and the frequency of resistance. Proc. Natl. Acad. Sci. U. S. A. 1999;96:1152– 1156.

Goossens H, Ferech M, Vander Stichele R, Elseviers M; ESAC Project group. Outpatient antibiotic use in Europe and association with resistance: Across-national data base study. Lancet. 2005; 365:579–587.

Hicks LA, Chien YW, Taylor TH, Haber M, Klugman KP, Active Bacterial Core Surveillance (ABCs) Team. Outpatient antibiotic prescribing and non-susceptible Streptococcus pneumoniae in the United States, 1996–2003. Clin. Infect. Dis. 2011; 53:631–639.

Jensen US, Muller A, Brandt CT, Frimodt-Moller N, Hammerum AM, Monnet DL, DANRES study group. Effect of generics on price and consumption of ciprofloxacin in primary healthcare: The relationship to increasing resistance. J. Antimicrob. Chemother. 2010;65:1286–1291.

Malhotra-Kumar S, Lammens C, Coenen S, Van Herck K, Goossens H.Effect of azithromycin and clarithromycin therapy on pharyngeal carriage of macrolide-resistant streptococci in healthy volunteers: a randomized, double-blind, placebo-controlled study. Lancet. 2007;369:482–490.

Metz-Gercek S, Maieron A, Strauss R, Wieninger P, Apfalter P, Mittermayer H. Ten years of antibiotic consumption in ambulatory care: Trends in prescribing practice and antibiotic resistance in Austria. BMC Infect. Dis. 2009;9:61.

McCaig LF, Hicks LA, Roberts RM, Fairlie TA. Office-related antibiotic prescribing for persons aged 14 years—United States, 1993–1994 to 2007–2008. MMWR Morb. Mortal. Wkly. Rep. 2011;60:1153–1156.

Hersh AL, Shapiro DJ, Pavia AT, Shah SS. 2011. Antibiotic prescribing in ambulatory pediatrics in the United States. Pediatrics. 2011;128:1053–1061.

Grijalva CG, Nuorti JP, Griffin MR. Antibiotic prescription rates for acute respiratory tract infections in US ambulatory settings. JAMA. 2009;302:758–766.

McCaig LF, Besser RE, Hughes JM. Antimicrobial drug prescription sinambulatorycare settings, United States. 1992–2000. Emerg. Infect. Dis. 2003;9: 432–437.

Steinman MA, Gonzales R, Linder JA, Landefeld CS. Changinguse of antibiotics in community-based outpatient practice, 1991–1999. Ann. Intern. Med. 2003;138: 525–533.

Fairlie T, Shapiro DJ, Hersh AL, Hicks LA. National trends in visit rates and antibiotic prescribing for adults with acute sinusitis. Arch. Intern. Med. 2012;172:1513–1514.

Sun L, Klein EY, Laxminarayan R. Seasonality and temporal correlation between community antibioticusean dresistance in the United States. Clin. Infect. Dis. 2012;55:687–694.

Elseviers MM, Ferech M, Vander Stichele RH, Goossens H, ESAC Project Group. Antibiotic use in ambulatory care in Europe (ESAC data 1997–2002): trends, regional differences and seasonal fluctuations. Pharmacoepidemiol. Drug Saf. 2007;16: 115–123.

Ferech M, Coenen S, Malhotra-Kumar S, Dvorakova K, Hendrickx E, Suetens Cet al. European surveillance of antimicrobial consumption (ESAC): outpatient antibiotic use in Europe. J. Antimicrob. Chemother. 2006;58:401–407.

Suda KJ, Hicks LA, Roberts RM, Hunkler RJ, Taylor TH. Trends and seasonal variation in outpatient antibiotic prescription rates in the United States, 2006 to 2010. Antimicrob Agents Chemother. 2014;58(5):2763-6.

Achermann R, Suter K, Kronenberg A, Gyger P, Muhlemann K, Zimmerli W, et al. Antibiotic use in adult outpatients in Switzerland in relation to regions, seasonality and point of care tests. Clin. Microbiol. Infect. 2011;17:855–861.

Patrick DM, Marra F, Hutchinson J, Monnet DL, Ng H, Bowie WR. Per capita antibiotic consumption: How does a North American jurisdiction compare with Europe? Clin. Infect. Dis.2004;39:11–17.

Dagan R, Bakai G, Givon-Lavi N, Sharf AZ, Vardy D, Cohen T, et al. Seasonality of antibiotic-resistant Streptococcus pneumoniae that causes acute otitis media: A clue for an antibioticrestriction policy? J. Infect. Dis. 2008;197:1094–1102.

Bauchner H, Pelton SI, Klein JO. Parents, physicians and antibiotic use. Pediatrics. 1999;103:395–401.

Durkin MJ, Jafarzadeh SR, Hsueh K, Sallah YH, Munshi KD, Henderson RR, et al. Outpatient antibiotic prescription trends in the United States: A National Cohort Study. Infect Control Hosp Epidemiol. 2018;39(5):584-589.

Centers for Disease Control and Prevention. The Flu Season; 2018.
Available: [Accessed 32020].

Pathak A, Mahadik K, Dhaneria SP, Sharma A, Eriksson B, Lundborg CS. Antibiotic prescribing in outpatients: Hospital and seasonal variations in Ujjain, India. Scand J Infect Dis. 2011;43(6-7): 479-88.

Safaeian L, Mahdanian AR, Salami S, Pakmehr F, Mansourian M. Seasonality and physician-related factors associated with antibiotic prescribing: A cross-sectional study in Isfahan, Iran. Int J Prev Med. 2015;15;6:1.