Trends in antibiotic prescribing by general practitioners in Belgium (2014-2023) and association with changing workforce demographics.
5 affiliations
- 1Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.
- 2Centre for General Practice, Department of Family Medicine and Population Health (FAMPOP), University of Antwerp, Antwerp, Belgium.
- 3National Institute for Health and Disability Insurance, Brussels, Belgium.
- 4Faculty of Medicine, Université libre de Bruxelles, Anderlecht, Belgium.
- 5Faculty of Medicine and Pharmacy, Université de Mons (UMons), Mons, Belgium.
Abstract
Background
General practitioners (GPs) account for most antibiotic prescriptions in the community. GP age and sex may influence prescribing, particularly in the context of demographic shifts in the GP workforce. We aimed to assess trends in antibiotic prescribing by GPs in Belgium and associations between GP age and sex with prescribing volume and quality.Methods
A retrospective analysis on nationwide administrative health data was conducted. Aggregated data on reimbursed systemic antibiotics (Anatomical Therapeutic Chemical J01) prescribed by GPs (2014-2023) were linked to the insured population (2014-2023), GP demographics (2014-2022) and consultation data (2014-2022). Volume was measured using population-based indicators: defined daily doses (DDD) and packages per 1000 beneficiaries per day (DBD and PBD) and prescriber-based indicators (DDD per GP, DDD and packages per consultation). Quality was evaluated using the proportion of amoxicillin among amoxicillin plus amoxicillin/clavulanate and the broad- to narrow-spectrum antibiotic ratio. Trends were analysed using Pearson correlations; associations using multivariable linear mixed models.Results
Between 2014 and 2023, antibiotic volume decreased across all population-based indicators, with DDD, DBD and PBD decreasing by 16%, 19% and 18% (P < 0.01). Prescriber-based indicators also decreased between 2014 and 2022, with DDD per GP and packages per consultation declining by 27% and 40%, respectively (P < 0.01). Quality improved, with a 34% decrease in broad-to-narrow ratio and a 14% increase in the proportion of amoxicillin. Older and male GPs had higher volumes and less favourable quality indicators.Conclusions
Antibiotic prescribing by Belgian GPs declined over the past decade, but differences by GP age and sex suggest opportunities for targeted antimicrobial stewardship.
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BibTeX
@article{domen2026trends,
title = {{Trends in antibiotic prescribing by general practitioners in Belgium (2014-2023) and association with changing workforce demographics.}},
author = {Julie Domen and Moira Kelly and Samuel Coenen and Kasso Daïnou and Boudewijn Catry and Lucy Catteau},
journal = {JAC-antimicrobial resistance},
year = {2026},
month = oct,
doi = {10.1093/jacamr/dlag218},
url = {https://europepmc.org/article/MED/42923594},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Trends in antibiotic prescribing by general practitioners in Belgium (2014-2023) and association with changing workforce demographics.
AU - Julie Domen
AU - Moira Kelly
AU - Samuel Coenen
AU - Kasso Daïnou
AU - Boudewijn Catry
AU - Lucy Catteau
PY - 2026
DA - 2026/10/22
JO - JAC-antimicrobial resistance
DO - 10.1093/jacamr/dlag218
UR - https://europepmc.org/article/MED/42923594
AB - Background General practitioners (GPs) account for most antibiotic prescriptions in the community. GP age and sex may influence prescribing, particularly in the context of demographic shifts in the GP workforce. We aimed to assess trends in antibiotic prescribing by GPs in Belgium and associations between GP age and sex with prescribing volume and quality.Methods A retrospective analysis on nationwide administrative health data was conducted. Aggregated data on reimbursed systemic antibiotics (Anatomical Therapeutic Chemical J01) prescribed by GPs (2014-2023) were linked to the insured population (2014-2023), GP demographics (2014-2022) and consultation data (2014-2022). Volume was measured using population-based indicators: defined daily doses (DDD) and packages per 1000 beneficiaries per day (DBD and PBD) and prescriber-based indicators (DDD per GP, DDD and packages per consultation). Quality was evaluated using the proportion of amoxicillin among amoxicillin plus amoxicillin/clavulanate and the broad- to narrow-spectrum antibiotic ratio. Trends were analysed using Pearson correlations; associations using multivariable linear mixed models.Results Between 2014 and 2023, antibiotic volume decreased across all population-based indicators, with DDD, DBD and PBD decreasing by 16%, 19% and 18% (P < 0.01). Prescriber-based indicators also decreased between 2014 and 2022, with DDD per GP and packages per consultation declining by 27% and 40%, respectively (P < 0.01). Quality improved, with a 34% decrease in broad-to-narrow ratio and a 14% increase in the proportion of amoxicillin. Older and male GPs had higher volumes and less favourable quality indicators.Conclusions Antibiotic prescribing by Belgian GPs declined over the past decade, but differences by GP age and sex suggest opportunities for targeted antimicrobial stewardship.
SN - 2632-1823
ER -