Abstract
Aim: We aimed to investigate community systemic antibiotic dispensing in New Zealand across 2010-2019.
Methods: This longitudinal study utilised dispensing data from the National Pharmaceutical Collection and population data from the Health New Zealand - Te Whatu Ora populations web tool. Dispensing rates were measured as the number of defined daily doses/1,000 inhabitants per day (DIDs) and courses dispensed/1,000 inhabitants/year. Dispensing data were stratified by antibiotic group, AWaRe (Access, Watch, Reserve) categories, district health board (DHB) region and patient characteristics.
Results: Between January 1 2010 and December 31 2019, community systemic antibiotic dispensing in New Zealand declined, with courses dispensed dropping from 930 to 782 (average annual change [AAC] -1.9%) and DID from 20.9 to 19.6 (AAC -0.75%). Watch antibiotics decreased by 8% in courses dispensed/1,000 inhabitants/year, with quinolones showing the largest proportional reduction (-37 courses dispensed/1,000 inhabitants/year; AAC -13.4%). Conversely, first-generation cephalosporins increased significantly (+45 courses dispensed/1,000 inhabitants/year; AAC +56%), primarily due to cefalexin. Ethnic differences persisted, with Pacific people consistently exhibiting the highest dispensing rates. Most DHB regions experienced an overall decline in dispensing during this period.
Conclusions: The study identified encouraging trends in antibiotic dispensing, reflecting New Zealand's antimicrobial stewardship initiatives, but also highlighted the rise in cefalexin and ongoing variations that require further investigation.