National outpatient antibiotic prescriptions in Cyprus, 2020–2022

Background: The misuse of antibiotics and the consequential rise in antimicrobial resistance (AMR) represent a significant global health concern. Cyprus currently reports to ESAC-Net the total consumption of antimicrobials, without distinguishing between hospital- and community-based antibiotic use. As a result, these data can only provide generalized insights into antimicrobial trends in the country. Aim: To evaluate antibiotic prescribing patterns in national outpatient services in Cyprus. Material and methods: We retrospectively analyzed the national community antibiotic prescriptions in Cyprus for the period 2020 – 2022. Data on community antimicrobial prescription were extracted from the National Insurance Organization (HIO) database. Orally administered dispensed antibiotics were categorized according to the WHO Anatomical Therapeutic Chemical (ATC) classification and by the WHO’s AWaRe (Access, Watch, Reserve) classification of antibiotics. Antibiotic prescriptions were calculated in both packages consumed and per 1000 beneficiaries, overall, by year, age groups, and medical specialty of prescribers. Results: During the period of 2020 – 2022, in total 1,458,723 antibacterial prescriptions for systemic use were ordered in Cyprus for outpatients. The annual rates of prescriptions per 1,000 beneficiaries demonstrated an increasing trend from 535.7 in 2020 to 653 in 2022, respectively. A decrease by 3.1% in the prescription of WHO “Access” antibiotics was observed, reaching 42.3% in 2022, which is much lower than the WHO’s goal of 60% and the EU’s goal of 70% for “Access” antibiotic consumption. Conclusions: Between 2020 and 2022, antibiotic prescriptions in the community of Cyprus showed an overall increase, accompanied by a declining trend in the proportion of “Access” antibiotics prescribed.