Number of Antibiotics, Asthma Medications Decreased for COVID-19 Pandemic

Ilari Kuitunen, MD, PhD

A nationwide study from Finland showed that from 2019 to 2020, the number of antibiotics and asthma medicines decreased by 59.6% and 19.8%, respectively.

Investigators led by Ilari Kuitunen, MD, PhD, University of Eastern Finland, Institute of Clinical Medicine, noted that this change led to a cost saving of 3.4 million Euros.

The investigators noted that during the COVID-19 pandemic, childhood infections had significantly reduced due to nationwide lockdowns and social restrictions. As such, they hypothesized that the need for systemic antibiotics and asthma medicines also changed during the pandemic.

This hypothesis was supported by similar studies that were conducted in the past, some of which noted that the overall number of emergency visits and hospitalizations due to respiratory infectious diseases decreased globally in children during the pandemic.

Additionally, an Italian study found that asthma control appeared to improve in about 20-30% of children during spring 2020.

Kuitunen and colleagues evaluated whether reduced infection rates were reflected by a decline in the number of systemic antibiotics and asthma medicines dispensed to children aged 0-12 in Finland during 2020.

The number of primary care visits in 2020 were compared to those in 2019, as well as the economic implications of these changes, were also evaluated.

The Study

The study was supported by data collected form nationwide open-access registers in Finland.

Medical drug use was collected form the register of reimbursed prescription medicines, which was maintained by the Social Insurance Institution of Finland.

The data also included the number of prescriptions for antibiotics and asthma medicine that were dispended for children aged 0-12 years in 2019 and 2020 and subsequently reimbursed.

Investigators then calculated prescription rates from reimbursed medicines per 1000 children as well as the changes between 2019 and 2020 with 95% confidence intervals.

Data on prescriptions and primary care visits were divided by 4 separate quarters in each year.

The Findings

Overall, a total of 331,857 dispensed prescriptions for courses of antibiotics were included in the data, 69.1% of which were dispensed in 2019 and 30.9% in 2020.

The total reimbursable expenses were 1,956,154 Euros in 2020 and 4,295,412 Euros in 2019, which was a total saving of 2.3 million Euros (54.5%).

Investigators found that dispensed prescriptions for all antibiotics fell by 55.3% in 2020, with the biggest decrease being recorded for macrolides (59.2%) and the smallest for cephalosporins (31.7%).

Likewise, the overall number of dispensed asthma medicines decreased in 2020, except for the group of other asthma medicines, which was higher than 2019.

Additionally, the number of asthma medicine prescriptions dispensed decreased by 19.8% in 2020 and the number of short-acting beta-agonist prescriptions dispensed reduced the most, by 27.3%.

Regarding primary care visits, a decreased was recorded in 2020 that was below the 2019 level in the second quarter but were higher than the third and fourth quarter of 2019.

Crucially, the data presented in the study showed that the first lockdown of the Covid-1 pandemic reduced the dispensing rates for systemic antibiotics and most of the asthma medicines available for Finnish children from birth to 12 years of age.

Investigators noted that these changes might have developed due to the impaired capacity of primary care resources rather than a real reduced need for the medicines, though they believed the data did not indicate this.

“Lockdowns and social restrictions during the first and second waves of COVID-19 in Finland led to significant reductions in antibiotics and asthma medicines dispensed to children aged 0-12,” the team wrote. “In turn, this led to a large reduction in reimbursement rates. The reductions in dispensing were not due to insufficient primary care resources.”

The study, “Systemic antibiotics and asthma medicines dispensed to 0-12 year olds significantly decreased during the COVID-19 pandemic in 2020,” was published online in Acta Paediatrica.