# Antibiotic Prescription Patterns in Poland in the Years 2019–2024 Based on Reimbursement Data from the National Healthcare Fund

## TL;DR

This study examines how antibiotic prescriptions in Poland changed from 2019 to 2024, showing a decline during the pandemic followed by a rise, with amoxicillin with clavulanic acid being the most prescribed.

## Contribution

The study provides new insights into antibiotic prescription trends in Poland during and after the pandemic, highlighting the impact of point-of-care testing and prescribing preferences.

## Key findings

- Oral antibiotic prescriptions in Poland dropped during the pandemic but increased afterward.
- Amoxicillin with clavulanic acid was the most prescribed antibiotic, with its use increasing over time.
- Despite POC testing, antibiotic use continued to rise, indicating a need for improved stewardship.

## Abstract

Background/Objectives: The global response to the COVID-19 pandemic included a notable shift in antibiotic prescribing patterns, with use declining and then rising again as restrictions were lifted. In Poland, point-of-care (POC) testing for infections such as influenza A/B, COVID-19, respiratory syncytial virus (RSV), and Group A Streptococcus was widely introduced in primary care in recent years. This study investigates the patterns of oral antibiotic prescription in Poland during the pandemic and post-pandemic periods. Methods: We analyzed Polish National Healthcare Fund data on reimbursed oral antibiotics—Anatomical Therapeutic Chemical (ATC) J01 class—sold between 2019 and 2024. We quantified antibiotic groups by the number of packages sold and individual agents using the defined daily dose per 1000 inhabitants per day (DDD/TID). Results: Total oral antibiotic reimbursements noted a significant fall from 2019 to 2020 (20.9 million vs. 14.5 million packages reimbursed) and subsequently surged from 16.3 million packages in 2021 to 20.9 million in 2024. The most prescribed groups were penicillins (J01C), macrolides (J01F), and other beta-lactams (J01D). Amoxicillin with clavulanic acid was the most commonly used individual antibiotic, with its DDD/TID rising from an average of 2.3 to 2.6 in 2024. Although the use of phenoxymethylpenicillin initially decreased after the introduction of “strep-tests” in 2022 (DID 0.18 in 2023 vs. 0.23 in 2022), it increased again to 0.26 in 2024. Conclusions: Our findings demonstrate a slight continuous increase in oral antibiotic use in Poland, despite the current widespread availability of POC testing. The persistent and growing preference for amoxicillin with clavulanic acid, an agent not typically recommended as first-line treatment for most infections, suggests that antibiotic stewardship efforts need to continue in order to curb inappropriate prescription.