Background: Antibiotic consumption in Italy is above the European average, as is the rate of antimicrobial resistance. In 2022, an updated national action plan was implemented to address this concern.       

Aims: To determine current antibiotic prescribing patterns of Italian general practitioners (GPs) for sore throat.

Methods: A retrospective observational study analysed Italian primary care prescribing data between November 2018 and October 2021. The dataset from IQVIA Ltd® Longitudinal Patient Database (LPD) was filtered to identify patients with laryngitis, pharyngitis (sore throat), tonsilitis, or, glandular fever diagnosis within 14 days of an antibiotic prescription.

Results: Antibiotic prescribing mirrored the seasonal trend of selected respiratory infections and was most closely associated with high-prescriber GPs. Over three years, a downward trend in patients diagnosed with sore throat was seen (reduced by 20,000 between Nov 2018 and Oct 2021). Despite a ?49% decline in the absolute number of antibiotics prescribed to patients diagnosed with sore throat, there was a 6% increase in the proportion of antibiotics prescribed (2019 vs. 2021). Of all GPs, 24% (?17,000) were high-prescribers, accounting for 53% of all antibiotic prescriptions, of which, 59% were to patients with sore throat (Oct 2021). The majority of second-line prescriptions were a subsequent antibiotic, including to patients with sore throat.

Conclusion: Despite a decline in antibiotic prescribing, data demonstrate the ongoing use of antibiotics first-line to patients with sore throat, highlighting a need to facilitate educational campaigns and antimicrobial stewardship, possibly mostly targeting high antibiotic prescribers.