Purpose: Antibiotic resistance is one of the biggest threats to global health today. The aim of this study was to analyze antibiotic prescribing patterns and quality of prescribing in Croatian dental practices over a 5-year period. Methods: This is a retrospective observational study based on the analysis of the electronic prescriptions (medicines in ATC groups J01 and P01) from dental practices in Croatia prescribed from 1 January 2015 to 31 December 2019. Prescriptions were retrieved from the Croatian Health Insurance Fund (HZZO). The analyses included the number of prescriptions, type and quantity of prescribed drugs, indication, and the patient’s and prescriber’s characteristics. Results: The consumption increased from 1.98 DID in 2015, to 2.10 DID in 2019. The most prescribed antibiotic was Amoxicillin with clavulanic acid followed by Amoxicillin, Clindamycin, Metronidazole and Cefalexin. The analyses showed that 29.79% of antibiotics were not prescribed in accordance with the contemporary guidelines for the proper use of antibiotics. Additionally, 22% of antibiotics were prescribed in inconclusive indications. Conclusion: The research showed an increase in antibiotic consumption over five years along with unnecessary prescribing of antibiotics in cases with no indications for its use. The development of national guidelines for antibiotic use is necessary.

Purpose: The COVID-19 pandemic had detrimental effects on the mental health of populations, with differing influences on different demographic groups. Varying national countermeasures to the pandemic may have further impacted these effects. This study aimed to explore the effects of the pandemic on dispensed volumes of antidepressants in outpatient settings in different regions of Europe and to assess potential age- and sex-related differences of its impact on incidence of antidepressant dispensing. Methods: We used descriptive and interrupted time series analyses of pharmacy dispensing data on volumes. For six regions, we analysed volume and incident use stratified by age and sex. Results: During the pandemic, the preexisting long-term trend in unstratified dispensed volumes significantly increased only in Slovenia and Germany and weakened in Scotland and Wales (estimated changes in slope + 0.16, + 0.10, − 0.23, and − 0.68 defined daily doses per thousand inhabitants per day, respectively, for each month). The stratified quarterly analysis revealed the greatest relative increase in females aged 0–17 (+ 64% in Sweden to + 167% in Croatia in the last quarter of 2022 compared with the last quarter of 2019). Both rate of change and difference between sexes were lower in higher age groups. Incidence increased most steeply in females aged 0–17, where the estimated pandemic-related increase explained 11% (Sweden) to 55% (Lombardy) of new patients receiving antidepressants. Conclusion: Our findings indicate the need to develop targeted mental health supporting measures to increase resilience, especially in young people, and mitigate the impact of potential future public health crises.

Biopharmaceuticals add value in the treatment of many diseases but different health systems in Europe face clinical and economic challenges with introducing them. Joint efforts across Europe are therefore essential to ensure their sustainable and equitable use. However, to date few cross-national comparative studies have assessed their introduction. This study aimed to assess the availability of health authority data and variation in the early diffusion of biopharmaceuticals across Europe. A cross-sectional study was undertaken to analyze the diffusion of 17 biopharmaceuticals, approved between 2015 and 2019, among European countries between 2015 and 2022. The study assessed data availability, diffusion rates measured as accumulated defined daily doses per 1000 inhabitants, as well as relative rankings between countries during the first 4 years following market authorization. Twenty countries and two regions out of 31 European countries provided data on biopharmaceutical utilization for out-of-hospital care, 15 provided wholesaler data, and 14 provided hospital data. Certain countries and regions contributed data in multiple categories, while six did not provide any data. Diffusion rates were assessed for 17 countries and two regions, which showed appreciable variation, with secukinumab and erenumab being introduced in most countries and follitropin delta and tildrakizumab in the least number of countries. Germany, Austria, and Norway demonstrated the highest early diffusion rates, while Lithuania, Romania, and Latvia had the lowest. This study revealed a substantial variation between European countries and regions in the early diffusion of biopharmaceuticals and the availability of data to monitor their use. The reasons behind these patterns require further investigation to support European countries in optimizing the use of biopharmaceuticals to reach an equitable and cost-effective use of medicines across Europe.

This work aimed to analyze pediatric Post-Authorization Studies (PASs) registered in the European Union electronic Register of Post-Authorization Studies (EU PAS Register) from September 2010 until April 2023 to identify trends in terms of timing, age groups and therapeutic areas, and to discuss pediatric specificities and sources of funding for the PASs. A screening process identified PASs conducted exclusively on the pediatric population, and instructions were provided to ensure standardized data collection from the EU PAS Register. A univariate linear regression descriptive analysis was performed to assess trends over time, while a multivariate linear regression analysis helped explore additional characteristics of the studies. Of the 2,574 PASs extracted from the EU PAS Registry, 165 were included in the analysis. The majority of pediatric PASs were observational studies (86%), and most of them utilized secondary data (53%). The annual number of PASs increased significantly between 2010 and 2023. As envisaged, the largest part was funded by pharmaceutical companies (62%). Anti-infectives for systemic uses (25%), medicines for the nervous system (18%), and antineoplastic and immunomodulating agents (15%) resulted the most studied drugs. Our findings show that post-marketing observational research in pediatric populations has increased over time. Nevertheless, industry-academia collaboration should be encouraged, and regulatory guidance is needed to prioritize research in areas of unmet therapeutic need.

To assess antidepressant prescribing patterns in Croatia. This retrospective study assessed electronic prescription patterns for antidepressants (Anatomical Therapeutic Chemical code N06A) in Croatia from 2017 to 2022. We collected data on annual prescription counts, drug types, drug utilization, utilization trends, indications, and patient demographics. Over six years, 8.66 million antidepressant prescriptions were issued to 415 328 patients in Croatian primary care. Utilization increased by 22.32% (from 22.4 to 27.4 defined daily doses per 1000 inhabitants per day) but remained below the European average. Selective serotonin reuptake inhibitors accounted for nearly 60% of prescriptions. Women and older adults (≥65 years) were the primary users. Despite rising antidepressant use, Croatia lags behind other European countries, possibly due to high benzodiazepine use. The prescribing pattern highlights the need for targeted, evidence-based mental health policies. Special attention should be given to pediatric patients, the elderly, and patients affected by war-related trauma, while also exploring socioeconomic influences on prescribing practices.