ABSTRACT
Introduction: The inappropriate use of antibiotics is associated with greater antimicrobial resistance, health care costs, adverse events, and worse clinical outcomes. Objective: To determine the prescription patterns and approved and non-approved indications of macrolides in a group of patients from Colombia. Materials and methods: a cross-sectional study on the indications for the use of macrolides in outpatients based on a drug dispensing database of approximately 8.5 million people affiliated with the Colombian Health System. Sociodemographic, pharmacological and clinical variables were considered. Results: 9344 patients were identified with some macrolide prescription, with a median age of 40.1 years [interquartile range: 27.1-53.3 years] and 58.3% women. The most commonly prescribed macrolide was azithromycin (38.8%) and the most frequently found uses were Helicobacter pylori infection (15.9%) and pneumonia treatment (15.8%). 31.3% of prescriptions were used for unapproved indications, with the common cold (7.8%), COVID-19 (4.0%), and acute bronchitis (3.5%) standing out. Reside in the Caribbean region (OR:1.17;95%CI:1.05-1.31), dental prescriptions (OR:2.75;95 degrees ACI:1.91-3.96), have chronic respiratory comorbidities (OR:1.30;95 degrees ACI:1.08-1.56), prescribe erythromycin (OR:3.66;95%CI:3.24-4.14) or azithromycin (OR:2.15;95%CI:1,92-2.41), were associated with a higher probability of receiving them for unapproved indications, but being between 18-64 years old (OR:0.81;95 degrees ACI:0.71-0.93), 65 or more years (OR:0.77;95%CI:0.63-0.94) and residing in Bogota-Cundinamarca (OR:0.74;95%CI:0.65-0.85) reduced this risk. Conclusions: Most patients have received macrolides for respiratory tract infections;however, erythromycin and azithromycin are being used in unapproved indications in people under 18 years of age, and those with chronic respiratory diseases.