{"id":"https://openalex.org/W4389925657","doi":"https://doi.org/10.1371/journal.pone.0296048","title":"Outpatient antibiotic prescribing during the first two years of the COVID-19 pandemic: A nationwide register-based time series analysis","display_name":"Outpatient antibiotic prescribing during the first two years of the COVID-19 pandemic: A nationwide register-based time series analysis","publication_year":2023,"publication_date":"2023-12-18","ids":{"openalex":"https://openalex.org/W4389925657","doi":"https://doi.org/10.1371/journal.pone.0296048","pmid":"https://pubmed.ncbi.nlm.nih.gov/38109384","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/10727428"},"language":"en","primary_location":{"id":"doi:10.1371/journal.pone.0296048","doi":"https://doi.org/10.1371/journal.pone.0296048","is_oa":true,"landing_page_url":"https://doi.org/10.1371/journal.pone.0296048","pdf_url":null,"source":{"id":"https://openalex.org/S202381698","display_name":"PLoS ONE","issn_l":"1932-6203","issn":["1932-6203"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","cwts-core","doaj","dongbi-c","doyens","erih-plus","jufo-1","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315706","host_organization_name":"Public Library of Science","host_organization_lineage":["https://openalex.org/P4310315706"],"host_organization_lineage_names":["Public Library of Science"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"PLOS ONE","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.1371/journal.pone.0296048","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5044890862","display_name":"Heini Kari","orcid":"https://orcid.org/0000-0002-2061-2552","observed_orcids":["https://orcid.org/0000-0002-2061-2552"]},"institutions":[{"id":"https://openalex.org/I2799521863","display_name":"Social Insurance Institution","ror":"https://ror.org/057yw0190","country_code":"FI","type":"government","lineage":["https://openalex.org/I2799521863"]}],"countries":["FI"],"is_corresponding":true,"raw_author_name":"Heini Kari","raw_affiliation_strings":["Research Unit, The Social Insurance Institution of Finland (Kela), Helsinki, Finland"],"raw_orcid":"https://orcid.org/0000-0002-2061-2552","affiliations":[{"raw_affiliation_string":"Research Unit, The Social Insurance Institution of Finland (Kela), Helsinki, Finland","institution_ids":["https://openalex.org/I2799521863"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5030664556","display_name":"Hanna R\u00e4tt\u00f6","orcid":"https://orcid.org/0000-0002-5122-1175","observed_orcids":["https://orcid.org/0000-0002-5122-1175"]},"institutions":[{"id":"https://openalex.org/I2799521863","display_name":"Social Insurance Institution","ror":"https://ror.org/057yw0190","country_code":"FI","type":"government","lineage":["https://openalex.org/I2799521863"]}],"countries":["FI"],"is_corresponding":false,"raw_author_name":"Hanna R\u00e4tt\u00f6","raw_affiliation_strings":["Research Unit, The Social Insurance Institution of Finland (Kela), Helsinki, Finland"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Research Unit, The Social Insurance Institution of Finland (Kela), Helsinki, Finland","institution_ids":["https://openalex.org/I2799521863"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5027143404","display_name":"Leena Saastamoinen","orcid":"https://orcid.org/0000-0002-0887-0137","observed_orcids":["https://orcid.org/0000-0002-0887-0137"]},"institutions":[{"id":"https://openalex.org/I4210150926","display_name":"Finnish Medicines Agency Fimea","ror":"https://ror.org/04mjpp490","country_code":"FI","type":"government","lineage":["https://openalex.org/I4210150926","https://openalex.org/I4210159665"]}],"countries":["FI"],"is_corresponding":false,"raw_author_name":"Leena Saastamoinen","raw_affiliation_strings":["The Finnish Medicines Agency, Fimea, Helsinki, Finland"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"The Finnish Medicines Agency, Fimea, Helsinki, Finland","institution_ids":["https://openalex.org/I4210150926"]}]},{"author_position":"last","author":{"id":null,"display_name":"Hanna Koskinen","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2799521863","display_name":"Social Insurance Institution","ror":"https://ror.org/057yw0190","country_code":"FI","type":"government","lineage":["https://openalex.org/I2799521863"]}],"countries":["FI"],"is_corresponding":false,"raw_author_name":"Hanna Koskinen","raw_affiliation_strings":["Research Unit, The Social Insurance Institution of Finland (Kela), Helsinki, Finland"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Research Unit, The Social Insurance Institution of Finland (Kela), Helsinki, Finland","institution_ids":["https://openalex.org/I2799521863"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5044890862"],"corresponding_institution_ids":["https://openalex.org/I2799521863"],"apc_list":{"value":1805,"currency":"USD","value_usd":1805},"apc_paid":{"value":1805,"currency":"USD","value_usd":1805},"fwci":2.5037,"has_fulltext":true,"cited_by_count":13,"citation_normalized_percentile":{"value":0.88629957,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":88,"max":99},"biblio":{"volume":"18","issue":"12","first_page":"e0296048","last_page":"e0296048"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10897","display_name":"Antibiotic Use and Resistance","score":0.9961000084877014,"subfield":{"id":"https://openalex.org/subfields/2725","display_name":"Infectious Diseases"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10897","display_name":"Antibiotic Use and Resistance","score":0.9961000084877014,"subfield":{"id":"https://openalex.org/subfields/2725","display_name":"Infectious Diseases"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11296","display_name":"COVID-19 and healthcare impacts","score":0.0015999999595806003,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10410","display_name":"COVID-19 epidemiological studies","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2611","display_name":"Modeling and Simulation"},"field":{"id":"https://openalex.org/fields/26","display_name":"Mathematics"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/covid-19","display_name":"COVID-19 pandemic","score":0.9800000190734863},{"id":"https://openalex.org/keywords/outpatient-antibiotic-prescribing","display_name":"outpatient antibiotic prescribing","score":0.9589999914169312},{"id":"https://openalex.org/keywords/respiratory-tract-infections","display_name":"respiratory infections","score":0.9139999747276306},{"id":"https://openalex.org/keywords/children","display_name":"children","score":0.5820000171661377},{"id":"https://openalex.org/keywords/azithromycin","display_name":"azithromycin","score":0.9879999756813049},{"id":"https://openalex.org/keywords/amoxicillin","display_name":"amoxicillin","score":0.9959999918937683},{"id":"https://openalex.org/keywords/doxycycline","display_name":"doxycycline","score":0.9990000128746033},{"id":"https://openalex.org/keywords/finland","display_name":"Finland","score":0.7429999709129333}],"concepts":[{"id":"https://openalex.org/C89623803","wikidata":"https://www.wikidata.org/wiki/Q12184","display_name":"Pandemic","level":5,"score":0.8067684769630432},{"id":"https://openalex.org/C2778907293","wikidata":"https://www.wikidata.org/wiki/Q165399","display_name":"Azithromycin","level":3,"score":0.8014653921127319},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.7849768400192261},{"id":"https://openalex.org/C2426938","wikidata":"https://www.wikidata.org/wiki/Q3355478","display_name":"Medical prescription","level":2,"score":0.7846629619598389},{"id":"https://openalex.org/C187212893","wikidata":"https://www.wikidata.org/wiki/Q123028","display_name":"Pediatrics","level":1,"score":0.5146063566207886},{"id":"https://openalex.org/C61511704","wikidata":"https://www.wikidata.org/wiki/Q1671857","display_name":"Incidence (geometry)","level":2,"score":0.4756735861301422},{"id":"https://openalex.org/C2776012195","wikidata":"https://www.wikidata.org/wiki/Q754447","display_name":"Respiratory tract infections","level":3,"score":0.46957799792289734},{"id":"https://openalex.org/C501593827","wikidata":"https://www.wikidata.org/wiki/Q12187","display_name":"Antibiotics","level":2,"score":0.4679167568683624},{"id":"https://openalex.org/C3008058167","wikidata":"https://www.wikidata.org/wiki/Q84263196","display_name":"Coronavirus disease 2019 (COVID-19)","level":4,"score":0.43685993552207947},{"id":"https://openalex.org/C2779708577","wikidata":"https://www.wikidata.org/wiki/Q201928","display_name":"Amoxicillin","level":3,"score":0.4262828826904297},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.2890692353248596},{"id":"https://openalex.org/C524204448","wikidata":"https://www.wikidata.org/wiki/Q788926","display_name":"Infectious disease (medical specialty)","level":3,"score":0.21887832880020142},{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.1157049834728241},{"id":"https://openalex.org/C534529494","wikidata":"https://www.wikidata.org/wiki/Q7891","display_name":"Respiratory system","level":2,"score":0.09360957145690918},{"id":"https://openalex.org/C89423630","wikidata":"https://www.wikidata.org/wiki/Q7193","display_name":"Microbiology","level":1,"score":0.0},{"id":"https://openalex.org/C86803240","wikidata":"https://www.wikidata.org/wiki/Q420","display_name":"Biology","level":0,"score":0.0},{"id":"https://openalex.org/C120665830","wikidata":"https://www.wikidata.org/wiki/Q14620","display_name":"Optics","level":1,"score":0.0},{"id":"https://openalex.org/C98274493","wikidata":"https://www.wikidata.org/wiki/Q128406","display_name":"Pharmacology","level":1,"score":0.0},{"id":"https://openalex.org/C121332964","wikidata":"https://www.wikidata.org/wiki/Q413","display_name":"Physics","level":0,"score":0.0}],"mesh":[{"descriptor_ui":"D000086382","descriptor_name":"COVID-19","qualifier_ui":"Q000453","qualifier_name":"epidemiology","is_major_topic":true},{"descriptor_ui":"D000900","descriptor_name":"Anti-Bacterial Agents","qualifier_ui":"Q000627","qualifier_name":"therapeutic use","is_major_topic":false},{"descriptor_ui":"D002648","descriptor_name":"Child","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D010045","descriptor_name":"Outpatients","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D010818","descriptor_name":"Practice Patterns, Physicians'","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D012141","descriptor_name":"Respiratory Tract Infections","qualifier_ui":"Q000188","qualifier_name":"drug therapy","is_major_topic":true},{"descriptor_ui":"D012141","descriptor_name":"Respiratory Tract Infections","qualifier_ui":"Q000453","qualifier_name":"epidemiology","is_major_topic":true},{"descriptor_ui":"D013997","descriptor_name":"Time Factors","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D058873","descriptor_name":"Pandemics","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":4,"locations":[{"id":"doi:10.1371/journal.pone.0296048","doi":"https://doi.org/10.1371/journal.pone.0296048","is_oa":true,"landing_page_url":"https://doi.org/10.1371/journal.pone.0296048","pdf_url":null,"source":{"id":"https://openalex.org/S202381698","display_name":"PLoS ONE","issn_l":"1932-6203","issn":["1932-6203"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","cwts-core","doaj","dongbi-c","doyens","erih-plus","jufo-1","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315706","host_organization_name":"Public Library of Science","host_organization_lineage":["https://openalex.org/P4310315706"],"host_organization_lineage_names":["Public Library of Science"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"PLOS ONE","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:10727428","doi":null,"is_oa":true,"landing_page_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/10727428","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC10727428/pdf/pone.0296048.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"PLoS One","raw_type":"Text"},{"id":"pmid:38109384","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/38109384","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"PloS one","raw_type":"Journal Article"},{"id":"pmh:oai:doaj.org/article:bb1ca2be2e3d4ce2acb3af7a0c685f04","doi":null,"is_oa":true,"landing_page_url":"https://doaj.org/article/bb1ca2be2e3d4ce2acb3af7a0c685f04","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-sa","license_id":"https://openalex.org/licenses/cc-by-sa","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"PLoS ONE, Vol 18, Iss 12, p e0296048 (2023)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.1371/journal.pone.0296048","doi":"https://doi.org/10.1371/journal.pone.0296048","is_oa":true,"landing_page_url":"https://doi.org/10.1371/journal.pone.0296048","pdf_url":null,"source":{"id":"https://openalex.org/S202381698","display_name":"PLoS ONE","issn_l":"1932-6203","issn":["1932-6203"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","cwts-core","doaj","dongbi-c","doyens","erih-plus","jufo-1","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315706","host_organization_name":"Public Library of Science","host_organization_lineage":["https://openalex.org/P4310315706"],"host_organization_lineage_names":["Public Library of Science"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"PLOS ONE","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":0.9940000176429749,"display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[],"funders":[{"id":"https://openalex.org/F4320332162","display_name":"Centers for Disease Control and Prevention","ror":"https://ror.org/042twtr12"}],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W4389925657.pdf","grobid_xml":"https://content.openalex.org/works/W4389925657.grobid-xml"},"referenced_works_count":40,"referenced_works":["https://openalex.org/W2064618548","https://openalex.org/W2110132657","https://openalex.org/W2116512828","https://openalex.org/W2153686999","https://openalex.org/W2171609823","https://openalex.org/W2788449581","https://openalex.org/W2899841051","https://openalex.org/W2946159727","https://openalex.org/W3048866099","https://openalex.org/W3081257581","https://openalex.org/W3083086284","https://openalex.org/W3090113966","https://openalex.org/W3107105670","https://openalex.org/W3129497188","https://openalex.org/W3138970751","https://openalex.org/W3151080094","https://openalex.org/W3161021559","https://openalex.org/W3207150419","https://openalex.org/W3209912185","https://openalex.org/W3211444262","https://openalex.org/W3211612101","https://openalex.org/W3213715446","https://openalex.org/W3214518775","https://openalex.org/W3216351184","https://openalex.org/W4210735115","https://openalex.org/W4210844632","https://openalex.org/W4214807149","https://openalex.org/W4220892919","https://openalex.org/W4220893544","https://openalex.org/W4225562530","https://openalex.org/W4229010988","https://openalex.org/W4229049870","https://openalex.org/W4280648473","https://openalex.org/W4281384289","https://openalex.org/W4281390447","https://openalex.org/W4281842559","https://openalex.org/W4283813547","https://openalex.org/W4290473322","https://openalex.org/W4307122135","https://openalex.org/W6803253813"],"related_works":["https://openalex.org/W4280557331","https://openalex.org/W3210368323","https://openalex.org/W3113524663","https://openalex.org/W3194495328","https://openalex.org/W4306736872","https://openalex.org/W4403955233","https://openalex.org/W3209912185","https://openalex.org/W4290861712","https://openalex.org/W4214622184","https://openalex.org/W4403155304"],"abstract_inverted_index":{"The":[0,42,162],"COVID-19":[1,54,139,215],"pandemic":[2,55,140,216],"has":[3],"imposed":[4],"an":[5,80],"enormous":[6],"burden":[7],"on":[8,56],"health":[9],"care":[10],"systems":[11],"around":[12],"the":[13,23,50,53,63,68,91,97,100,102,138,159,188,195,214],"world.":[14],"Simultaneously,":[15],"many":[16],"countries":[17],"have":[18],"reported":[19],"a":[20,36,121,144],"decrease":[21,164,189],"in":[22,38,60,126,165,179],"incidence":[24],"of":[25,44,52,67,104,107,124,129,148],"other":[26],"infectious":[27],"diseases,":[28],"such":[29],"as":[30],"acute":[31],"respiratory":[32,185],"infections,":[33,187],"leading":[34],"to":[35,48,115,134,153,192],"decline":[37,147],"outpatient":[39,57],"antibiotic":[40,58,108,166,176,181,210],"use.":[41],"aim":[43],"this":[45],"study":[46],"is":[47],"assess":[49],"impact":[51],"prescribing":[59,167,177,211],"Finland":[61],"during":[62,213],"first":[64],"2":[65],"years":[66],"pandemic.":[69],"We":[70],"used":[71],"nationwide":[72],"register":[73],"data,":[74],"applied":[75],"descriptive":[76],"methods,":[77],"and":[78,118,202,217],"conducted":[79],"interrupted":[81],"time":[82],"series":[83],"analysis":[84],"(ITSA)":[85],"using":[86],"ARIMA":[87,92],"modelling.":[88],"Results":[89],"from":[90,158,190],"modelling":[93],"showed":[94],"that":[95],"at":[96],"baseline,":[98],"before":[99],"pandemic,":[101],"level":[103],"monthly":[105,127],"number":[106,128],"prescriptions":[109,130,156],"was":[110,120,143,168,194],"248,560":[111],"(95%":[112,131,150],"CI:":[113,132,151],"224,261":[114],"272,856;":[116],"p<0.001)":[117,155],"there":[119,142],"decreasing":[122],"trend":[123],"1,202":[125],"-2,107":[133],"-262;":[135],"p<0.01).":[136],"After":[137],"began,":[141],"statistically":[145],"significant":[146],"48,470":[149],"-76,404":[152],"-20,535,":[154],"(-19.5%":[157],"baseline":[160],"level).":[161],"greatest":[163],"observed":[169],"among":[170],"children":[171],"aged":[172],"0-17":[173],"years.":[174],"While":[175],"declined":[178],"all":[180],"groups":[182],"associated":[183],"with":[184,197],"tract":[186],"2019":[191],"2020":[193],"largest":[196],"azithromycin":[198],"(52.6%),":[199],"amoxicillin":[200],"(44.8%),":[201],"doxycycline":[203],"(43.8%).":[204],"Future":[205],"studies":[206],"should":[207],"continue":[208],"exploring":[209],"trends":[212],"beyond.":[218]},"counts_by_year":[{"year":2026,"cited_by_count":6},{"year":2025,"cited_by_count":6},{"year":2024,"cited_by_count":1}],"updated_date":"2026-11-07T11:25:07.637180","created_date":"2023-12-19T00:00:00"}