Background

The prescription and use of antibiotics is the basic component of every national health policy. Rational utilization is important both for proper treatment and to prevent antimicrobial resistance.

Objectives

The objective of our study is to analyze the prescribing practice of antibiotics after the introduction of electronic prescriptions. We also analyzed the rationality of prescribing by comparing prescribed International Nonproprietary Names (INNs) with those recommended by the World Health Organization (WHO), prescribed generic antibiotics, as well as the prescribing of pediatric dosage forms.

Material and methods

The study is a comparative, quantitative research on the types of antibiotics prescribed in four major regional cities. Data were collected from April to December 2024.

Results

The most frequently prescribed antibiotics are amoxicillin with a beta-lactamase inhibitor, clarithromycin, cefixime, and azithromycin. They are listed in the WHO Model Essential Medicines List. In total, 51% of prescribed INNs are included in the Essential Medicines List (EML). Generics prescriptions made up 86.4% of all prescribed medicines. The consumption of cefixime reaches to 61.9% in pediatrics from total cefixime utilization, 64.23% of total utilization of clarithromycin are pediatric, and 44% of amoxicillin with clavulanic acid prescriptions are devoted to children’s therapy.

Conclusions

Prescribing of antibiotics is oriented towards wide spectrum therapeutic groups in the adult and pediatric population. The diversity in the market and the high utilization of registered generics are positive indicators, confirming that Bulgaria’s health policy effectively provides affordable and accessible therapy. Further analysis is needed to explain the regional variations and prescribing habits across different areas.