Generic Versus Brand-Name Antibiotic Prescribing and Utilization Patterns Across Healthcare Settings: A Narrative Review

Author

Harshith Gowda Mysore Nagendra, Anu Shashidhara, Hithesh Saligrama Rudrachala, Shreyas Ramasamudra Venkatesha, Sheba Baby John, Bettaswamy Huraliganaganahalli Vykuntappa, Hanumantachar Joshi

Abstract

 Background: Antibiotics are essential medicines for the treatment of bacterial infections, but their benefits can be reduced when prescribing is inappropriate or unnecessarily costly. The choice between generic and brand-name prescribing is an important aspect of rational medicine use, as it may influence prescription transparency, treatment cost, and antimicrobial stewardship. Previous studies have reported considerable differences in prescribing practices across clinical specialties and healthcare settings, with brand-name prescribing remaining common in many hospital-based settings.

Objective: To review and summarize the available evidence on generic versus brand-name antibiotic prescribing and to identify variations in prescribing patterns across different healthcare settings.

Methods: A structured literature review was conducted using PubMed, Google Scholar, and Scopus. Studies published between 2021 and 2026 were considered using search terms related to antibiotic prescribing, generic prescribing, brand-name prescribing, antibiotic utilization, and rational medicine use. Studies conducted in hospitals and other healthcare settings and reporting relevant antibiotic prescribing data were included. Eleven eligible studies were identified. Information on study design, setting, population, and generic and brand-name antibiotic prescribing patterns was extracted and synthesized narratively. Results: The review demonstrated substantial variation in antibiotic prescribing practices between healthcare settings and patient groups. Of the 11 included studies, brand-name prescribing was predominant in 8 studies (72.7%), whereas generic prescribing was predominant in 3 studies (27.3%). Higher levels of brand-name prescribing were reported in surgical (86.21%), postoperative (80%), and ENT (100%) settings. In contrast, generic prescribing was more prominent in some outpatient and paediatric settings, including 87.5% in a South Indian outpatient study and 74.18% in a pediatric outpatient study. These findings indicate that prescribing practices are influenced by the clinical setting, patient population, institutional practices, and prescriber preferences.

Conclusion: Brand-name antibiotics were more frequently reported than generic antibiotics across the reviewed studies, particularly in several hospital-based and specialty settings. Promoting the use of generic or International Nonproprietary Names (INN), together with regular prescription audits, hospital-specific prescribing guidelines, and educational initiatives, may improve prescription transparency and support more economical and rational antibiotic use. Strengthening such measures could also contribute to broader antimicrobial stewardship efforts.

Keywords

Antibiotics; generic prescribing; brand-name prescribing; antibiotic utilization; rational drug use; antimicrobial stewardship.

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References

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