Amoxicillin dosing recommendations are very different in European countries: a cross-sectional survey

Abstract

National antibiotic stewardship programmes recommend monitoring antibiotic consumption and benchmarking. The WHO recommend the Anatomic Therapeutic Chemical classification and respective Defined Daily Doses (DDD) for drug utilization research [1]. This is the most frequently used unit of measure within the European Union (EU). Wide variations in antibiotic consumption exist between EU countries in the outpatient setting, ranging in 2012 from 11.3 (the Netherlands) to 31.9 DDD per 1000 inhabitants and per day (Greece) [2]. Penicillins are the most consumed antibacterial agents in the community in all EU countries. Amoxicillin and amoxicillin/clavulanate are the two most widely prescribed penicillins, except in Denmark, Norway and Sweden where penicillin V and other very narrow-spectrum penicillins are used preferentially [2].

Preparedness to prescribe antibiotics responsibly: a comparison between final year medical students in France and Sweden

“…This manuscript presents a detailed sub-group analysis of responses from all participating medical schools in France and Sweden, which were selected for further analyses for two reasons: first, there are significant differences between these countries in the intensity and type of antibiotic use [6, 7]. The consumption of antibiotics is about two times higher per capita in France based on Defined Daily Doses, (although dosing is lower in Sweden), and narrow-spectrum antibiotics are used more frequently in Sweden [8]. Second, the response rates in the study were broadly consistent for participating schools in both countries.…”

Amoxicillin‐induced crystal nephropathy: A nationwide French pharmacovigilance databases study

“…In 2 of the 3 casereports, AICN contributing factors were found (low urinary pH, dehydration). One explanation of this discrepancy could be that France recommends higher intravenous AMX dose regimen in comparison to other European countries 38. Moreover, detection/identification of AMX crystals is not available in many countries, making the diagnosis of AICN difficult and probably leading to under-diagnosis.This study has several limitations.…”

Antibiotic stewardship: update and perspectives

“…In a cross-sectional observational study of 653 French adults, Demor e et al observed that participants' self-reports were relatively reliable for recent use of an antibiotic, but not for its name; they therefore recommend the use of electronic medical records shared among prescribers [13]. In a European survey, ESGAP (ESCMID Study Group for Antimicrobial stewardshiP) authors questioned the validity of Defined Daily Doses for comparing antibiotic use between countries, as amoxicillin dosing recommendations vary hugely between countries [14]. Finally, Singh and Manchanda presented suggestions for high-impact interventions to control multidrug-resistant Gram-negative bacteria in resource-limited settings [15].…”