Consumption of antibiotics in the community, European Union/European Economic Area, 1997–2017

Abstract

Objectives Data on antibiotic consumption in the community were collected from 30 EU/EEA countries over two decades. This article reviews temporal trends, seasonal variation, presence of change-points and changes in the composition of the main antibiotic groups. Methods For the period 1997–2017, data on consumption of antibiotics, i.e. antibacterials for systemic use (ATC group J01), in the community, aggregated at the level of the active substance, were collected using the WHO ATC/DDD methodology (ATC/DDD index 2019). Consumption was expressed in DDD per 1000 inhabitants per day and in packages per 1000 inhabitants per day. Antibiotic consumption was analysed based on ATC-3 groups, and presented as trends, seasonal variation, presence of change-points and compositional changes. Results In 2017, antibiotic consumption in the community expressed in DDD per 1000 inhabitants per day varied by a factor 3.6 between countries with the highest (Greece) and the lowest (the Netherlands) consumption. Antibiotic consumption in the EU/EEA did not change significantly over time. Antibiotic consumption showed a significant seasonal variation, which decreased over time. The number of DDD per package significantly increased over time. The proportional consumption of sulphonamides and trimethoprim (J01E) relative to other groups significantly decreased over time, while the proportional consumption of other antibacterials (J01X) relative to other groups significantly increased over time. Conclusions Overall, antibiotic consumption in the community in the EU/EEA did not change during 1997–2017, while seasonal variation consistently decreased over time. The number of DDD per package increased during 1997–2017.

Point-of-care testing, antibiotic prescribing, and prescribing confidence for respiratory tract infections in primary care: a prospective audit in 18 European countries

“…Several other studies have described the differences in numbers, types and appropriateness of prescribed antibiotics between European countries. 1,3,6,7,19,30,31 The prescribing proportion in our PPAS were not always congruent with the ranking in ECDC reports 6,7 in which, for example, the Netherlands ranks lowest and Belgium considerably higher. However, overall antibiotic use is not only determined by the prescribing proportion, but also by the number of patients that yearly present to a GP, the denominator.…”

“…This prospective 18-country audit of nearly 5,000 primary care consultations for RTI confirms considerable variation in both the proportion and the class of antibiotics prescribed. 6,7 There was also considerable variation in clinical assessments, POC and laboratory/hospital-based testing, and in non-antibiotic prescriptions. However, GPs consistently expressed a high level of confidence in their decision whether or not to prescribe antibiotics.…”

“…3 Despite antibiotic surveillance and stewardship programs in many countries, these differences persist. [4][5][6][7] Prudent use of antibiotics is fundamental to contain antimicrobial resistance, reduce unnecessary exposure of patients to its side-effects, contain costs, and guide patients expecting antibiotics for common infectious syndromic illness. [8][9][10][11] About 80-90% of antibiotics are prescribed in primary care, where over-prescribing is common for respiratory tract infections (RTI).…”

Consumption of Antibacterials for Systemic Use in Slovakia: A National Study and the Quality Indicators for Outpatient Antibiotic Use

“…We demonstrated that the consumption of antibacterials for systemic use in the primary care sector fell by 31.29% in Slovakia between 2011 and 2020. An international study by Bruyndonckx et al [16] describes trends in 30 EU/EEA countries, including Slovakia, of antibiotic consumption for the primary care sector and shows a decrease in Slovakia consistent with the results of our study.…”

Occurrence of Nine Antibiotics in Different Kinds of Sewage Sludge, Soils, Corn and Grapes After Sludge Spreading

“…Globally, between the years 2000-2015, 42.3 billion DDD were consumed by humans and the antibiotics consumption rate increased 39%, being higher in high-income countries (Klein et al, 2018), with amoxicillin and amoxicillin/clavulanic acid being the most frequently consumed antibiotics in most countries (Aldeyab et al, 2020). Within the European Union, the antibiotics more consumed are the ones from the group of β-Lactam antibacterial molecules and penicillins (42.3%) and the general consumption pattern has not significantly change in the period 1997-2017 (Bruyndonckx et al, 2021). The country raking of antibiotic consumption in Europe is led by Greece, with Cyprus and Spain in second and third place, respectively (Bruyndonckx et al, 2021).…”