European Surveillance of Antimicrobial Consumption (ESAC): outpatient antibiotic use in Europe, 1998-2005

Abstract

†These authors contributed equally to this work.Objectives: To describe total outpatient systemic antibiotic use in Europe from 1997 to 2009 and to analyse statistically trends of total use and composition of use over time.Methods: For the period 1997-2009, data on outpatient use of systemic antibiotics aggregated at the level of the active substance were collected and expressed in defined daily doses (WHO, version 2011) and packages per 1000 inhabitants per day (DID and PID, respectively). Outpatient antibiotic (ATC J01) use in DID in the 33 European countries able to deliver valid data was analysed using longitudinal and compositional data analyses.Results: Total outpatient antibiotic use in 2009 varied by a factor of 3.8 between the countries with the highest (38.6 DID in Greece) and lowest (10.2 DID in Romania) use. For Europe, a significant increase was found in total outpatient antibiotic use, as well as a significant seasonal variation, which decreased over time from 1997 to 2009. Relative use of penicillins and quinolones significantly increased over time with respect to sulphonamides and trimethoprim, and relative use of quinolones increased with respect to macrolide/lincosamide/ streptogramin as well. More detailed analyses of these major antibiotic subgroups will be described in separate papers.Conclusions: Outpatient antibiotic use in Europe measured as DID has increased since 1997, whereas seasonal variation has decreased over time. European Surveillance of Antimicrobial Consumption (ESAC) data on outpatient antibiotic use in Europe enable countries to audit their antibiotic use. Complemented by longitudinal and compositional data analyses, these data provide a tool for assessing public health strategies aimed at reducing antibiotic resistance and optimizing antibiotic prescribing.

Point prevalence study of antibiotic use in a paediatric hospital in Italy

“…In our study, the most frequently used antibiotic was the combination of amoxicillin plus clavulanic acid, as observed in primary care [1,14]. This finding confirms that hospital antimicrobial use tends to display a similar distribution pattern to that observed in the ambulatory use [4].…”

“…In 2005, Italy ranked third among European countries with the highest consumption of antibiotics in outpatient care [14], and a recent literature review of studies published in USA, Canada, north-central Europe and Italy found that Italy also has one of the highest paediatric outpatient antibiotic prescription rates [15]. Although a strong positive correlation between the extent of antibiotic consumption in outpatient and inpatient care has been shown [4], no national data on hospital consumption have been collected in Italy up to now, and no national policies on the prudent use of antibiotic have been implemented.…”

GPs' views in five European countries of interventions to promote prudent antibiotic use

“…22 It was desirable to include GPs with experience of several strategies, and these were more likely to be found in countries with national antibiotic campaigns.…”

Influence of patient payment on antibiotic prescribing in Irish general practice: a cohort study

“…3 The percentage of antibiotics prescribed unnecessarily is unknown, but it is believed that a number are used to treat minor respiratory tract infections (RTIs). 4 These conditions -such as the common cold, sore throat, acute otitis media and acute bronchitis -are often of viral aetiology and there is no compelling evidence to support the use of antibiotics in their treatment. [5][6][7][8] It has been shown that using antibiotics to treat these conditions does not prevent serious complications in otherwise healthy adults.…”