Outpatient antibiotic use in Europe and association with resistance: a cross-national database study

2.50
Hdl Handle:
http://hdl.handle.net/2336/3024
Title:
Outpatient antibiotic use in Europe and association with resistance: a cross-national database study
Authors:
Goossens, Herman; Ferech, Matus; Vander Stichele, Robert; Elseviers, Monique; ESAC Project Group (including Kristinsson KG)
Citation:
Lancet 2005, 365(9459):579-87
Issue Date:
7-Jun-2006
Abstract:
BACKGROUND: Resistance to antibiotics is a major public-health problem and antibiotic use is being increasingly recognised as the main selective pressure driving this resistance. Our aim was to assess outpatient use of antibiotics and the association with resistance. METHODS: We investigated outpatient antibiotic use in 26 countries in Europe that provided internationally comparable distribution or reimbursement data, between Jan 1, 1997, and Dec 31, 2002, by calculating the number of defined daily doses (DDD) per 1000 inhabitants per day, according to WHO anatomic therapeutic chemical classification and DDD measurement methodology. We assessed the ecological association between antibiotic use and antibiotic resistance rates using Spearman's correlation coefficients. FINDINGS: Prescription of antibiotics in primary care in Europe varied greatly; the highest rate was in France (32.2 DDD per 1000 inhabitants daily) and the lowest was in the Netherlands (10.0 DDD per 1000 inhabitants daily). We noted a shift from the old narrow-spectrum antibiotics to the new broad-spectrum antibiotics. We also recorded striking seasonal fluctuations with heightened winter peaks in countries with high yearly use of antibiotics. We showed higher rates of antibiotic resistance in high consuming countries, probably related to the higher consumption in southern and eastern Europe than in northern Europe. INTERPRETATION: These data might provide a useful method for assessing public-health strategies that aim to reduce antibiotic use and resistance levels.
Description:
To access publisher full text version of this article. Please click on the hyperlink in Additional Links field
Additional Links:
http://www.sciencedirect.com/science/article/B6T1B-4FFX4C2-15/2/9561b1cbc8062ea8be8df0d77a4d27cd

Full metadata record

DC FieldValue Language
dc.contributor.authorGoossens, Herman-
dc.contributor.authorFerech, Matus-
dc.contributor.authorVander Stichele, Robert-
dc.contributor.authorElseviers, Monique-
dc.contributor.authorESAC Project Group (including Kristinsson KG)-
dc.date.accessioned2006-06-07T15:45:48Z-
dc.date.available2006-06-07T15:45:48Z-
dc.date.issued2006-06-07T15:45:48Z-
dc.identifier.citationLancet 2005, 365(9459):579-87en
dc.identifier.issn1474-547X-
dc.identifier.pmid15708101-
dc.identifier.doi10.1016/S0140-6736(05)17907-0-
dc.identifier.urihttp://hdl.handle.net/2336/3024-
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links fielden
dc.description.abstractBACKGROUND: Resistance to antibiotics is a major public-health problem and antibiotic use is being increasingly recognised as the main selective pressure driving this resistance. Our aim was to assess outpatient use of antibiotics and the association with resistance. METHODS: We investigated outpatient antibiotic use in 26 countries in Europe that provided internationally comparable distribution or reimbursement data, between Jan 1, 1997, and Dec 31, 2002, by calculating the number of defined daily doses (DDD) per 1000 inhabitants per day, according to WHO anatomic therapeutic chemical classification and DDD measurement methodology. We assessed the ecological association between antibiotic use and antibiotic resistance rates using Spearman's correlation coefficients. FINDINGS: Prescription of antibiotics in primary care in Europe varied greatly; the highest rate was in France (32.2 DDD per 1000 inhabitants daily) and the lowest was in the Netherlands (10.0 DDD per 1000 inhabitants daily). We noted a shift from the old narrow-spectrum antibiotics to the new broad-spectrum antibiotics. We also recorded striking seasonal fluctuations with heightened winter peaks in countries with high yearly use of antibiotics. We showed higher rates of antibiotic resistance in high consuming countries, probably related to the higher consumption in southern and eastern Europe than in northern Europe. INTERPRETATION: These data might provide a useful method for assessing public-health strategies that aim to reduce antibiotic use and resistance levels.en
dc.language.isoenen
dc.publisherElsevieren
dc.relation.urlhttp://www.sciencedirect.com/science/article/B6T1B-4FFX4C2-15/2/9561b1cbc8062ea8be8df0d77a4d27cden
dc.subjectDrug Resistance, Bacterialen
dc.subjectAnti-Bacterial Agentsen
dc.subjectAmbulatory Careen
dc.subjectDrug Utilizationen
dc.subjectEuropeen
dc.subjectHumansen
dc.subjectResearch Support, Non-U.S. Gov'ten
dc.titleOutpatient antibiotic use in Europe and association with resistance: a cross-national database studyen
dc.typeArticleen
dc.format.digYES-

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