Impact of amoxicillin and oral amoxicillin-clavulanic acid defined daily doses on consumption indicators

Charra, Florent; Berthelot, Philippe; Bergheau, F.

doi:10.1016/j.medmal.2018.10.009

Cited by 4 publications

(1 citation statement)

References 4 publications

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“…Most importantly, the DDD for amoxicillin (J01CA04) and amoxicillin/clavulanic acid (J01CR02) changed from 1 g to 1.5 g for oral use. 8 In contrast to the results of the study by Charra et al , 21 this change did not dramatically influence ranking or alter conclusions on the quality of antibiotic consumption compared with the assessment with previous DDD values (ATC/DDD index 2011). The largest shifts in ranking were observed for Lithuania (higher quality) and Denmark (lower quality).…”

Section: Discussionmentioning

confidence: 80%

Quality appraisal of antibiotic consumption in the community, European Union/European Economic Area, 2009 and 2017

Adriaenssens

Bruyndonckx

Versporten

et al. 2021

Journal of Antimicrobial Chemotherapy

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Objectives The quality of antibiotic consumption in the community can be assessed using 12 drug-specific quality indicators (DSQIs) developed by the European Surveillance of Antimicrobial Consumption (ESAC) project. We compared quality in 2009 and 2017 in the EU/European Economic Area (EEA) and evaluated the impact of using different DDD values (ATC/DDD indices 2011 and 2019) for the 2009 quality assessment using these DSQIs and a joint scientific opinion (JSO) indicator. Methods We calculated the 12 DSQIs and the JSO indicator for 2017 and for 2009 for EU/EEA countries able to deliver values. For each of the indicators we grouped the 2017 and 2009 indicator values into four quartiles. To evaluate changes in quality between 2009 and 2017, we used the quartile distribution of the 2009 indicator values in 30 EU/EEA countries as benchmarks. In addition, we compared the quality assessment for 2009 using the ATC/DDD indices 2011 and 2019. Results In 2017, a difference in the quality of antibiotic consumption in the community between northern and southern EU/EEA countries remained, but also several eastern EU/EEA countries shifted towards lower quality. Quality of antibiotic consumption decreased between 2009 and 2017 in particular indicator values for penicillin, quinolone, relative β-lactam and broad- versus narrow-spectrum antibiotic consumption, and seasonal variation. Using different ATC/DDD indices did not substantially change countries’ ranking based on their DSQI values. Conclusions The quality of antibiotic consumption in the community as measured by the DSQIs further decreased between 2009 and 2017, especially in Southern and Eastern European countries. A continuous effort to improve antibiotic consumption is essential to reduce antibiotic consumption in general and the use of broad-spectrum antibiotics in particular.

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Section: Discussionmentioning

confidence: 80%

Quality appraisal of antibiotic consumption in the community, European Union/European Economic Area, 2009 and 2017

Adriaenssens

Bruyndonckx

Versporten

et al. 2021

Journal of Antimicrobial Chemotherapy

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Penicillins’ defined daily doses must be changed

Charra¹,

Berthelot

Bergheau³

2018

Proc. Natl. Acad. Sci. U.S.A.

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Klein et al. (1) suggest that defined daily doses (DDDs) are not a perfect outcome measure of antibiotic prescribing, particularly for penicillins (39% of total DDDs in 2015 for broad-spectrum penicillins). We identified the same limitations as illustrated by the results of our study (2), which measured the bias of estimation for amoxicillin's indicators (oral and i.v. administrations) and oral amoxicillin clavulanic acid's indicator. We identified that the DDDs for amoxicillin (oral and i.v.) and oral amoxicillin clavulanic acid are 1 g/d, whereas the average maintenance dose recommended by actual guidelines to treat common infections is 3 g/d (3-5). No difference was observed with i.v. amoxicillin clavulanic acid (3 g/d) (6). By modifying these DDDs to 3 g/d, we recalculated the French community consumption rate for the years 2004 and 2014. We also applied modified DDDs of amoxicillin (i.v. and oral) for community consumption rate in 2015 for the 10 largest European consumers (2). Concerning evolution of the French community consumption rate between 2004 and 2014, an initial increase of 6.7% became, by applying modified DDDs, a decrease of 9.9% (2).

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The Implementation Challenges of Undertaking National Antimicrobial Usage Surveillance

Thursky

2020

Clinical Infectious Diseases

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Impact of amoxicillin and oral amoxicillin-clavulanic acid defined daily doses on consumption indicators

Cited by 4 publications

References 4 publications

Quality appraisal of antibiotic consumption in the community, European Union/European Economic Area, 2009 and 2017

Quality appraisal of antibiotic consumption in the community, European Union/European Economic Area, 2009 and 2017

Penicillins’ defined daily doses must be changed

The Implementation Challenges of Undertaking National Antimicrobial Usage Surveillance

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